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- All Subjects: Brain--Concussion.
- All Subjects: Hearing impaired children--Education (Early childhood)
- Genre: Academic theses
- Creators: Dorman, Michael
- Creators: Berg, Dena
Description
Concussion, a subset of mild traumatic brain injury (mTBI), has recently been brought to the forefront of the media due to a large lawsuit filed against the National Football League. Concussion resulting from injury varies in severity, duration, and type, based on many characteristics about the individual that research does not presently understand. Chronic fatigue, poor working memory, impaired self-awareness, and lack of attention to task are symptoms commonly present post-concussion. Currently, there is not a standard method of assessing concussion, nor is there a way to track an individual's recovery, resulting in misguided treatment for better prognosis. The aim of the following study was to determine patient specific higher-order cognitive processing deficits for clinical diagnosis and prognosis of concussion. Six individuals (N=6) were seen during the acute phase of concussion, two of whom were seen subsequently when their symptoms were deemed clinically resolved. Subjective information was collected from both the patient and from neurology testing. Each individual completed a task, in which they were presented with degraded speech, taxing their higher-order cognitive processing. Patient specific behavioral patterns are noted, creating a unique paradigm for mapping subjective and objective data for each patient's strategy to compensate for deficits and understand speech in a difficult listening situation. Keywords: concussion, cognitive processing
ContributorsBerg, Dena (Author) / Liss, Julie M (Committee member) / Azuma, Tamiko (Committee member) / Caviness, John (Committee member) / Arizona State University (Publisher)
Created2013
Description
The recent spotlight on concussion has illuminated deficits in the current standard of care with regard to addressing acute and persistent cognitive signs and symptoms of mild brain injury. This stems, in part, from the diffuse nature of the injury, which tends not to produce focal cognitive or behavioral deficits that are easily identified or tracked. Indeed it has been shown that patients with enduring symptoms have difficulty describing their problems; therefore, there is an urgent need for a sensitive measure of brain activity that corresponds with higher order cognitive processing. The development of a neurophysiological metric that maps to clinical resolution would inform decisions about diagnosis and prognosis, including the need for clinical intervention to address cognitive deficits. The literature suggests the need for assessment of concussion under cognitively demanding tasks. Here, a joint behavioral- high-density electroencephalography (EEG) paradigm was employed. This allows for the examination of cortical activity patterns during speech comprehension at various levels of degradation in a sentence verification task, imposing the need for higher-order cognitive processes. Eight participants with concussion listened to true-false sentences produced with either moderately to highly intelligible noise-vocoders. Behavioral data were simultaneously collected. The analysis of cortical activation patterns included 1) the examination of event-related potentials, including latency and source localization, and 2) measures of frequency spectra and associated power. Individual performance patterns were assessed during acute injury and a return visit several months following injury. Results demonstrate a combination of task-related electrophysiology measures correspond to changes in task performance during the course of recovery. Further, a discriminant function analysis suggests EEG measures are more sensitive than behavioral measures in distinguishing between individuals with concussion and healthy controls at both injury and recovery, suggesting the robustness of neurophysiological measures during a cognitively demanding task to both injury and persisting pathophysiology.
ContributorsUtianski, Rene (Author) / Liss, Julie M (Thesis advisor) / Berisha, Visar (Committee member) / Caviness, John N (Committee member) / Dorman, Michael (Committee member) / Arizona State University (Publisher)
Created2014
Description
Children with hearing impairment are at risk for poor attainment in reading decoding and reading comprehension, which suggests they may have difficulty with early literacy skills prior to learning to read. The first purpose of this study was to determine if young children with hearing impairment differ from their peers with normal hearing on early literacy skills and also on three known predictors of early literacy skills – non-verbal cognition, executive functioning, and home literacy environment. A second purpose was to determine if strengths and weaknesses in early literacy skills of individual children with hearing impairment are associated with degree of hearing loss, non-verbal cognitive ability, or executive functioning.
I assessed seven children with normal hearing and 10 children with hearing impairment on assessments of expressive vocabulary, expressive morphosyntax, listening comprehension, phonological awareness, alphabet knowledge, non-verbal cognition, and executive functioning. Two children had unilateral hearing loss, two had mild hearing loss and used hearing aids, two had moderate hearing loss and used hearing aids, one child had mild hearing loss and did not use hearing aids, and three children used bilateral cochlear implants. Parents completed a questionnaire about their home literacy environment.
Findings showed large between-group effect sizes for phonological awareness, morphosyntax, and executive functioning, and medium between-group effect sizes for expressive vocabulary, listening comprehension, and non-verbal cognition. Visual analyses provided no clear pattern to suggest that non-verbal cognition or degree of hearing loss were associated with individual patterns of performance for children with hearing impairment; however, three children who seemed at risk for reading difficulties had executive functioning scores that were at the floor.
Most prekindergarten and kindergarten children with hearing impairment in this study appeared to be at risk for future reading decoding and reading comprehension difficulties. Further, based on individual patterns of performance, risk was not restricted to one type of early literacy skill and a strength in one skill did not necessarily indicate a child would have strengths in all early literacy skills. Therefore, it is essential to evaluate all early literacy skills to pinpoint skill deficits and to prioritize intervention goals.
I assessed seven children with normal hearing and 10 children with hearing impairment on assessments of expressive vocabulary, expressive morphosyntax, listening comprehension, phonological awareness, alphabet knowledge, non-verbal cognition, and executive functioning. Two children had unilateral hearing loss, two had mild hearing loss and used hearing aids, two had moderate hearing loss and used hearing aids, one child had mild hearing loss and did not use hearing aids, and three children used bilateral cochlear implants. Parents completed a questionnaire about their home literacy environment.
Findings showed large between-group effect sizes for phonological awareness, morphosyntax, and executive functioning, and medium between-group effect sizes for expressive vocabulary, listening comprehension, and non-verbal cognition. Visual analyses provided no clear pattern to suggest that non-verbal cognition or degree of hearing loss were associated with individual patterns of performance for children with hearing impairment; however, three children who seemed at risk for reading difficulties had executive functioning scores that were at the floor.
Most prekindergarten and kindergarten children with hearing impairment in this study appeared to be at risk for future reading decoding and reading comprehension difficulties. Further, based on individual patterns of performance, risk was not restricted to one type of early literacy skill and a strength in one skill did not necessarily indicate a child would have strengths in all early literacy skills. Therefore, it is essential to evaluate all early literacy skills to pinpoint skill deficits and to prioritize intervention goals.
ContributorsRunnion, Elizabeth (Author) / Gray, Shelley (Thesis advisor) / Dorman, Michael (Committee member) / Thompson, Marilyn (Committee member) / Arizona State University (Publisher)
Created2017