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- Genre: Doctoral Dissertation
Description
Spatial awareness (i.e., the sense of the space that we are in) involves the integration of auditory, visual, vestibular, and proprioceptive sensory information of environmental events. Hearing impairment has negative effects on spatial awareness and can result in deficits in communication and the overall aesthetic experience of life, especially in noisy or reverberant environments. This deficit occurs as hearing impairment reduces the signal strength needed for auditory spatial processing and changes how auditory information is combined with other sensory inputs (e.g., vision). The influence of multisensory processing on spatial awareness in listeners with normal, and impaired hearing is not assessed in clinical evaluations, and patients’ everyday sensory experiences are currently not directly measurable. This dissertation investigated the role of vision in auditory localization in listeners with normal, and impaired hearing in a naturalistic stimulus setting, using natural gaze orienting responses. Experiments examined two behavioral outcomes—response accuracy and response time—based on eye movement in response to simultaneously presented auditory and visual stimuli. The first set of experiments examined the effects of stimulus spatial saliency on response accuracy and response time and the extent of visual dominance in both metrics in auditory localization. The results indicate that vision can significantly influence both the speed and accuracy of auditory localization, especially when auditory stimuli are more ambiguous. The influence of vision is shown for both normal hearing- and hearing-impaired listeners. The second set of experiments examined the effect of frontal visual stimulation on localizing an auditory target presented from in front of or behind a listener. The results show domain-specific effects of visual capture on both response time and response accuracy. These results support previous findings that auditory-visual interactions are not limited by the spatial rule of proximity. These results further suggest the strong influence of vision on both the processing and the decision-making stages of sound source localization for both listeners with normal, and impaired hearing.
ContributorsClayton, Colton (Author) / Zhou, Yi (Thesis advisor) / Azuma, Tamiko (Committee member) / Daliri, Ayoub (Committee member) / Arizona State University (Publisher)
Created2021
Description
Stroke is the leading cause of long-term disability in the U.S., with up to 60% of strokescausing speech loss. Individuals with severe stroke, who require the most frequent, intense speech therapy, often cannot adhere to treatments due to high cost and low success rates. Therefore, the ability to make functionally significant changes in individuals with severe post- stroke aphasia remains a key challenge for the rehabilitation community. This dissertation aimed to evaluate the efficacy of Startle Adjuvant Rehabilitation Therapy (START), a tele-enabled, low- cost treatment, to improve quality of life and speech in individuals with severe-to-moderate stroke. START is the exposure to startling acoustic stimuli during practice of motor tasks in individuals with stroke. START increases the speed and intensity of practice in severely impaired post-stroke reaching, with START eliciting muscle activity 2-3 times higher than maximum voluntary contraction. Voluntary reaching distance, onset, and final accuracy increased after a session of START, suggesting a rehabilitative effect. However, START has not been evaluated during impaired speech. The objective of this study is to determine if impaired speech can be elicited by startling acoustic stimuli, and if three days of START training can enhance clinical measures of moderate to severe post-stroke aphasia and apraxia of speech. This dissertation evaluates START in 42 individuals with post-stroke speech impairment via telehealth in a Phase 0 clinical trial. Results suggest that impaired speech can be elicited by startling acoustic stimuli and that START benefits individuals with severe-to-moderate post-stroke impairments in both linguistic and motor speech domains. This fills an important gap in aphasia care, as many speech therapies remain ineffective and financially inaccessible for patients with severe deficits. START is effective, remotely delivered, and may likely serve as an affordable adjuvant to traditional therapy for those that have poor access to quality care.
ContributorsSwann, Zoe Elisabeth (Author) / Honeycutt, Claire F (Thesis advisor) / Daliri, Ayoub (Committee member) / Rogalsky, Corianne (Committee member) / Liss, Julie (Committee member) / Schaefer, Sydney (Committee member) / Arizona State University (Publisher)
Created2022
Description
Speech sound disorders (SSDs) are the most prevalent type of communication disorder in children. Clinically, speech-language pathologists (SLPs) rely on behavioral methods for assessing and treating SSDs. Though clients typically experience improved speech outcomes as a result of therapy, there is evidence that underlying deficits may persist even in individuals who have completed treatment for surface-level speech behaviors. Advances in the field of genetics have created the opportunity to investigate the contribution of genes to human communication. Due to the heterogeneity of many communication disorders, the manner in which specific genetic changes influence neural mechanisms, and thereby behavioral phenotypes, remains largely unknown. The purpose of this study was to identify genotype-phenotype associations, along with perceptual, and motor-related biomarkers within families displaying SSDs. Five parent-child trios participated in genetic testing, and five families participated in a combination of genetic and behavioral testing to help elucidate biomarkers related to SSDs. All of the affected individuals had a history of childhood apraxia of speech (CAS) except for one family that displayed a phonological disorder. Genetic investigation yielded several genes of interest relevant for an SSD phenotype: CNTNAP2, CYFIP1, GPR56, HERC1, KIAA0556, LAMA5, LAMB1, MDGA2, MECP2, NBEA, SHANK3, TENM3, and ZNF142. All of these genes showed at least some expression in the developing brain. Gene ontology analysis yielded terms supporting a genetic influence on central nervous system development. Behavioral testing revealed evidence of a sequential processing biomarker for all individuals with CAS, with many showing deficits in sequential motor skills in addition to speech deficits. In some families, participants also showed evidence of a co-occurring perceptual processing biomarker. The family displaying a phonological phenotype showed milder sequential processing deficits compared to CAS families. Overall, this study supports the presence of a sequential processing biomarker for CAS and shows that relevant genes of interest may be influencing a CAS phenotype via sequential processing. Knowledge of these biomarkers can help strengthen precision of clinical assessment and motivate development of novel interventions for individuals with SSDs.
ContributorsBruce, Laurel (Author) / Peter, Beate (Thesis advisor) / Daliri, Ayoub (Committee member) / Liu, Li (Committee member) / Scherer, Nancy (Committee member) / Weinhold, Juliet (Committee member) / Arizona State University (Publisher)
Created2020
Description
Parkinson's Disease (PD) is a progressive neurodegenerative disorder that affects movement and balance control. Falls are a common and often debilitating consequence of PD, and reactive balance control is critical in preventing falls. This dissertation aimed to determine the adaptability and neural control of reactive balance responses in people with PD. Aim 1 investigated whether people with PD at risk for falls can improve their reactive balance responses through a 2-week, 6-session training protocol. The study found that reactive step training resulted in immediate and retained improvements in stepping, as measured by the anterior-posterior margin of stability (MOS), step length, and step latency during backward stepping. The second aim explored the neural mechanisms behind eliciting and learning reactive balance responses in PD. The study investigated the white matter (WM) correlates of reactive stepping and responsiveness to step training in PD. White matter was not significantly correlated with any baseline stepping outcomes. However, greater retention of step length was associated with increased fractional anisotropy (FA) within the left anterior corona radiata, left posterior thalamic radiation, and right and left superior longitudinal fasciculi. Lower radial diffusivity (RD) within the left posterior and anterior corona radiata were associated with retention of step latency improvements. These findings highlight the importance of WM microstructural integrity in motor learning and retention processes in PD. The third aim examined the role of the somatosensory system in reactive balance control in people with PD. The tactile and proprioceptive systems were perturbed using vibrotactile stimulation during backward feet-in-place balance responses. The results showed that tactile and proprioceptive stimulation had minimal impact on reactive balance responses. Small effects were observed for delayed tibialis anterior (TA) onsets with proprioceptive stimulation at a medium intensity. Overall, this dissertation provides insights into improving reactive balance responses and the underlying neural mechanisms in PD, which can potentially inform the development of targeted interventions to reduce falls in people with PD.
ContributorsMonaghan, Andrew S (Author) / Peterson, Daniel S (Thesis advisor) / Ofori, Edward (Committee member) / Daliri, Ayoub (Committee member) / Buman, Matthew P (Committee member) / Fling, Brett W (Committee member) / Arizona State University (Publisher)
Created2023