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Comparing Preliminary Telehealth Outcomes to In-Person Delivery of a Rehabilitation Program for Stroke Survivors with Aphasia

Kortney M. Sims, University of Montana, Missoula
Claire Buehler, University of Montana, Missoula

Background. Aphasia is a language impairment, typically resulting from left hemisphere strokes. Aphasia impairs the neural networks that allow individuals to read, write/type, speak, and understand spoken information, negatively impacting daily communication and quality of life. Intensive Comprehensive Aphasia Programs (ICAPs) are stroke rehabilitation programs that help people living with aphasia improve their language function, communicative participation, and quality of life. In response to COVID-19, ICAPs could no longer take place in-person, necessitating a rapid move to telehealth models. No evidence has been provided in the literature to demonstrate the efficacy or effectiveness of telehealth ICAPs.

Purpose. The purpose of this project was to compare language outcomes across two methods of ICAP delivery: telehealth (summer 2020) and in-person (summers 2014-2019).

Methods. Participants. Stroke survivors with chronic aphasia participated in in-person or telehealth ICAPs at the University of Montana (UMT). Five stroke survivors participated in the novel summer 2020 UMT telehealth ICAP (IRB #87-20). Fifty-three stroke survivors participated in 2014-2019 UMT in-person ICAPs (IRB #116-14). Procedures. Language outcomes were evaluated using the Western Aphasia Battery-Revised (WAB-R) aphasia quotient (AQ). Individual characteristics of the telehealth participants were matched with participants from the 2014-2019 in-person data set. Three participant characteristics were considered during this matching process: (1) age (+/- 10 years), (2) biological sex, and (3) time post-stroke (+/- 6 months). Pre- and post-ICAP WAB-R AQ scores were compared across telehealth and in-person participants to assess telehealth ICAP efficacy.

Results & Conclusions. The average change score on the WAB-R AQ for the telehealth cohort (5.42) was similar to the in-person cohorts (5.28), suggesting that telehealth delivery for ICAPs may be as efficacious as in-person delivery.

Significance. COVID-19 has changed the landscape of stroke rehabilitation for people living with aphasia – particularly for those living in rural regions like the Mountain West. Telehealth models of service delivery have the potential to increase access to post-stroke services for rural residents beyond the pandemic era. Preliminary evidence suggests that telehealth delivery of an ICAP has the potential to result in similar language outcomes as in-person ICAP delivery.

Curriculum-based Interventions: A Systematic Review of School-based SLPs' Service Delivery

Taylor Stoeger
Kaelyn Hanson

School-based speech-language pathologists (SLPs) provide preventative and intervention services to students with a wide range of language and literacy delays and disorders. School-based SLPs are often a member of an interprofessional team -including classroom teachers and special service providers- to support students’ academic achievement. Over three decades ago, the conversation around curriculum-based language intervention (CBLI) began as a viable option to support children a) within their academic environment, b) using the material they are being presented in their classroom to c) increase carryover to all academic subjects for which students engage. However, the primarily service delivery model employed by school-based SLPs is to provide speech-language intervention outside of the classroom using materials that are not from the classroom curriculum.

Following Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA, 2015), a systematic review of the literature is being conducted to explore how CBLIs are being implemented to support language and literacy development. For this undergraduate senior capstone project, four databases using four specific search syntax terms are being searched to analyze full-text, peer-reviewed articles from 1989 through March 2021that explore CBLIs for language-literacy support. Following a full-text article review of all articles that meet our criteria, data will be extracted using the PRISMA (2015) flowchart. The preliminary analysis of these manuscripts reviewed thus far reveal few high-level research design studies employed to assess the efficacy of CBLIs. Rather, our preliminary analysis reveals there are well-designed quasi-experimental studies and nonexperimental studies (i.e., correlational and case studies) published to support the delivery of CBLIs. This mid-project analysis has also identified barriers to implementing CBLIs in the classroom with the school-based interprofessional team. A full analysis of the systematic review, barriers to implementing CBLIs, and future directions will be available for conference participants.

Inequality and the Dead: Historic Cemetery in Missoula and the Chinese People Left Behind

Emily Owens, University of Montana, Missoula

Missoula grew rapidly over the past century and a half, with urban expansion quickly infringing on past “edges” of the city where burial grounds were rapidly replaced by residential development. The Cherry Street Cemetery in the Lower Rattlesnake neighborhood is one such place. While some of the graves at the Cherry Street Cemetery were reinterred to another cemetery in Missoula in advance of 20th-century urban growth, my research draws attention to the fact that not everyone was reinterred. As a result, burials left behind have been built over for over 100 years. As an Anthropology student focusing on archaeology and bioarchaeology, the Cherry Street Cemetery immediately caught my attention when mentioned in one of my classes. Since learning about this site, I have embarked upon a multi-semester research project with the help of Archaeology Professor Kelly Dixon and PhD Candidate Nikki Manning. Here I present an overview of my research to date, drawing from at least one bioarchaeological case of a Chinese child, as well as archival and oral evidence. While there is another community of UM historical archaeology students exploring artifacts from the late 19 and early 20th-century Chinese community/-ies downtown Missoula, I am building on and expanding the context of this research to the Cherry Street Cemetery. It is likely that funeral ceremonies for this child started downtown at the Chinese temple ended up at Cherry Street. By studying the Cemetery, I will try to determine whether and how this Cemetery was associated with Missoula’s historic Chinese community. In turn, I will also explore how the subsequent treatment of the people left behind is a microcosm of the social injustices that the Chinese—and other non-White people—faced while residing in Missoula. Indeed, the Cherry Street Cemetery seems to have been “swept under the rug” due to city expansion and/or historical amnesia. I believe that people still buried there require recognition since they were so easily forgotten and their resting place disturbed. I see this as a start to an even larger problem that is being faced in today’s society, as a result of minority burial sites being desecrated and disturbed due to city expansion. Bearing this in mind, there is a dire need for a non-invasive survey and commemorative interpretive signage at places like this to protect souls in the future.

Is play behavior in adolescent rats regulated at the level of dyads or individuals?

Sunny Mathaun, The University Of Montana
Susan Greene
Patrick Hanni, The University Of Montana

Sunny Mathaun, Susan Greene, Patrick Hanni, Nathan Insel

Is play behavior in adolescent rats regulated at the level of dyads or individuals?

COVID19 has caused our society to take a number of measures that have increased social isolation. As social beings, our brain’s response to social isolation is to find a way back to social interactions and relationships. But there may be many different reasons we are driven to interact socially. In some cases, we may be looking to form or develop specific relationships, while in others we may just be interested in interacting--or playing. The research question for this study asks if play behavior in adolescent rats is regulated at the level of individuals (increases if the individual is socially isolated) or dyads (increases if individuals are isolated, or if dyads are separated). Based on prior research performed in adult female degus, we hypothesize that adolescent female rats will play with one-another more if they have been previously separated, as a means to re-establish their dyadic relationship. We predict that both types of social encounters, after separation versus after isolation, should be higher compared with if animals are only isolated for a 1-minute period. To conduct this research, we video recorded physical interactions of rat dyads following different isolation or separation manipulations. After recording the physical interactions, we scored the behaviors using BORIS (Behavioral Observation Research Interactive Software) which allows users to mark behavioral ethogram events during video playback. The preliminary data from a total of 26 rat reunion sessions suggest that play behavior may increase if individuals are isolated, but not if dyads are separated. Unexpectedly, when measuring all interactions, including sniffing, no differences were observed in total interaction levels across the three conditions. These results were inconsistent with hypotheses, and suggest that play behavior may not be driven by a motivation to re-establish relationships. In other words: if adolescent rats received their daily dose of play with a cagemate, they are not also motivated to play more with other individuals who they have not recently encountered. This study has implications for understanding how different social behaviors are motivated in different species, or between different life stages.

Minority Stress, Cannabis Use, and Self-Compassion in Sexual Minority Women

Morgan Beavers

Most gender and sexual minority (GSM) health research focuses on lesbian and gay populations (Bariola, Lyons & Lucke, 2017), while a growing literature base has identified bisexual, or non-exclusively oriented (NO, i.e., those who identify with a sexual orientation other than heterosexual or homosexual), individuals' unique experiences and health concerns (Paul et al., 2014). Minority stress theory (Meyer, 2003) posits that GSM individuals experience unique daily stressors due to their socially-stigmatized identities, and that cumulative higher stress load precipitates health disparities. Binegative minority stress (BNMS) may be considered a type of minority stress specific to NO individuals, contributing to cumulative stress loads (Yost & Thomas, 2012). This stress can be divided, in terms of Minority Stress Theory, into proximal stress--internalized reactions to stress such as expectations of rejection and concealment, and distal stress--victimization and discrimination coming from outside of the individual. Thus, the terms binegative proximal minority stress (BPMS) and binegative distal minority stress (BDMS) are utilized in the current study.

Distress is related to higher levels of cannabis use among SM individuals (Bränström & Pachankis, 2018). Thus, BNMS may explain harmful cannabis use among NO individuals. Interventions like self-compassion may moderate the negative psychological impacts of minority stress (Vigna, Poehlmann-Tynan, & Koenig 2018), which may reduce harmful cannabis use. Therefore, the aims of this study are to explore the relationships between BNMS and cannabis misuse, examining self-compassion (SC) as a moderator.

432 women participated in an online survey. We conducted a hierarchical linear regression analysis to examine the relationships between binegative proximal minority stress (BPMS) and binegative distal minority stress (BDMS), SC, and disordered cannabis use (CUD). We entered age, income, and recovery status into the first block, BDMS, BPMS, and SC into the second block, and the interaction between BDMS and SC into the third block of the equation. Covariates did not account for variance in CUD (p = 0.883); however, BDMS was positively related to CUD (B = 0.034, p = 0.004) and accounted for 5.7% of the variance in CUD. BPMS (p = 0.119) and SCS (p = 0.242) were not related to CUD. SC did not moderate the relationship between BDMS and CUD (p = 0.33).

Importantly, BNMS predicted hazardous cannabis use, in line with previous research on minority stress and substance abuse. Specifically, this relationship was driven by distal stress, such as experiences of discrimination and victimization. More research is needed to assess whether there could be an impact of trait and/or practiced self-compassion on the relationship between minority stress and cannabis use among GSM.

Morphological Awareness Skills in Kindergarten Children at Risk For Developmental Language Disorder (DLD) and its Relationship to Literacy Success.

Samantha Hege, The University Of Montana
Mary Fahlman, The University Of Montana

Purpose: To assess whether there is a relationship between morphological awareness and literacy success in children with and without language impairments.

Background: Morphological awareness is defined as the conscious awareness of the morphological composition of words and the ability to reflect on and manipulate morphological structures. Literacy success refers to the ability to read and write while achieving developmentally appropriate milestones in school-aged children. Developmental language disorder (DLD) occurs when a child has difficulty using and/or understanding language.

Methods: This research included data from the Orthography and Word Learning (OWL) research battery. A whole-classroom screener was administered to 620 kindergarten students in Missoula, Montana in 2019-2020. Using a cutoff score, a subset of children were selected for further assessment. We will compare demographic data, language skills assessed by the Clinical Evaluation of Language Fundamentals Fifth Edition (CELF-5), and literacy skills assessed by Woodcock-Johnson Letter-Word Identification (WJ-LWID) to determine if there are significant differences between typically developing children and those identified at-risk for DLD.

Significance: Current research establishes that morphological awareness training beginning as early as preschool age can be a predictor of literacy success in typically developing children. Other research has found that morphological awareness develops over a number of years and, because of this, likely plays a role in the development of children’s literacy skills. Additionally, morphological instruction has the potential to support literacy success for low achieving students, who typically need additional support learning to read and spell. In our own research, our aim is to compare how well children with and without language impairments perform on morphological awareness tasks and whether morphological awareness could be used to predict language and literacy outcomes.

Outdoor recreation in the Winter of a Pandemic

Joshua Christopher Cobb, Division of Biological Sciences Student

A pandemic has the ability to affect lives from many different perspectives. The COVID-19 pandemic has altered the way people live, learn, and interact with one another; and it will create new social patterns reaching across virtually all platforms. One of the unforeseen problems with a pandemic includes the adaption needed to partake in social and recreational activities. Using a Qualtrics online survey posted on a popular forum for outdoor recreationists, this research study looked to investigate the varying trends due to COVID-19 on the winter outdoor sports community. The results demonstrate that the pandemic affected how people recreate, including whether they obtained resort passes and where they recreated. Additionally, it seems that the impact COVID-19 had on outdoor recreation varied across different geographic regions. In conclusion, this research suggests that the pandemic has caused changes within the outdoor winter recreation community. Understanding these effects is important on both individual and macroscale levels. Indeed, the data supports that resorts and communities dependent on tourism may see a decrease in commerce. Further, as recreationists find new places to recreate, safety concerns may increase. The trends in the data allow for an increase in the understanding of how global crises, akin to the COVID-19 pandemic, affect outdoor recreation and tourism, as well as how such crises impact emergency personnel.

Preparing Students who Stutter for Postsecondary Employment: A Survey of SLPs in Montana

Neiman Alexis Snetzer, University of Montana, Missoula

People who stutter often experience adversity in the workplace in the form of discrimination, lower pay, and low self-esteem (Plexico et. al., 2019; Klein & Hood, 2004; Gerlach et. al., 2018). The goal of secondary schools is to prepare all students for life after graduation, including postsecondary education/training, independent living, and employment. Students with disabilities are aided in this process through the development and implementation of an Individualized Transition Plan (ITP; Individuals with Disabilities Act, 2004). To successfully develop postsecondary transition plans to improve employment outcomes for students who stutter (SWS), the difficulties they experience when preparing for, seeking, and maintaining employment must be understood. Because speech-language therapy is the primary special service that SWS receive in school, a voluntary online survey was distributed to school-based speech-language pathologists in Montana. The survey consisted of twenty-one questions including true or false, free response, and multiple choice. The codes and themes of this qualitative analysis will be discussed regarding the wide range of therapeutic foci, experience preparing students who stutter for postsecondary employment, and level of confidence working with this population.

The Longitudinal Effects of Sleep Quality on Executive Function

Oscar Kronenberger
Cali Caughie

Poor sleep quality is common today. However, our understanding of how sleep quality affects cognition over time is limited. The current study thus investigates the relationship between sleep quality and executive function longitudinally. Data from Waves 2 and 3 of the Midlife Development in the United States (MIDUS) research project, an ongoing longitudinal study on health and well-being in mid-life adults, was used. During Wave 2, 881 participants were administered the Pittsburgh Sleep Quality Index (PSQI) and performed the Stop and Go Task (SGT), which measures executive function. Nine years later, during Wave 3, these 881 participants were again administered the SGT. Executive function decline was assessed as the change in task performance on SGT from Wave 2 to Wave 3. A main effect of global sleep quality on decline in executive function, when controlling for age, was supported (F(2,878)=10.868, p<.001). Specifically, lower global sleep quality was significantly predictive of executive function decline over a nine-year period in middle-aged adults. These findings provide insight into how a potentially modifiable lifestyle factor — sleep quality — may predict longitudinal cognitive decline. Evidence-based interventions that seek to improve sleep quality are proposed as a potential factor for preserving cognitive function as we age.

Variables in Speech Sound Disorder Treatment: Applying a Published Taxonomy to Clinical Practice

Danielle E. Birney
Adele J. Kopp

Variables in Speech Sound Disorder Treatment: Applying a Published Taxonomy to Clinical Practice

Purpose: Some children have difficulties learning speech sounds within an expected developmental time frame and require speech therapy to improve their intelligibility (i.e., how easily they can be understood by others). Treatment approaches for speech sound disorder can vary greatly in procedures and may differ in efficacy and efficiency. Thus, the purpose of this retrospective study is to examine and describe treatment characteristics that were implemented by a speech-language pathologist as part of a prior study and apply a taxonomy of variables to more readily make comparisons to treatments described in the literature. Baker, Williams, McLeod, and McCauley (2018) developed a treatment taxonomy to analyze and describe 15 speech sound disorder treatments by evaluating the degree, presence, or absence of 72 different variables, which were further divided into categories and subcategories. This taxonomy was applied in the current study to the treatment method that included a modified cycles approach with dynamic levels of scaffolding, or support given to the child during speech production.

Significance: This study is significant because using the taxonomy to describe a treatment approach in detail will allow for a deeper analysis of the treatment approach, comparisons to other approaches, and potentially lead to better measurement of efficacy and efficiency in future studies.

Methods: The participants included two children with speech sound disorder engaged in treatment with a speech-language pathologist or graduate student clinician. To describe the treatment, two research assistants watched videos of the dynamic treatment and recorded quantitative and qualitative data for each variable in the taxonomy. Quantitative measures included a tally of the number of categories that were: 1) observable within one session, 2) observable when multiple sessions were combined, and 3) not observable, and only evident with additional background information from the clinician. In addition, qualitative descriptions were given for each of the 72 variables that were observed.

Results: The results of the quantitative and qualitative analyses will be presented. The number of more observable and less observable variables of the taxonomy will be highlighted and descriptions of qualitative observations will be provided.

Conclusion: Furthermore, the clinical implications of this research will be discussed and the conclusions may inform the delivery of future treatment for speech sound disorders.