SAMPLING MASLP

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• SAMPLING: In statistics, quality assurance, and survey methodology, sampling is the selection of a subset (a statistical sample) of individuals from within a statistical population to estimate characteristics of the whole population. Statisticians attempt to collect samples that are representative of the population in question. Sampling has lower costs and faster data collection than measuring the entire population and can provide insights in cases where it is infeasible to measure an entire population. • SAMPLE: A sample is defined as a smaller set of data that a researcher chooses or selects from a larger population by using a pre-defined selection method. These elements are known as sample points, sampling units, or observations. Creating a sample is an efficient method of conducting research. In most cases, it is impossible or costly and time-consuming to research the whole population. Hence, examining the sample provides insights that the researcher can apply to the entire population. • POPULATION: A population is the entire group that you want to draw conclusions about. In research, a population doesn’t always refer to people. It can mean a group containing elements of anything you want to study, such as objects, events, organizations, countries, species, organisms, etc. Reasons for Sampling: a) Necessity: Sometimes it’s simply not possible to study the whole population due to its size or inaccessibility. b) Practicality: It’s easier and more efficient to collect data from a sample. c) Cost-effectiveness: There are fewer participant, laboratory, equipment, and researcher costs involved. d) Manageability: Storing and running statistical analyses on smaller datasets is easier and reliable. Sampling Advantages: a) Reduced cost & time: Since using a sample reduces the number of people that have to be reached out to, it reduces cost and time. Imagine the time saved between researching with a population of millions vs. conducting a research study using a sample. b) Reduced resource deployment: It is obvious that if the number of people involved in a research study is much lower due to the sample, the resources required are also much less. The workforce needed to research the sample is much less than the workforce needed to study the whole population. c) Accuracy of data: Since the sample is indicative of the population, the data collected is accurate. Also, since the respondent is willing to participate, the survey dropout rate is much lower, which increases the validity and accuracy of the data. d) Intensive & exhaustive data: Since there are lesser respondents, the data collected from a sample is intense and thorough. More time and effort is given to each respondent rather than having to collect data from a lot of people.

Healthcare

UNIT 4
RESEARCH METHODS:
(Techniques of sampling- sampling and randomness- principles of randomization- random assignment-
methods- random sampling- stratified sampling, incidental sampling- purposive samples of one to one matched
sampling- six of sampling)
Submitted to Submitted by
DR. SATISH K. HIMANI BANSAL
MVSCOSH MASLP 1st year

POPULATION
(entire group)
SAMPLE
(smaller set of
data)
SAMPLING
(selection of a subset)

Reduced cost &
time
Accuracy of
data
Apply
properties to a
larger
population
Intensive &
exhaustive data
Reduced
resource
deployment
ADVANTAGES
Of
SAMPLING

PROBABILITY
SAMPLING
METHODS
SIMPLE
RANDOM
SAMPLING
SYSTEMATIC
SAMPLING
STRATIFIED
RANDOM
SAMPLING
CLUSTER
SAMPLING
SAMPLING
TECHNIQUES
I. PROBABILITY/RANDOM
SAMPLING METHODS

Cost Effective
Involves lesser degree of judgment
Comparatively easier way of sampling
Less time consuming
Can be done even by non- technical persons
Sample representative of population
ADVANTAGES Of PROBABILITY SAMPLING

DISADVANTAGES Of PROBABILITY SAMPLING
Chances of selecting
specific class of samples
only
Redundant and
monotonous work

SAMPLING TECHNIQUES
II. NON PROBABILITY/NON RANDOM SAMPLING
METHODS
CONVENIENCE
SAMPLING
PURPOSIVE
SAMPLING
SNOWBALL
SAMPLING
QUOTA SAMPLING
NON PROBABILITY
SAMPLING
METHODS

ADVANTAGES Of NON PROBABILITY SAMPLING
Inexpensive
Reduce
respondent
burden
Quick and
convenient

DISADVANTAGES Of NON PROBABILITY
SAMPLING
Selection bias
Noncoverage (undercoverage) bias
Difficulty of assessing the quality

PRINCIPLES OF EXPERIMENTAL DESIGN
RANDOMIZATION
• The allocation of treatment to experimental
units at random to avoid any bias in the
experiment resulting from the influence of
some extraneous unknown factor that may
affect the experiment.
REPLICATION
• Any treatment is repeated a number
of times to obtain a valid and more
reliable estimate than which is
possible with one observation only.
LOCAL CONTROL
•The experimental units are divided into
different homogeneous groups within the
blocks, then the variation among the blocks
is eliminated and ideally, the error
component will contain the variation due to
the treatments only.

1. State the difference between probability and non- probability sampling. Explain probability sampling
techniques. (8 marks, 2019)
2. Discuss the advantages of sampling over census. Explain different random sampling techniques. (16
marks, 2015)
3. Define population and sample. Distinguish between probability and non-probability sampling. (16 marks,
2014)
4. Explain any two types of probability and non- probability sampling techniques. (16 marks, 2014)
5. What is sampling? Explain any two sampling techniques. (8 marks, 2013)
6. Short note on simple random sampling. (8 marks, 2012)
7. Short note on stratified sampling method. (4 marks, 2011)

1. Clinical Research in Communicative Disorders (2nd edition). M.N. Hegde.
2. https://www.scribbr.com/methodology/sampling-methods/
3. https://corporatefinanceinstitute.com/resources/knowledge/other/random-sampling/
4. https://byjus.com/maths/random-sampling/
5. https://www.investopedia.com/ask/answers/042815/what-are-disadvantages-using-simple-random-sample-
approximate-larger-population.asp
6. http://home.iitk.ac.in/~shalab/anova/chapter4-anova-experimental-design-analysis.pdf
7. https://www.wisdomjobs.com/e-university/research-methodology-tutorial-355/basic-principles-of-
experimental-designs-11465.html
8. https://www.emathzone.com/tutorials/basic-statistics/basic-principles-of-experimental-designs.html
9. https://www.qualtrics.com/au/experience-management/research/non-probability-sampling/
10. https://allthingsstatistics.com/miscellaneous/advantages-disadvantages-stratified-random-sampling/

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The current study was conducted for children with CP who are Hindi speakers, to analyze voice onset time (VOT) patterns associated with stop consonants. The purpose was to gain more detailed insights into how the coordination and timing needed for these articulations may be affected by the neurodevelopmental disorder ultimately opening up avenues for improved treatment solutions. Total 20 children in the age group of 6 - 8 years were taken for the study which was divided into two groups: 10 children diagnosed with spastic CP and 10 typical children speaking Hindi. Measuring VOT through voice analysis helped us gauge the interval lapsing between releasing a stop closure and voicing onset. The outcomes exhibited considerable variation in VOT values when comparing groups of children with cerebral palsy (CP) against typical children speaking Hindi. Specifically, CP children showed longer VOT durations indicating delayed voicing onset compared to controls. These findings point out that children who have cerebral palsy exhibit different timing and coordination patterns upon pronouncing stop consonants. It is essential to grasp the VOT traits in children with cerebral palsy. This will aid in creating suitable intervention techniques that enhance their speech comprehensibility and communication skills.

VOT in CP.pdf

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Language acquisition entails the acquisition of several crucial linguistic components like phonology, morphology, syntax and semantics. Individual elements merge seamlessly with each other giving birth to insightful communication whenever needed. Among these varied but fundamental aspects necessary for any competent communicator, is adding on the vital aspect of tense marking appropriately into conversations or text rendering accurately when an event occurred or will occur. We must appreciate this pivotal role played by acquiring uency in using verb tenses by young children seeking effective communication alongside understanding its importance a bit more in the language development process. The study attempts to investigate the acquisition of tense markers in typical children speaking Hindi with the goal of assessing data from children in the age range of 6-8 years. Results suggested that tense markers increased with age. Almost half of the tense markers were not fully acquired by the age of 8 years. The research also analysed various studies that uphold the ndings.

TENSE MARKERS HINDI

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RACT Children require time and several distinct stages when growing up through which they learn specic languages for embracing coherent communication mechanisms effectively then they must understand syntax -mechanics governing phrase construction among other language requirements. Being able to oversee a child's level of growth with regards to linguistic skill-set development while watching over its morphosyntactic functions becomes important since performing well here can lead spell long-term benets enhancing critical reading, writing or even public speaking. Plural marker, case marker, PNG marker are all examples of morpho-syntactic language-related concepts children should learn about. This study explores typical children speaking Hindi aged between 6-8 years, we will be focusing on understanding how and why PNG markers become more apparent as they progress through this developmental stage. As standardised tests for Hindi are currently unavailable as precise acquisition data cannot be accessed hence, we want to explore several aspects by studying the normal developmental characteristics of typical children speaking Hindi. The fact is that most children learn a lot about such markers even before they turn six years old, these results were further cemented by age where it showed the importance necessary for development were fully acquired by eight years old. Our findings support greater attention to assessing various interventions, including developing evaluation strategies for child's language lear

PNG MARKERS HINDI

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Motor Speech Disorders • Motor speech disorders (MSDs) can be defined as speech disorders resulting from neurologic impairments affecting the planning, programming, control, or execution of speech. MSDs include the dysarthrias and apraxia of speech. Dysarthria • Dysarthria is a collective name for a group of neurologic speech disorders that reflect abnormalities in the strength, speed, range, steadiness, tone, or accuracy of movements required for the breathing, phonatory, resonatory, articulatory, or prosodic aspects of speech production. The responsible neuropathophysiologic disturbances of control or execution are due to one or more sensorimotor abnormalities, which most often include weakness, spasticity, incoordination, involuntary movements, or excessive, reduced or variable muscle tone. This definition explicitly recognizes or implies the following: 1. Dysarthria is neurologic in origin. 2. It is a disorder of movement. 3. It can be categorized into different types, each type characterized by distinguishable perceptual characteristics and, presumably, a different underlying neuropathophysiology. The ability to categorize the dysarthrias, therefore, has implications for the localization of the causal disorder. This definition is considerably narrower and more specific than that used in many medical dictionaries and texts. Apraxia Of Speech • Apraxia of speech is a neurologic speech disorder that reflects an impaired capacity to plan or program sensorimotor commands necessary for directing movements that result in phonetically and prosodically normal speech. It can occur in the absence of physiologic disturbances associated with the dysarthrias and in the absence of disturbance in any component of language. Unlike dysarthria, the existence of apraxia of speech as a distinct clinical entity often is ignored outside the speech pathology literature. Consequently, its distinctive clinical manifestations frequently are buried within categories of aphasia or under the generic heading of “dysarthria.” This is unfortunate, because the nature of apraxia of speech is different from that of aphasia and dysarthria; its localization is quite different from that for most types of dysarthria; and its management is different from that for dysarthria and aphasia.

MSD REVIEW MASLP

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• According to Jean Piaget, "play provides the child with the live, dynamic, individual language indispensable for the expression of [the child’s] subjective feelings for which collective language alone is inadequate." Play helps a child develop a sense of true self and a mastery over her/his innate abilities resulting in a sense of worth and aptitude. During play, children are driven to meet the essential need of exploring and affecting their environment. Play also contributes in the advancement of creative thinking. Play likewise provides a way for children to release strong emotions. During play, children may play out challenging life experiences by re-engineering them, thereby discharging emotional states, with the potential of integrating every experience back into stability and gaining a greater sense of mastery.

SPECIAL PSYCHOTHERAPIES MASLP

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• Hearing loss is widely recognized as one of the most common human disorders. (Nipalko J.K., 2002). Hearing loss affects up to 10% of the population. The prevalence increases with age and over one third of people older than 65 years have a significant hearing loss. Only approximately 20% of people with hearing loss seek assistance from hearing aids, of these, as many as 16.2% do not wear their devices. • It has been reported that 5 of 10,000 infants less than 2 years of age are profoundly hearing impaired. They are unable to hear any sound from the outside world. • The problem is critical for adults and dramatic for children. Early onset profound hearing loss has been shown to have devastating consequences for the development of language that is essential for learning almost anything. It allows us to participate, to understand, to interact with the world around us, and to avoid social isolation. (Moeller, 1998) • Sensorineural hearing loss is caused by defect of the inner ear or central auditory pathways. Treatment is dependent on the degree of hearing impairment. Hearing aids are indicated for mild to severe sensorineural hearing loss. In patients with severe to profound hearing loss due to cochlear defects or any abnormalities will result in severe handicap. To overcome this severe handicap, application of implantable hearing aids is indicated.

IMPLANTABLE HEARING DEVICES MASLP

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• The purposes of the motor speech examination often vary as a function of practice site and the stage of care. Sometimes the priority is to establish the speech diagnosis and its implications for localization and neurologic diagnosis. Under other circumstances, formulating treatment recommendations takes precedence. The emphasis here is on several activities with goals that are relevant to diagnosis. These goals include description, establishing diagnostic possibilities, establishing a diagnosis, establishing implications for localization and disease diagnosis, and specifying severity. The goal of the dysarthria assessment is to: 1. describe perceptual characteristics of the individual's speech and relevant physiologic findings; 2. describe speech subsystems affected (i.e., articulation, phonation, respiration, resonance, and prosody) and the severity of impairment for each; 3. identify other systems and processes that may be affected (e.g., swallowing, language, cognition); and 4. assess the impact of the dysarthria on speech intelligibility and naturalness, communicative efficiency and effectiveness, and participation. Establishing diagnostic possibilities such as: 1. Is the problem neurologic? 2. If the problem is not neurologic, is it nonetheless organic or is it psychogenic? 3. If the problem is or is not neurologic, is it recently acquired or longstanding? 4. If the problem is neurologic, is it motor speech disorder or another neurologic disorder that is affecting verbal expression (e.g., aphasia, dementia. etc)? 5. If the problem is speech related, is it a dysarthria or apraxia of speech? 6. If dysarthria is present, then is it developmental or acquired? What is its type? etc... Establishing a Diagnosis Once all reasonable diagnostic possibilities have been recognized, a single diagnosis may emerge or at the least, the possibilities may be ordered from most to least likely. For example, concluding that speech is not normal, that it is not psychogenic in origin, and that it is a dysarthria but of undetermined type, is of diagnostic value. It implies the existence of an organic process and places the lesion within motor components of the nervous system. If it also can be concluded that the dysarthria is not flaccid, then the lesion is further localized to the central and not the peripheral nervous system, and certain neurologic diagnoses can be eliminated or considered unlikely. If the characteristics of the disorder are unambiguous and compatible with only a single diagnosis, then a single speech diagnosis can be given along with its implications for localization.

MSD ASSESSMENT MASLP

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Earlier speech language pathologists used to focus on each specific sound error in the client as a separate entity. Lately they are being urged to try and find out underlying patterns of productions that could account for several errors at one time. This recent methodology is called phonological process analysis/ phonological rule analysis, or simply, phonological analysis. With the development in the procedures for phonological analysis, there has been a change in the focus of therapy for children and adults with speech disorders. There has-been a growing tendency to de-emphasize traditional approaches stressing on motoric manipulation of articulators in favor of more conceptually based programs. With this new approach children who have been attending therapy for many years, have been discharged in 12-18 months with phonologically based therapy. Phonological analysis is an advance in our concepts of articulation analysis; it is not the discovery of a new world. So it also can be used with disordered groups- clients with aphasia, apraxia, cleft palate, or hearing loss etc. This new methodology involves-relearning what clinicians once studied, rather than new learning of concepts. To derive a speaker’s meaning, the listener is basically concerned with the phonemes in the speech message. Phonology is the sub-discipline of linguistics that focuses on speech sounds & sound patterns. Speech sounds refers to linguistically relevant sounds used in the formation of syllables, words & sentences. The goal of phonology is “to study the properties of the sound systems which speakers must learn or internalize in order to use their language for communication” (Hyman, 1975). It includes: a. Describing a sound patterns of the languages b. Describing the organization of the speech sounds in the mind c. Describing how languages differ from 1 another in the organization d. Describing phonological universals- common properties shared by the various sound system of the world’s language The SLPs is not a phonologist, although the professionals do share a common interest in the sound system of language. The SLPs, although grounded in normal language development, is concerned with the analysis & remediation of impaired language systems. Many concepts used by SLPs have their origins in the field of linguistics. For ex- concepts of phoneme, phonological processes, distinctive features, deep & surface structures & phonological rules the influence can be seen in the growth of assessment instruments making use of phonological analysis.

CLINICAL PHONOLOGY MASLP

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 The recognition of spoken word can be viewed as classifying an auditory stimulus to one ‘’word form’’ category, chosen from many alternatives.  This process requires matching of the spoken input with the mental representation associated with the word candidates and selecting one among the several candidates that are atleast partially consistent with the input.  Process of recognizing a spoken word is that it starts from a string of phonemes (Dahan, Magnuson, 2006) establishes how these phonemes should be grouped to form words and passes these words into the next level of processing.  Some theories, though, take a broader view and blur the distinction between speech perception, spoken word recognition, and sentence processing (Elman, 2004; Gaskell & Marslen 1997; Klatt, 1979; McClelland, 1989).

WORD RECOGNITION MASLP

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Speech perception is defined as the process by which a perceiver tries to identify the talkers underlying language patterns on the basis of speech sounds and movements. The ultimate goal of speech perception is to determine the meaning and intent behind the spoken message. -Arthur Boothroyd (1998) In many everyday situations, we find ourselves listening to speech-often trying to understand the speech of one particular person even as other conversions, radio broadcasts, and public address announcements create a troublesome speech background. How do we understand the speech of other people? How do we select one voice particularly from a crowd of conversing persons? By what processes do we take in the perishable acoustic signal of speech and quickly reach decision about who said it, what was said and how it was said? All of these decisions must be made before the speaker produces the next utterance. These are some of the questions that the study of speech perception attempts to answer. Auditory perception of speech is a process of interpreting the instructions imprinted on the acoustic wave by the speaker over a time span. Auditory perception of speech per se deals mainly with the temporal management of information from the input (Berlin 1969). • Speech is a continuous, unsegmented event. The organs of speech glide from one target position to the next, generating transitional information in the process. • The characteristics of the acoustic stimulus for any given phoneme are considerably influenced by its neighbors i.e., its phonetic context. Coarticulation results from overlapping of the articulatory constituents of one sound with the next. The perception of any sound can be considered in terms of either a) The manner of articulation used in its production b) The resultant acoustic event. McKay (1956) described two approaches for an explanation of how linguistic value is determined from a speech signal. They are 1) Active 2) Passive The passive system is envisaged as a filtered system functioning to identify and combine information so as to restructure the pattern. These theories are termed ‘Non mediated’ theories. The active models are viewed as comparator systems in which input pattern are compared to an internally generated pattern. These models/theories are referred to as ‘mediated’ theories.

SPEECH PERCEPTION THEORIES MASLP

HimaniBansal15

• Speech perception is defined as the process by which a perceiver tries to identify the talkers underlying language patterns on the basis of speech sounds and movements. The ultimate goal of speech perception is to determine the meaning and intent behind the spoken message. -Arthur Boothroyd (1998) • Speech perception refers to the processes by which humans are able to interpret and understand the sounds used in language. The study of speech perception is closely linked to the fields of phonetics and phonology in linguistics and cognitive psychology and perception in psychology. Research in speech perception seeks to understand how human listeners recognize speech sounds and use this information to understand spoken language. Speech research has applications in building computer systems that can recognize speech, as well as improving speech recognition for hearing- and language-impaired listeners. BASICS OF SPEECH PERCEPTION: • The process of perceiving speech begins at the level of the sound signal and the process of audition. (For a complete description of the process of audition see Hearing.) After processing the initial auditory signal, speech sounds are further processed to extract acoustic cues and phonetic information. This speech information can then be used for higher-level language processes, such as word recognition.

SPEECH PERCEPTION MASLP

HimaniBansal15

• A distinct expressive syndrome could thus arise from selective damage (line 1) to the output store located in Broca's area, while a receptive syndrome could arise from selective damage (line 2) to the input store (located in what is now known as Wernicke's area). • The differentiation between receptive and expressive difficulties was entailed by the model on the basis of information flow among component information transducers, as well as, but independently from the anatomical locale of the components. • These 'disconnection' syndromes required new tests to reveal quite a different set of critical symptoms, where a symptom is as importantly as a spared function as a deficit. • The fundamental point here is the overall pattern of deficient and spared functions. Historically, the most important symptom was the impairment or the sparing of repetition. • The model held that there existed a subcortical connexion between the auditory word images in Wernicke's area and the motor word images in Broca's area that mediated the exact repetition of heard speech, the lesioning of which (line 3) would lead to deficits on this task without other receptive or expressive difficulties. • A repetition impairment, even if it had been tested previously, would have been quite obscure without this model; a selective sparing of repetition in the absence of comprehension or volitional speech in the 'transcortical’ syndromes would have been even more obscure. • The model of the cortical speech centres developed by Lichtheim on the basis of Wernicke’s proposals has become known as the Wernicke-Lichtheim model. • These modifications were based on Lichtheim’s observations of two new aphasic syndromes. One type, now called transcortical sensory aphasia, is characterized by a reduced ability to comprehend speech similar to that observed with Wernicke’s aphasia and pure word deafness. • The patients with transcortical sensory aphasia are also fluent but have trouble expressing their thoughts. • However, unlike patients with Wernicke’s aphasia and pure word deafness, who cannot repeat or imitate speech, patients with transcortical sensory aphasia can repeat normally. • Thus, when a person hears another person speak, after auditory analysis (in Heschl’s gyrus), auditory information is passed to Wernicke’s area, where the representations of word sounds are activated and after these phonological word representations are activated this information is transmitted to the areas of the brain where concepts are elaborated (conceptual-semantic field). • Lichtheim suggested that when a person wants to speak, they activate these conceptual-semantic representations and these conceptual representations directly access and activate Broca’s area (Fig. pathway G).

LANGUAGE PROCESSING MODELS MASLP

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• A traumatic brain injury (TBI), also known as an intracranial injury, is an injury to the brain caused by an external force. TBI can be classified based on severity (ranging from mild traumatic brain injury [mTBI/concussion] to severe traumatic brain injury), mechanism (closed or penetrating head injury), or other features (e.g., occurring in a specific location or over a widespread area). Head injury is a broader category that may involve damage to other structures such as the scalp and skull. TBI can result in physical, cognitive, social, emotional and behavioural symptoms, and outcomes can range from complete recovery to permanent disability or death. • Causes include falls, vehicle collisions and violence. Brain trauma occurs as a consequence of a sudden acceleration or deceleration within the cranium or by a complex combination of both movement and sudden impact. In addition to the damage caused at the moment of injury, a variety of events following the injury may result in further injury. These processes include alterations in cerebral blood flow and pressure within the skull. Some of the imaging techniques used for diagnosis include computed tomography (CT) and magnetic resonance imaging (MRIs). • Prevention measures include use of seat belts and helmets, not drinking and driving, fall prevention efforts in older adults and safety measures for children. Depending on the injury, treatment required may be minimal or may include interventions such as medications, emergency surgery or surgery years later. Physical therapy, speech therapy, recreation therapy, occupational therapy and vision therapy may be employed for rehabilitation. Counselling, supported employment and community support services may also be useful. CLASSIFICATION: • Traumatic brain injury is defined as damage to the brain resulting from external mechanical force, such as rapid acceleration or deceleration, impact, blast waves, or penetration by a projectile. Brain function is temporarily or permanently impaired and structural damage may or may not be detectable with current technology. • TBI is one of two subsets of acquired brain injury (brain damage that occur after birth); the other subset is non-traumatic brain injury, which does not involve external mechanical force (examples include stroke and infection). All traumatic brain injuries are head injuries, but the latter term may also refer to injury to other parts of the head. However, the terms head injury and brain injury are often used interchangeably. Similarly, brain injuries fall under the classification of central nervous system injuries and neurotrauma. In neuropsychology research literature, in general the term "traumatic brain injury" is used to refer to non-penetrating traumatic brain injuries.

TBI MASLP

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Behaviour is defined as the externally visible activity of an animal, in which a coordinated pattern of sensory, motor and associated neural activity responds to changing external or internal conditions. Also, behaviour is the observable activity of an organism; anything an organism does that involves action and/or response to stimulation. Because the brain is the principle mediating organ of behaviour, and because brain structure and function across individuals is reliably similar, a knowledge of habitual brain-behaviour relationships, both healthy and impaired, will provide diagnostician with a more detailed understanding of the behaviour of the subject being studied and a greater probability of predicting the limits of that behaviour. Neurobehavioral testing is a non-invasive method used to evaluate the performance of the central nervous system in an individual or group with similar exposures. It involves assessing areas such as memory, abstract reasoning, problem solving, spatial abilities, emotions and personality consequences of the brain. The result of a neuropsychological assessment is ideally a clear, coherent description of the impact that brain dysfunction has had on a patient’s cognition, personality, emotions, interpersonal relationships and vocational functioning. Major domains assessed through a neurobehavioral testing are: i. Attention ii. Memory iii. Visuospatial function iv. Language v. Praxis vi. Gnosis Article: ● Roitsch ,Prebor and Raymer (2021) conducted an 18-item web-based survey in 100 SLPs, asking them to select which cognitive assessment tools they use to evaluate the cognitive-communication status of individuals with Parkinson's disease, multiple sclerosis, dementia, stroke and TBI. Results revealed no unique pattern of assessment tool use was noted across neurologic disorders. A common set of non-standardized and observational assessment practices was reported most commonly, regardless of the neurologic condition. ● Marra, Hamlet, Bauer & Bowers (2020) reviewed and reported that there appears to be good support for tele-neuropsychology assessments in older adults during Covid- 19 pandemic. PURPOSE OF NEUROBEHAVIORAL TESTING: ● Lesion Location ● Diagnosis ● Level of functioning ● Strengths/ Weaknesses ● Rehabilitation Recommendations ● Prognosis

NEUROBEHAVIORAL TESTING ALD MASLP

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VOICE THERAPY  Voice therapy may be defined as an effort to return the voice to a level of adequacy that can be realistically achieved and that will satisfy the patient’s occupational, emotional, and social needs Aronson (1990) The decision to start voice therapy and the timing and the design of the voice therapy program depend on both the type and severity of a patient’s voice disorder. Voice therapy may be recommended before and/ or after surgical treatment, depending on the patient’s needs. Purposes of voice therapy • To improve vocal communication. • Normalize vocal function; i.e., to restore function so that the vocal profile falls within the accepted normal range. • If it is a degenerative disorder, voice therapy may be initiated to maintain the current level of function as long as possible and reduce ineffective compensatory behaviors. • In case of medical intervention approach, preoperative voice therapy may be undertaken to eliminate vocal abuses and to provide model for optimizing the postoperative voice. Guidelines for voice therapy: • Without an understanding of the nature of the problem, the patient’s approach to therapy often will be highly skeptical. Therefore a thorough understanding of the normal voice physiology and the patient’s deviance from it can be critical to the patient’s response to the therapy. • Throughout therapy, encourage the patient to verbalize perceptions of how the voice sounds and feels. This provides information to the clinician and also sensitizes the patient to the voice and increases the self awareness. • The use of auditory and visual feedback can be extremely helpful to the client. They can be provided by the judicious use of the equipments. The patient is taught to identify certain desirable and undesirable laryngeal behaviors and has the benefit of the image to assist in shaping laryngeal activity. • Therapy should move gradually from one step to the other. The patient should be provided adequate timing to practice the technique and master it. • Clinician should always model the task for the patient. • Recording therapy session in whole or in part is important. Doing so provides a record of the patient’s voice and of therapy session. Memory of the voice is very fleeting and both the clinician and the patient may readily forget what the voice sounded at certain point of time. • Patients should be carefully instructed in what to practice, for how long, and how often. Have the patient demonstrate the exercise or therapy to be practical before leaving the therapy session. • The prognostic statement made at the initiation of a program of vocal rehabilitation must be viewed as an educated guess about the outcome of the therapy.

VOICE MASLP

HimaniBansal15

PROBABILITY: • “Probability measures provide the decision maker in business and in government with the means for qualifying the uncertainties which affect his choice of appropriate actions.” -Morris Hamburg • One of the primary reasons for the development of the theory of probability is the presence in almost every aspect of life, of random phenomenon. A phenomenon is random if chance factors determine its outcomes. All the possible outcomes may be known in advance, but the particular outcome of a single trial in any experimental operation cannot be pre -determined. Nevertheless, some regularity is built into the process so that each of the possible outcomes can be assigned a probability fraction. • Probability is especially important in statistics because of the many principles and procedures that are based on this concept. Reasoning in terms of probabilities is one weapon by which we attempt to reduce this uncertainty or ignorance. In statistics, probability is a numerical value that measures the uncertainty that a particular event will occur. THEORIES OF PROBABILITY: • The solution to many problems involving probabilities requires a thorough understanding of some of basic rules which govern the manipulation of probabilities. They are generally called probability theorems.

THEORY OF PROBABILITY MASLP

HimaniBansal15

• During the past years the understanding and the measurement of stuttering appear to have been dominated by different concept of the stuttering behaviour. It should be noted that is also common for stuttering events to be described as moments of fluency, disfluency or dysfluency, these terms are essentially interchangeable to some authors. But others distinguish between normal disfluencies and abnormal dysfluencies (Quesel, 1988). The traditional view is that the speech behaviours that listeners identify as stuttering are at once the disfluencies and stuttering that is a stuttering is a dysfluency or a speech interruption. • Option that is perceived by the speaker or the listener as an abnormal or stuttered disfluency rather than the normal disfluency. It is the symptomatic many of the difficulties in the stuttering measurement that such disagreements exist over these basic behavioural descriptors. • Johnson and Johnson 1959 recognised that the speech of those who stutter does contain distinctive intervals of non-fluency that could be labelled moments of stuttering (Johnson and Knott 1936) Moments of stuttering are bouts of non- fluency accompanied by some reaction on the part of the speaker or another listener that caused the entire event to be labelled as stutter. Marcel Wingate 1964 proposed a standard definition of stuttering that incorporate much of Johnson concept of stuttering and at the same time focused attention the behaviours that the listeners seem to associate with the label stuttering. Wingate definition drew heavily on his experience with children. • Disruption in the fluency of verbal expression which is characterized by involuntary audible or silent repetition or prolongations in the utterance of short speech elements namely sound, syllables and the words of one syllable. These disruptions usually occur frequently or a marked in character and are not readily controllable (Wingate). • Occasions of stuttering are defined simply as those events that an observer recognizes as stuttering behaviour. Because they exceed some threshold for stuttering identification.

FLUENCY MASLP

HimaniBansal15

The vestibular sensory organs of the inner ear responds to physical stimuli related to movement and orientation of the head in three-dimensional space. In response to mechanical forces acting on the inner ear, neural messages regarding head motion and position are generated by the vestibular apparatus and relayed to the brain. That information along with visual and proprioceptive input, is used by the central nervous system (CNS) to maintain clear vision during head movement, to control muscles responsible for upright posture and to provide a sense of orientation of the body with respect to the surrounding environment. Although the vestibular system is one of our major sensory modalities, it differs somewhat from other senses such as vision and hearing in that it operates largely in the service of motor reflexes, outside the field of conscious perception. Thus we are not aware of vestibular sensory input unless the system is subjected to unusually high levels of stimulation or is compromised by disease, in which importance of vestibular function becomes acutely obvious. Some fundamental aspects of vestibular anatomy and physiology, emphasis on features of the system that provide the foundation for clinical testing of vestibular function.

VESTIBULAR SYSTEM MASLP

HimaniBansal15

INTRODUCTION: The relationship between ontogeny and phylogeny is a recurring theme in developmental, systematic, and evolutionary biology (e.g., Gould, 1977; Alberch et al., 1979; Fink, 1982; Humphries, 1988) All growth is the result of cell division of pre- existing cells, through a process known as mitosis. The cell and nucleus then subdivided into 2 identical daughter cells. one of the earliest organizational developments in the embryo is the differentiation of cells into 3 super- imposed, cellular plates called germ layers. These germ layers are known as ectoderm, mesoderm and endoderm. Ectoderm is generally responsible for development of the outer skin layers but also gives rise to the nervous system and the sense organs. The outer and inner portions of the ear develop from ectodermal tissue, while the M.E ossicles and the bone surrounding the inner ear originate from mesodermal tissue. The ear begins its development during the early life of the embryo. The embryonic disk is split by a primitive streak at about 25 hours, which leads the way for development of the ectodermal lined primitive groove and primitive fold. The primitive groove deepens into a primitive pit, which in turn becomes the neural groove and neural fold. The ectodermal lined neural folds come together to close off the neural groove, which is now known as the neural tube. It is during the stage of the neural tube that the earliest beginning of the ear is seen. The ear is contained within the temporal bone. The cochlea as well as the middle and external ear, vestibular apparatus, and seventh and eighth cranial nerves are all housed in the temporal bone. Temporal bone is a hard bone that has myriad cavities, channels, and canals that subserve the organs of hearing and balance. Temporal bone is paired: RIGHT TEMPORAL BONE & LEFT TEMPORAL BONE. The ear is the organ that detects sounds. It not only acts as a receiver for sound, but also plays a major role in the sense of balance and body position. The ear is the part of auditory system. The word ear may be used correctly to describe the entire organ or just the visible portion. In most animals the visible ear is a flap of tissue that is also called the pinna and is the first of many steps in hearing. In people the pinna is often called the auricle. Vertebrates have a pair of ears placed symmetrically on opposite side of the face. This arrangement aids in the ability to localize sound source. We humans hear the way we do because of at least three major forces. The first is phylogeny, the evolutionary changes in the auditory system since its beginnings. Another is embryology, the development of the system in each individual before birth. Finally, there is the biologically determined auditory mechanism we are born with and our interaction with the environment in early postnatal life.

OUTER EAR MASLP

HimaniBansal15

a) What happens to language and communication after brain damage of different types? b) How did the ability to communicate and the ability to use language develop in the evolution of the species? How can we relate this development to the evolution of the brain? c) How do children learn to communicate and use language? How can we relate their acquisition of language to the development of their brains? d) How can we measure and visualize processes in the brain that are involved in language and communication? e) How can we make good models of language and communication processes that will help us to explain the linguistic phenomena that we study? f) How can we make computer simulations of language processing, language development and language loss? g) How can we make experiments that will allow us to test our models and hypotheses about language processing? ACQUIRED LANGUAGE DISORDERS: • Aphasia- language loss due to brain damage, cause can be infarction, hemorrhage or head trauma • Either comprehension or expression of language or both is effected • Aphasiology or linguistics aphasiology is the dominant branch of neurolinguistics. Aphasia is an acquired language disorder, a focal lesion. Another cause of acquired disorders can e progressive neurological disease, such as, dementia. Language and memory are closely connected and interdependent, especially in higher cognitive functions. DEVELOPMENTAL LANGUAGE DISORDERS: • Disorders that are found in children who have not experienced any specific lesion event. • Neurolinguists compare developmental language disorders (like SLI, dyslexia) to similar acquired disorders with the view of language acquisition and plasticity (ability to be moulded) of young brains, they also study the language develooment of children with non specific developmental disorders affecting language. LANGUAGE AND SPEECH: • Neurolinguists study development of language and speech, their prerequisites in the evolution of species. The changes in the structure and function f the brain are compared to different species ways of living. • Experiments are being carried out with primates that are being taught human communication systems.

Neurolinguistics MASLP

HimaniBansal15

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