FAMILY CHARACTERISTICS, STATE PROGRAM EFFECTIVENESS, AND REPORT OF INADEQUATE CARE AMONG FAMILIES OF YOUNG CHILDREN WITH HEARING LOSS

Approximately 1.6 per 1,000 newborns in the U.S. are born with hearing loss. Congenital hearing loss poses a risk to their speech, language, cognitive, and social-emotional development. Early detection and intervention can improve outcomes. Every state has an Early Hearing Detection and Intervention program (EHDI) to promote and track screening, audiological assessments and linkage to early intervention. However, a large percentage of children are “lost to system (LTS),” meaning that they did not receive recommended care or that it was not reported. This study used data from the 2009-2010 National Survey of Children with Special Health Care Needs and data from the 2011 EHDI Hearing Screening and Follow-Up Survey to examine how 1) family characteristics; 2) EHDI program effectiveness, as determined by LTS percentages; and 3) the family conditions of education and poverty are related to parental report of inadequate care. The sample comprised 684 children between the ages of 0 and 5 years with hearing loss. The results indicated that living in states with less effective EHDI programs was associated with an increased likelihood of not receiving early intervention services (EIS) and of reporting poor family-centered communication. Sibling classification was associated with both receipt of EIS and report of unmet need. Single mothers were less likely to report increased difficulties accessing care. Poor and less educated families, assessed separately, who lived in states with less effective EHDI programs, were more likely to report non-receipt of EIS and less likely to report unmet need as compared to similar families living in states with more effective programs. Poor families living in states with less effective programs were more likely to report less coordinated care than were poor families living in states with more effective programs. This study supports the conclusion that both family characteristics and the effectiveness of state programs affect quality of care outcomes. It appears that less effective state programs affect disadvantaged families’ service receipt report more than that of advantaged families. These findings are important because they may provide insights into the development of targeted efforts to improve the system of care for children with hearing loss.

An Exploration of Auditory Brainstem Encoding of Stop Consonants in Infants and Implications for Language Outcomes

Current trends in speech-language pathology focus on early intervention as the preferred tool for promoting the best possible outcomes in children with language disorders. Neuroimaging techniques are being studied as promising tools for flagging at-risk infants. In this study, the auditory brainstem response (ABR) to the syllables /ba/ and /ga/ was examined in 41 infants between 3 and 12 months of age as a possible tool to predict language development in toddlerhood. The MacArthur-Bates Communicative Development Inventory (MCDI) was used to assess language development at 18 months of age. The current study compared the periodicity of the responses to the stop consonants and phase differences between /ba/ and /ga/ in both at-risk and low-risk groups. The study also examined whether there are correlations among ABR measures (periodicity and phase differentiation) and language development. The study found that these measures predict language development at 18 months.

Language Outcomes of the Play and Language for Autistic Youngsters (PLAY) Project Home Consultation model—An Extended Analysis

The current study is a post-hoc analysis of data from the original randomized control trial of the Play and Language for Autistic Youngsters (PLAY) Home Consultation program, a parent-mediated, DIR/Floortime based early intervention program for children with ASD (Solomon, Van Egeren, Mahone, Huber, & Zimmerman, 2014). We examined 22 children from the original RCT who received the PLAY program. Children were split into two groups (high and lower functioning) based on the ADOS module administered prior to intervention. Fifteen-minute parent-child video sessions were coded through the use of CHILDES transcription software. Child and maternal language, communicative behaviors, and communicative functions were assessed in the natural language samples both pre- and post-intervention. Results demonstrated significant improvements in both child and maternal behaviors following intervention. There was a significant increase in child verbal and non-verbal initiations and verbal responses in whole group analysis. Total number of utterances, word production, and grammatical complexity all significantly improved when viewed across the whole group of participants; however, lexical growth did not reach significance. Changes in child communicative function were especially noteworthy, and demonstrated a significant increase in social interaction and a significant decrease in non-interactive behaviors. Further, mothers demonstrated an increase in responsiveness to the child’s conversational bids, increased ability to follow the child’s lead, and a decrease in directiveness. When separated for analyses within groups, trends emerged for child and maternal variables, suggesting greater gains in use of communicative function in both high and low groups over changes in linguistic structure. Additional analysis also revealed a significant inverse relationship between maternal responsiveness and child non-interactive behaviors; as mothers became more responsive, children’s non-engagement was decreased. Such changes further suggest that changes in learned skills following PLAY parent training may result in improvements in child social interaction and language abilities.

Three Voices in the Wilderness: Foote, Bloch, and Korngold in the Early Twentieth-Century America

Barbara Hanning points out in her book Concise History of Western Music, that "Twentieth-century American music was in large measure an extension of European music" (Hanning 1998, 515). My dissertation/perforrnance project features cello works written by three contemporary composers who lived in America but were connected to the European heritage in different ways; each contributed significantly to the development of American classical concert life, music education, and even popular culture. Programs of my performances are intended to illustrate their unique compositional styles. The first recital consists of five cello compositions of Massachusetts-born Arthur Foote (1853 - 1937): Drei Stucke fur Pianoforte und Violoncello, Op. 1; Scherzo, Op.22; Romanza, Op.33; Aubade, Op.77; and Sonata for Violoncello and Piano, Op.78. Foote was influenced by the German-trained John Knowles Paine at Harvard University; he composed music famous for its extensive chromaticism in both harmony and melodic line, and for clearly-defined formal structure. The second recital explores the music of Swiss-American composer Ernest Bloch (1880-1959): a short Meditation Hebraique, a Suite No. I for Violoncello Solo and the famous rhapsody Schelomo. Born in Geneva, Switzerland, and settling in the United States in 1916, Bloch is a composer deeply influenced by the European late-Romantic tradition and is also well-known for employing "Hebraic" elements into his works. The final performance comprises two other of Bloch's cello works and one cello concerto by the Austrian-American composer, Erich Wolfgang Korngold (1897- 1957). Bloch's Voice in the Wilderness is a symphonic poem for orchestra and cello (accompanied by piano in this performance), consisting of six movements performed without pause. His Suite No.3 for Cello Solo is shorter and has a simpler style than the first Suite. Korngold was recognized as a child prodigy in his native Austria. After a Nazi-induced exile, he immigrated to America and became a film music composer in Hollywood. The Cello Concerto was used in the movie "Deception" (1 946), for which Korngold provided the film score. The impassioned harmonic language and lavish melodic lines inherited from the high-romanticism make this work one of comparative discordant beauty among other compositions of his time.

Selected Works from Character Pieces in the 19th - Early 20th Centuries

During the Romantic Era, the character piece flourished and became one of the most important genres. Even though character pieces existed as early as the eighteenth century, it was not until the nineteenth century that Romantic Era literary figures discovered that music was as powerful as any other artistic medium in expressing unspeakable emotions. The character piece allowed composers to express a definite mood, a programmatic idea, or a pictorial association. Character pieces often have titles that suggest briehess or casualness, such as a Beethoven Bagatelle, a Schubert Impromptu or Moment musicaux. Others have expressive programmatic titles, such as Schumann's Kreisleriana and Liszt's Apres une lecture de Dante. Ths dissertation was based on selected works from the nineteenth century and early-twentieth century in order to demonstrate the great variety of musical thought and stylistic development. I have examined composers from different countries and of different nationalities to establish what and how they contributed to the remarkable diversity in this genre. The selected works allowed for very personal programs. These concerts, in addition to being good combinations of pieces, are representative of the genre. The first program consisted of Chopin's Preludes, Op. 28; three pieces from Debussy7s Images Books I and 11; and Liszt7s Apres une lecture de Dante. The second program included seven of Beethoven's Bagatelles, Op. 33; Schumann's Kinderscenen, Op. 15; Poulenc's Mouvements perpetuels and Intermezzo in A-jlat Major; Faure7s Nocturne in B Major, Op. 33, No. 2 and Impromptu No. 2 in F Minor; three of Mompou's Canciones y Danzas; four of Villa-Lobos Prole do bebe Suite No. 1; and Albkniz's Navarra. The third and final program comprised four selections from Rachrnaninoff s Moment musicaux, Op. 16; five pieces from Grieg's Lyric Pieces; and Arensky7s Suite No. 1 for Two Pianos and Suite No. 2 for Two Pianos. I wanted to bring out nuances specific to the individual composers and show how their character pieces helped in shaping the Romantic Era. Even in the twenty-first century, an era of highly specialized musical tastes, the popularity and accessibility of character pieces stand out.