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.

Nurturing Change: Lilly Martin Spencer's Images of Children

This dissertation is the first full-length study to concentrate on American genre painter Lilly Martin Spencer's images of children, which constituted nearly one half of her saleable production during the height of her artistic career from 1848 to 1869. At this time, many young parents received advice regarding child rearing through books and other publications, having moved away from their families of origin in search of employment. These literatures, which gained in popularity from the 1830s onward, focused on spiritual, emotional, and disciplinary matters. My study considers four major themes from the period's writing on child nurture that changed over time, including depravity and innocence, parent/child bonding, standards of behavior and moral rectitude, and children's influence on adults. It demonstrates how Spencer's paintings, prints, and drawings featuring children supported and challenged these evolving ideologies, helping to shed light not only on the artist's reception of child-rearing advice, but also on its possible impact on her middle-class audience, to whom she closely catered. In four chapters, I investigate Spencer's images of sleeping children as visual equivalents of contemporary consolation literature during a time of high infant and child mortality rates; her paintings of parent/child interaction as promoting separation from mothers and emotional bonding with fathers; her prints of mischievous children as both considering changing ideals about children's behavior and comforting Anglo-American citizens afraid of what they saw as threatening minority groups; and her pictures with Civil War and Reconstruction subject matter as contending with the popular concept of the moral utility of children. By framing my interpretations of Spencer's output around key issues in the period's dynamic child-nurture literature, I advance new comprehensive readings of many of her most well-known paintings, including Domestic Happiness, Fi, Fo, Fum!, and The Pic Nic or the Fourth of July. I also consider work often overlooked by other art historians, but which received acclaim in Spencer's own time, including the lithographs of children made after her designs, and the allegorical painting Truth Unveiling Falsehood. Significantly, I provide the first in-depth analysis of a newly rediscovered Reconstruction-era painting, The Home of the Red, White, and Blue.

TALLY HORN! ECHOES OF HOOFBEATS AND HAUNTS: RECORDED SELECTIONS FOR HORN AND PIANO

In the 17th and 18th centuries, the European hunting horn was an instrument associated with the thrill of the chase, rustic scenes, and the pageantry of royal hunts. The sound of this horn and the music that evolved from its heritage would inspire composers writing for the modern horn. TALLY HOrn! Echoes of Hoofbeats and Haunts: Recorded Selections for Horn and Piano are two compact discs of works for horn and piano as well as solo horn reflecting this association with the hunt and include additional works of expressive contrast – lyrical pieces and nocturnes. Nine of the pieces reflect the modern horn’s beginnings and they are Abbot’s Alla Caccia, Berge’s Horn-Lokk, Boutry’s Chassacor, Bozza’s En Fôret, Büsser’s La Chasse de St. Hubert, Pessard’s In the Forest, Piantoni’s Air de Chasse, Schmid’s Im Tiefsten Walde, and Vinter’s Hunter’s Moon. By contrast, three of the selections, Gliére’s Nocturne, Strauss’ Nocturno, and Van Ecchaute’s Nachtpoëma are nocturnes that showcase the expressive quality of the horn. In addition, Bush’s Autumn Poem, Bacon’s Song After the Rain, and Webber’s Summer Pastures are included for their lyric qualities and evocations of nature. The largest work of the project is John Williams’s Concerto for Horn. Its five movements feature both hunting horn traits and expressive qualities. Alejandro Hernandez-Valdez and Grace Cho were the two pianists engaged for the recording. The recording engineer was Edward Kelly. The producer was Carlos Rodriquez. The pieces were recorded at the Spencerville Seventh-day Adventist Church sanctuary in Spencerville, Maryland between November 2010 and February 2011.

BAROQUE MUSIC FOR TRUMPET: A STUDY OF SOLO AND CHAMBER REPERTOIRE

The trumpet experienced important changes in terms of its musical use during the middle and late Baroque period. Prior to the Baroque, and even in to the first half of the 17th century, the trumpet had historically been used for rather "non-musical" purposes, sometimes as an instrument for battle or as a tool to be used in the town square to announce the arrival of a dignitary. On the whole, the trumpet was most certainly not used as an instrument of melody -that was typically reserved for violins, flutes, and oboes. However, in the late 1600's, composers such as Allesandro Stradella and Henry Purcell began to treat the trumpet differently. They saw the melodic potential in the trumpet and began to feature the trumpet more as an instrument of melody, as opposed to relegating it to only outlining triads and emphasizing harmony. Of course, keyboard, string, and woodwind instruments had long established a significant catalogue of works by the late 17th century. Additionally, even after the trumpet had been established as an instrument of melody, prominent composers of the time still wrote significantly more solo music for these other instrument families than for the trumpet. Consequently, the overall Baroque repertoire for the solo trumpet pales in comparison to that of the other families of instruments. But, much of this Baroque literature not originally written for trumpet can be presented effectively in the form of a transcription, thereby adding greatly to the repertoire of the Baroque solo trumpet. The goal of these three dissertation recitals is twofold: 1) to perform literature that offers music from a variety of countries of origin that span the entire Baroque era and 2) to feature music that has remained relatively unknown in the trumpet world, yet is musically strong. I will also introduce viable "new" music to the trumpet repertoire through Baroque transcriptions originally written for other instruments or voice. The majority of the transcriptions I will be performing have originated from my own listening and study of Baroque music, and I have selected music that I felt would translate well for the trumpet.

Cortisol Reactivity and Observed Parenting among Mothers of Children with and without ADHD

Parenting is a robust predictor of developmental outcomes among children with ADHD. Early parenting predicts the persistence and course of ADHD and comorbid problems above and beyond risk associated with shared genetic effects. Yet, on average, mothers of children with ADHD are less positive and more negative in their parent-child interactions compared to mothers of non-disordered children. Little is known about psychobiological markers which may be associated with individual variations in maternal parenting in families of children with ADHD. Neurobiological models of parenting suggest that maternal cortisol levels following a stressor may be positively associated with hostile and intrusive parenting; however, to date no studies have examined maternal cortisol reactivity and parenting in school-age, or clinical samples of, children. Mothers’ regulation of physiological stress responses may be particularly important for families of children with ADHD, as parenting a child with chronically challenging behaviors represents a persistent environmental stressor. The current study sought to extend the existing literature by providing an empirical examination of the relationship between maternal cortisol reactivity following two laboratory stressors and parenting among mothers of children with and without ADHD. It was hypothesized that child ADHD group would moderate the relationship between cortisol reactivity and self-reported and observed parenting. Greater total cortisol output and greater increase in cortisol during the TSST were associated with decreased positive parenting and increased negative and directive parenting, with the exception of parental involvement, which was associated with increased cortisol output during the TSST. Conversely, cortisol output during the PCI was associated with increased positive parenting, increased parental involvement, and decreased negative parenting. In contrast to the TSST, a greater decrease in cortisol during the PCI indicated more positive parenting and parental involvement. These associations were specific to mothers of children with ADHD, with the exception of maternal directiveness, which was specific to comparison mothers. Findings add to our understanding of physiological processes associated with maternal parenting and contribute to an integrative biological, psychological, and cognitive process model of parenting in families of children with ADHD.