Psychology Speech and Hearing

 

Project Number: 2019-8

Project Leader: Toby Macrae

Host Department: Psychology, Speech and Hearing

Project Title: Investigating sound change in Te Reo Maori.

Project outline: Te Reo Maori, the indigenous language of Aotearoa New Zealand, is an evolving language (see King, Maclagan, Harlow, Keegan, & Watson, 2011). The MAONZE project has revealed that pronunciation of Te Reo Maori has adapted over time "in ongoing interaction with English while retaining its own character (Watson, 2004)." Research has revealed changes in the pronunciation of both consonants and vowels and in prosodic features and that some of these changes are influenced by New Zealand English. However, more research is needed to gain a complete understanding of Te Reo Maori. This project will appeal to students who have an interest in sound change in languages and in particular in studying our indigenous language. The project will investigate research questions that have not been studied to date using the MAONZE database. For example, are there prosodic cues other than rhythm, such as intonation patterns, that distinguish Te Reo Maori from New Zealand English and have these cues changed over time to approximate New Zealand English more closely? Have consonants that haven't been studied extensively, for example, the voiced alveolar tap in Te Reo Maori, changed across time? This is one sound of Te Reo that causes particular difficulty for New Zealand English speakers to produce. It may be that these difficulties influence how the sound is produced in native speakers.

Specific Requirements: Students who are either (a) working towards a Bachelor of Speech and Language Pathology (BSLP) in the School of Psychology, Speech and Hearing or (b) working towards a Bachelor of Arts in Linguistics would be preferred, given their familiarity with the topic and with the analyses that will be required. If this is not possible, however, other students will benefit from the experience and will receive necessary training to be able to carry out the analyses and complete the research project.

 

 

Project Number: 2019-11

Project Leader: Ramakrishnan Mukundan (Associate Professor, Department of Computer Science and Software Engineering),  Maggie-Lee Huckabee (Professor, School of Psychology, Speech and Hearing)

Host Department: Computer Science and Software Engineering

Project Title: Tele-ultrasound Video Processing Algorithms for Automated Segmentation and Quantification of Image Features

Project outline: This project aims to develop efficient computational tools for processing ultrasound video frames generated by a Clarius tele-ultrasound scanning system. This is a collaborative project with the Rose Centre for Stroke Recovery and Research, where the tele-ultrasound systems are being used for the assessment and monitoring of conditions related to swallowing disorders. The primary goal of the summer project is to develop algorithms in Python language using the OpenCV library for reading and enhancing the contrast and features of video frames, and to automatically identify points and regions of interest within each frame based on different types of intensity and texture characteristics.  The extracted regions are further processed to derive quantitative measurements such as position, slope, length, area etc as required by the clinical application area where the video scans are used.  The project will also involve discussions with a clinician at the Rose Centre who will assess the quality of the generated images and provide the necessary information required for identifying image features within video frames.

Specific Requirements: Proficiency in Python programming

  • Ability to design algorithms and implement them in Python
  • Knowledge of Python libraries such as NumPy and Matplotlib
  • Knowledge of image processing functions and the OpenCV library is desirable.

 

 

Project Number: 2019-14

Project Leader: Seth Harty, PhD

Host Department: School of Psychology, Speech, and Hearing

Project Title: Predictors of emotional reactivity and risk taking

Project outline: This project will analyse data collected as part of a HEC approved lab study designed to explore the extent to which differences in executive cognitive processes, such as attention and working memory, predict reactivity to negative emotional stimuli and influence risky decision making. The selected student will be provided with opportunities to further develop their analytic and writing skills. The selected student will be involved in hypothesis testing, perform statistical analyses in SPSS, and engage in manuscript construction.

Specific Requirements: PSYC478 and PSYC470 (currently enrolled)

 

 

 

Project Number: 2019-21

Project Leader: Dr. Andrew Vonasch

Host Department: Psychology, Speech, and Hearing

Project Title: Testing the Tradeoff Justification Model

Project outline: The project will involve creating and implementing online and/or in person studies about how people judge others' intentions. The aim is to test the Tradeoff Justification Model (Vonasch & Baumeister, 2017), and apply it to a variety of situations.

Specific Requirements: Preference will be given to applicants who have studied both psychology and philosophy, and have previously conducted research on the Tradeoff Justification Model.

 

 

Project Number: 2019-25

Project Leader: Julia Rucklidge, Jacki Henderson

Host Department: Psychology

Project Title: A comparison of birth outcomes of mother exposed and not exposed to micronutrients during pregnancy

Project outline: Approximately 1 in 8 New Zealand women will experience antenatal depression. Research demonstrates these women have higher risk of premature birth, intrauterine growth restriction (IUGR), and infants that are small for gestational age and have lower Apgar scores. Premature birth and low birth weight are associated with increased foetal mortality, infant mortality and morbidity, as well as increased risk of developmental deficits and chronic disease in adulthood. Further, antenatal depression is linked to poorer maternal health behaviours, which can further impact birth outcomes. Research indicates antenatal antidepressant medications during pregnancy may negatively impact foetal development, highlighting the need for exploring safe and effective methods of addressing antenatal depression.

Broad-spectrum micronutrient supplements have been found to alleviate depressive symptoms in nonpregnant adults. The NutriMUM trial (a randomised controlled trial currently being conducted at UC) is investigating the use of broad-spectrum micronutrient supplements for women experiencing emotional distress during pregnancy compared to iodine. Data from this RCT group is also being compared to control women who are not struggling with mood issues during pregnancy, recruited via the Infant Development Study at UC.

As part of a PSYC470 project, birth data for the RCT and control women (who have given birth to date) have begun to be analysed. Initial analyses demonstrate similar or better outcomes for the RCT group across multiple areas compared to the control group.

Our initial comparisons have revealed that the women in the RCT group are having fewer perineum tears, lower use of pain management during labour (for vaginal birth), and lower infant resuscitation rates compared with the control women. The two groups did not differ on a number of measures indicated to be areas of concern for depressed mothers, including: gestational age, premature birth, infant head circumference, IUGR and Apgar scores.

The initial results demonstrate that RCT participation appears not only safe, but may confer benefits and/or protection against negative impacts of maternal depression, with no adverse effects found on any measure.

Due to the small sample size of the RCT group to date (n = 37), limitations surround interpretation of findings. Therefore, this Summer Research Project aims to increase the sample size in order to have greater power for interpreting our initial results. This work is likely to expand into a Masters project.

Specific Requirements: PSYC477 would be useful preparation for this project as well as completion of an honours project

 

 

 

Project Number: 2019-26

Project Leader: Jayne Newbury

Host Department: School of Psychology, Speech and Hearing

Project Title: Validation of the REsponsivity Training Scale (ReTS)

Project outline: Primary caregivers play a pivotal role in the development of their children's language skills particularly in the first three years of life. During this period the quality and quality of primary caregivers' interactions and language use with their children is an important predictor of subsequent language growth (Hart and Risley, 1995). Language interventions frequently focus on optimising child directed speech (CDS) in the child's daily experience. Results from a meta-analysis of interventions indicate that this approach has significant positive effects (Roberts and Kaiser, 2011).

When translating these findings from research to practice, however several barriers are present. A recent survey of clinicians revealed there is a lack of validated tools to measure CDS suitable for clinical practice (Newbury & Sutherland, 2019). We therefore developed the Child-Directed Speech Rating Scale (CDSRS) in response to clinician's needs and priorities. The psychometric properties of this scale were explored over 2018-2019. It has been revised since to:

  • increase its interrater reliability
  • to load on a single factor which is predictive of language outcomes between ages 24-42 months (responsivity)
  • to meet a narrower purpose of assessment, namely goal setting and detecting change

The new version has been renamed the “Responsivity Training Scale” (ReTS). The next step of this project seeks to validate the ReTS as a measure of CDS.

We will continue to use the data set from the 'Learning To Talk' Marsden funded project (Klee et al. 2011-2014) to explore the psychometric properties of the ReTS. One hundred and forty parent-child dyads were filmed interacting when the children were aged 2 and 3.5 years of age. We have language scores for these children at 2 years, 3.5 years and 5 years. Eighty videos were coded for behaviours relevant to the project last summer.

This summer we propose for a student to increase the number of coded videos to 110 and to trial using the ReTS. The student would acquire research skills including data entry, video coding, clinical assessment of CDS, completing a reliability study, basic statistical analyses and possibly a literature review if time allows.

This work would enable us to calculate the ReTS psychometric properties, namely, criterion (concurrent) validity, predictive validity (for language outcomes at 3.5 and 5 years), interrater reliability, internal consistency and factor analysis. The literature review will support the clinical trials of the tool (planned for 2020) and publications of the tools validation process.

Specific Requirements: We require a student who has completed at least the second professional year of the Bachelor of Speech Language Pathology (BSLP) or the first year of the Master of Speech Language Pathology (MSLP) degree.

 

 

 

Project Number: 2019-28

Project Leader: Toby Macrae

Host Department: Psychology, Speech and Hearing

Project Title: The effect of expressive phonological abilities on word learning.

Project outline: There is an increasing focus on children's vocabulary knowledge in the communication sciences and disorders literature, in particular as it relates to reading comprehension. The breadth and depth of young children's vocabulary knowledge exert direct and indirect effects on their future third-grade reading comprehension (NICHD ECCRN, 2005). In order for children to acquire new words, they must be exposed to them repeatedly and in meaningful contexts (Justice, 2016). Children who are raised in linguistically impoverished environments, for example, those from low-income households, have less exposure to new words than children raised in linguistically enriched environments and this can result in smaller vocabularies in these children.

Adult-child storybook reading has been shown to be successful in building these children's vocabulary knowledge (Justice, 2005). University of Canterbury researchers recently showed that teachers can be trained to implement a program in the classroom that improves vocabulary knowledge as well as two other skills that are critical for reading development: phonological awareness and letter knowledge (Gillon et al., 2019). The participants were children in their first year of school who were from low-income households and who had low levels of oral language. A subgroup of 51 children had difficulties with speech sound production. These children will be the focus of the current research project.

Numerous studies have shown that young, typically-developing children show selection and avoidance in their early word productions. That is, a child's first words are more likely to contain speech sounds that were present in his or her early babbling (e.g., Stoel-Gammon, 2011). It is unknown whether these phonological influences on vocabulary acquisition exist in older children with speech sound disorders who are taking part in vocabulary instruction. Therefore, the primary aim of the present research project is to determine if children with low levels of oral language and speech sound disorders show superior learning for words that begin with sounds they are capable of producing than for words that begin with sounds that they are not capable of producing. These analyses will be conducted on exisiting data that were collected as part of the Gillon et al. (2019) study. The results of this project will inform our theoretical understanding of word learning in children with speech sound disorders as well as clinical practice. In particular, if these children show lexical avoidance in their vocabulary acquisition, strategies will need to be developed to overcome this.

Specific Requirements: Students who are working towards a Bachelor of Speech and Language Pathology (BSLP) in the School of Psychology, Speech and Hearing would be preferred, given their familiarity with the topic and with the analyses that will be required. If this is not possible, however, other students will benefit from the experience and will receive necessary training to be able to carry out the analyses and complete the research project.

 

 

Project Number: 2019-80

Project Leader: Maggie-Lee Huckabee, Esther Guiu Hernandez, Applied Immersive Game Design faculty (TBA)

Host Department: School of Psychology, Speech and Hearing/ Rose Centre for Stroke Recovery and Research

Project Title: BiSSkApp (Biofeedback in Strength and Skill Training App): Development of an app based rehabilitation tool

Project outline: Clinicians and Engineers at the Rose Centre for Stroke Recovery and Research have developed and moved to market a swallowing rehabilitation software training protocol BiSSkiT (Biofeedback in Strength and Skill Training). We are now wishing to move this product to its 'next generation' BiSSkApp, by transitioning the software to an app format, improving the interface for ease of use by patients and using a wireless sEMG device. This collaborative project between the UC Rose Centre, and the UC School of product design will support this transition. The selected student will work with the Rose Centre biomedical engineer and patient consultant on interface and system design and layout and app development. The project will provide a unique opportunity to work on product design in a clinical setting and for clinical application.

Specific Requirements: This project is likely best suited for a student in Applied Emersive Game Design. Skills include:

App development

Interface design

System design

Coding

 

 

Project Number: 2019-82

Project Leader: Maggie-Lee Huckabee, 2. Ramakrishnan Mukundan

Host Department: School of Psychology, Speech and Hearing/ Rose Centre for Stroke Recovery and Research

Project Title: Clinician evaluation of enhanced ultrasound images: Maximising reliability for clinical application

Project outline: Recent research at the Rose Centre sought to translate use of a small, portable ultrasound device to clinical swallowing assessment. Unfortunately, inter- and intra-rater reliability for measurement of acquired images was inadequate for clinical translation. Colleagues in Engineering are exploring options for algorithms that can enhance contrast, improve image quality and potentially auto-detect regions of interest. This collaborative project with researchers from Computer Science and Software Engineering will explore reliability of measurement of archived images from healthy individuals and patients with swallowing impairment. Twenty clinicians (10 with and 10 without experience in interpreting ultrasound imaging) will be recruited to subjectively evaluate image quality and clarity in original format, and after image enhancement by computer algorithm. These data will be used to determine the optimal presentation of ultrasound to increase applicability in clinical practice. If issues of reliability can be resolved, use of inexpensive portable ultrasound instrumentation has the potential to significantly improvement clinical practice, particularly in community or rural settings where other instrumentation is not available.

 Specific Requirements: Completion of Dysphagia clinical papers

  • Interest in diagnostic instrumentation and ability to learn ultrasound imaging of swallowing
  • Engagement with clinical community for recruitment of participants.

 

 

Project Number: 2019-83

Project Leader: Randolph Grace

Host Department: Psychology, Speech and Hearing

Project Title: A test of extra-dimensional transfer of differences and ratios in an artificial algebra

Project outline: Research in our lab suggests that the perceptual system automatically computes two operations, corresponding to differences and ratios, when comparing stimulus magnitudes (Grace et al., in press, 2018). These studies have used our 'artificial algebra' task in which observers are trained to respond based on an arithmetical relation between magnitudes (e.g., line lengths, brightnesses) by feedback and without explicit instruction. If magnitudes are processed via a central system (e.g., Walsh, 2003) then training with a given relation with one stimulus dimension should transfer to a second dimension. As part of the summer scholarship, the student will conduct an experiment in which participants are trained to estimate differences (or ratios) of brightnesses in the first part of the session, and then tested with line lengths in the second part. We predict that training with brightnesses will carryover so that if participants learn brightness differences first they will find it easier to learn line length differences than ratios, whereas if they learn brightness ratios first they will find it easier to learn line length ratios.

Specific Requirements: none specified

 

 

Project Number: 2019-87

Project Leader: Dr. Andrew Vonasch

Host Department: Psychology, Speech, and Hearing

Project Title: Disgust Sensitivity Among Child Sexual Exploitation Material Users: An Exploratory Study

Project outline: Child Sexual Exploitation Material (CSEM) is deemed to be objectively disgusting, and violates social and moral convention. These judgements extend to individuals who engage in use of CSEM. The proposed study seeks to ascertain whether disgust sensitivity differs between a sample of individuals who use CSEM and a sample of individuals who do not use CSEM. Because disgust responses tend to motivate avoidance of the eliciting stimuli, and disgust and sexual arousal appear to have an inverse relationship, the hypothesis is that CSEM users will be less sensitive to disgust than comparison, which facilitates their engagement with CSEM.

Specific Requirements: Student must have taken Moral Psychology, Psyc468.

 

 

Project Number: 2019-102

Project Leader: Catherine Theys, Megan McAuliffe, Michael MacAskill

Host Department: School of Psychology, Speech and Hearing

Project Title: Communication problems in Parkinson's Disease: disentangling cognitive from motor contributors

Project outline: Parkinson's Disease (PD) is the second most common neurodegenerative disorder (Tanner & Goldman, 1996). By 2030, the global PD population is estimated to more than double, due to increasing prevalence and an aging world population (Dorey et al, 2018). Up to 90% of people with PD will develop communication difficulties as the disease progresses (Miller, 2017). These communication problems have traditionally been attributed to the motor changes associated with PD and speech-language therapy for individuals with PD typically targets motor speech impairments. However, a recent review has highlighted that cognitive factors also have a significant contribution to communicative changes (Smith & Caplan, 2018). Increased understanding of the language changes in individuals with PD, and whether they can be attributed to motor or cognitive changes, or both, is important for improving assessment and treatment approaches. This research summer scholarship will give the recipient the opportunity to investigate the relationship between cognitive functioning and expressive language by analysing speech samples of individuals with PD.

Speech samples are being collected as part of a longitudinal study on PD, led by the New Zealand Brain Research Institute (https://www.nzbri.org). As part of the summer scholarship, the student will have the opportunity to observe the test sessions, and will analyse speech samples of 100 people (with PD and control speakers). Speech samples consist of conversation, monologue and reading tasks and will be transcribed in CLAN (MacWhinney, 2000). The speech and language measures of interest will be compared with the participants' cognitive scores. The student will receive support to analyse data, perform statistical analyses in R and write a scientific summary of the research.

By completing this project, the student will gain valuable research experience in the Speech-Language Neuroscience Lab at the School of Psychology, Speech and Hearing. We intend for this project to provide data that lays the foundation for subsequent studies incorporating the results of neuropsychological tests and brain imaging, with the opportunity for further advanced study for suitable students.

We would like to acknowledge the New Zealand Brain Research Institute for providing co-funding for this summer scholarship.

Specific Requirements: none specified

 

 

Project Number: 2019-103

Project Leader: Catherine Theys & Megan McAuliffe

Host Department: School of Psychology, Speech and Hearing

Project Title: Speech disfluencies associated with Parkinson's Disease and healthy ageing

Project outline: Speech disfluencies commonly occur in the speech of people who do not stutter, but their influence on the forward flow of conversation seems minimal (Bortfeld et al, 2001). This differs from the disfluencies that are considered to be the core characteristic of stuttered speech production, with both qualitative and quantitative differences in disfluencies reported between stuttered and non-stuttered speech production. Much of the research on speech disfluencies has been conducted within the framework of developmental stuttering, and its primary focus has therefore been on disfluencies in childhood, close to the onset of developmental stuttering. However, an increased focus on speech disfluencies in older adults has been observed, especially in studies on populations with acquired neurogenic disorders such as stroke, traumatic brain injury and Parkinson's Disease (De Nil, Theys & Jokel, 2018). For example, it has recently been suggested that speech disfluencies are more common in people with Parkinson's Disease, and differ from those in normal ageing (Juste et al, 2018).

The scholarship will give the recipient the opportunity to further investigate the presence and characteristics of speech disfluencies in Parkinson's Disease. The project aims to investigate the presence of speech disfluencies in a larger participant group (N > 100), and to control for changes associated with not only ageing but also cognitive and language changes.

Speech samples are being collected as part of a longitudinal study on Parkinson's Disease, led by the New Zealand Brain Research Institute (https://www.nzbri.org). As part of the summer scholarship, the student will have the opportunity to observe the test sessions, and will analyse speech samples of 100 people (with Parkinson's Disease and control speakers). Speech samples consist of conversation, monologue and reading tasks and will be transcribed in CLAN (MacWhinney, 2000). The speech disfluencies will be coded and compared to the participants' language and cognitive scores. The student will receive support to analyse data, perform statistical analyses in R and write a scientific summary of the research.

By completing this project, the student will gain valuable research experience in the Speech-Language Neuroscience Lab at the School of Psychology, Speech and Hearing. We intend for this project to provide data that lays the foundation for subsequent studies incorporating the results of neuropsychological tests and brain imaging, with the opportunity for further advanced study for suitable students.

We would like to acknowledge the HOPE Foundation for Research on Ageing for providing co-funding for this summer scholarship.

Specific Requirements: none specified

 

 

Project Number: 2019-104

Project Leader: Catherine Theys, Doreen Hansmann & Megan McAuliffe

Host Department: School of Psychology, Speech and Hearing

Project Title: Speech disfluencies in healthy ageing: normative data

Project outline: Speech disfluencies commonly occur in people's everyday conversations. In fluent speakers, the influence of the disfluencies on the forward flow of conversation seems minimal (Bortfeld et al, 2001). However, for people who stutter, speech disfluencies are considered to be the core characteristic of stuttered speech production, with both qualitative and quantitative differences in disfluencies reported between stuttered and non-stuttered speech production. Much of the research on speech disfluencies has been conducted within the framework of developmental stuttering, and its primary focus has therefore been on disfluencies in childhood, close to the onset of developmental stuttering. More recently, an increased focus on speech disfluencies in older adults has been observed, especially in studies on populations with acquired neurogenic disorders such as stroke, traumatic brain injury and Parkinson's disease (De Nil, Theys & Jokel, 2018). Although most of these clients with acquired disfluencies are over 65 years of age, systematic data on speech disfluencies in large groups of healthy older speakers is missing. This complicates the diagnostic and treatment processes for this population. The scholarship falls under a larger project that aims to provide normative data on disfluencies in the New Zealand context. It will give the recipient the opportunity to investigate the relationship between speech disfluencies and healthy ageing.

As part of the project, speech samples of 115 older (>65 years of age) and 30 younger participants from the Language and Ageing Corpus at the New Zealand Institute of Language, Brain and Behaviour (https://www.canterbury.ac.nz/nzilbb/) will be analysed. Support will be given to transcribe speech samples, analyse disfluency data, perform statistical analyses in R and write a scientific summary of the research.

By completing this project, the student will gain valuable research experience in the Speech-Language Neuroscience Lab at the School of Psychology, Speech and Hearing. We intend for this project to provide data that lays the foundation for subsequent studies on speech disfluency in an ageing population, with the opportunity for further advanced study for suitable students.

We would like to acknowledge the HOPE Foundation for Research on Ageing for providing co-funding for this summer scholarship.

Specific Requirements: none specified

 

 

Project Number: 2019-105

Project Leader: Megan McAuliffe, Catherine Theys, Michael MacAskill

Host Department: School of Psychology, Speech and Hearing

Project Title: Relationship between communicative participation and speech production in people with Parkinson' s disease

Project outline: Up to 90% of people with Parkinson's Disease (PD) will develop communication difficulties as the disease progresses (Miller, 2017). When you cannot make yourself understood, or it is difficult for others to understand what you have said, this negatively affects all facets of everyday life—both for the person with PD and their whānau. Our research has shown speech difficulties, cognitive impairment, and fatigue all contribute to a person's levels of participation in speaking and communication (McAuliffe et al., 2017). However, this earlier work was based on an individual's perceptions of their deficits. There have been no large-scale studies that have used objective measures of speech and cognitive function to predict communicative participation in individuals with PD. The current study leverages data collected as part of the ongoing longitudinal study of Parkinson's disease being conducted at the New Zealand Brain Research Institute (NZBRI). With speech and cognitive data already collected from approximately 100 people with PD and matched controls, we will model which speech and cognitive measures best predict communicative participation outcomes. Understanding these relationships will enable early identification of those at risk; that is, those who would benefit most from speech intervention.

The Communicative Participation Item Bank (CPIB, Baylor et al., 2014) and associated speech samples are being collected as part of a longitudinal study on PD, led by the New Zealand Brain Research Institute (https://www.nzbri.org). As part of the summer scholarship, the student will analyse existing CPIB data, and in conjunction with other summer scholars, conduct perceptual analysis of speech samples collected. The summer scholar will also have the opportunity to observe test sessions at the NZBRI. The relationship between communicative participation and objective measures of speech intelligibility and cognitive function will be examined using correlation and regression analysis. The student will receive support to analyse data, perform statistical analyses in R and write a scientific summary of the research.

By completing this project, the student will gain valuable research experience in the Speech-Language Neuroscience Lab at the School of Psychology, Speech and Hearing and at the NZBRI. We intend for the results of this project to result in a publication in 2020, and provide the opportunity for further advanced study for suitable students.

Funding for this project is sought from the Canterbury Medical Research Foundation.

Specific Requirements: A background in speech-language therapy or linguistics.

 

 

 

Project Number: 2019-116

Project Leader: Phoebe Macrae

Host Department: psychology, speech and hearing

Project Title: Variability of patients' cough sensitivity after stroke

Project outline: Cough reflex testing is used widely within New Zealand district health boards to identify patients who are at risk of pneumonia after their stroke. The test provides an indication of whether patients have any sensory processing impairments from their stroke that may prevent them from responding to food or fluid going into the airway. While the cough reflex test has been documented to reduce pneumonia rates in post-stroke patients, this research is based on an initial, one-time assessment. Anecdotal evidence suggests that clinicians are using the cough reflex test to track change in patients cough sensitivity. However, we know that when repeating the test in healthy participants, thresholds change on the second session. This phenomenon is thought to reflect habituation to the citric acid used to induce cough. No research has investigated repeated cough reflex assessment in patients to document the variability and repeatability of the test. This information is crucial to support the clinical need for monitoring change in patients cough sensitivity. Three cough reflex assessments will be completed on patients with swallowing disorder following stroke, over the course of a week. Healthy participants will serve as a control group, by which change in patient thresholds can be compared.

Specific Requirements: none specified

 

 

Project Number: 2019-117

Project Leader: Phoebe Macrae

Host Department: psychology speech and hearing

Project Title: The effect of presentation order on cough reflex testing

Project outline: Cough reflex testing is used in the hospital for stroke patients to assess if they have intact airway sensation. Patients inhale nebulized citric acid to induce a cough, which gives some indication of the likelihood that the patient will cough if they swallow food or fluid down into the lungs. If the patient fails to produce a cough response when inhaling citric acid, clinicians get an indication that this patient may be at risk of developing pneumonia, due to the lack of airway sensation. This provides critical information for effective management of these patients, as they are not safe to eat and drink without further instrumental assessment. The current method of cough reflex testing presents citric acid from low concentrations, and increases until the patient coughs. This is done in an attempt to capture the lowest concentration required to elicit a cough, thereby obtaining their sensitivity threshold. However, we have shown that this method of presentation is subject to order effects, whereby people's thresholds change after their first session. We suspect that this habituation effect is related to the order that the concentrations are presented in. In this study, we will complete two cough reflex tests on healthy participants: one using current methods of increasing concentrations of citric acid, and the other with randomly presented concentrations. Comparison of within-participant cough thresholds across methods will provide insight into the effect of concentration presentation on cough sensitivity to citric acid. This will provide crucial information on the optimal methods for accurate cough sensitivity assessment.

Specific Requirements: None stipulated.

 

 

Project Number: 2019-123

Project Leader: Phoebe Macrae

Host Department: psychology speech and hearing

Project Title: Tracking pneumonia rates of patients with swallowing disorder after stroke

Project outline: Our laboratory conducted research between 2012 and 2016 to investigate the effect of cough reflex testing (CRT) as a screening tool for stroke patients with swallowing disorder. CRT provides information regarding a patient's ability to feel and respond (cough) to food or fluid going into the lungs. This assessment therefore gives clinicians an indication of patients who are at risk of developing a pneumonia as a result of their swallowing problems. When implemented alongside a structured management protocol, CRT screening after stroke reduced pneumonia rates from 28% to 10% for the CDHB (Perry, Miles, Fink & Huckabee, 2018), reflecting major financial and health benefits of this protocol for service and patient outcomes. CRT screening and a structured management protocol of stroke patients with swallowing disorders have continued within CDHB services, however, slight methodologic variations have been implemented across providers. It is unknown if the initial reduction in pneumonia rates, seen after introduction of CRT, has been maintained. This project will involve a clinical audit of patient notes from 2016 to 2019, to assess the current pneumonia rate in patients with swallowing impairment after stroke at CDHB. Additionally, screening and management details will be recorded to assess the influence of protocol variations on any changes in pneumonia rates since 2016. This research is crucial to provide updated information on the management of Canterbury patients after stroke.

Specific Requirements: none specified.