Amy Shollenbarger

Purpose: This clinical focus article describes innovative, evidence-based approaches to teaching health literacy in communication sciences and disorders (CSD) academic programs. Method: A targeted review of the literature on health literacy strategies and instructional methods was conducted to identify comprehensive and relevant approaches for educating health care students. Selected strategies were intentionally aligned with evidence-based, active-learning practices and broader higher education pedagogical frameworks to promote student engagement, academic achievement, and long-term knowledge and skill retention. This clinical focus article was not subject to an institutional review board approval process. Results: Ten health literacy strategies that address both individual- and organizational-level competencies were identified. More than 25 instructional activities were developed to operationalize these strategies within CSD coursework. Conclusions: Embedding heath literacy instruction through active, evidence-based teaching methods provides CSD educators with a practical and adaptable framework for curricular integration. These approaches prepare future speech-language pathologists and audiologists to deliver patient-centered, health-literate care and support health literacy practices across clinical settings.

Background/Objectives: Concussions produce a wide array of symptoms that are often subtle and difficult to quantify. One such symptom involves reaction or response time (RT), consisting of perceptual latency time (LT) and movement time (MT). This pilot study examined the relationship between concussion history, mental health, and perceptual-motor performance among military veterans using a virtual reality (VR)-based assessment. The primary outcome was intraindividual variability (IIV), defined as the standard deviation of an individual’s responses across repeated trials. Methods: Of 78 veterans who volunteered, 29 (22 males, 7 females) provided complete VR data. Participants completed surveys assessing concussion and combat history, mental health issues, and suicide ideation. During VR testing, participants responded to 40 trials requiring neck rotation, arm reach, and a step toward left or right virtual targets. Associations between predictors (e.g., concussion, mental health) and VR outcomes (RT, LT, IIV) were evaluated using Receiver Operating Characteristic (ROC) Area Under the Curve (AUC) values. Results: Concussion history was the strongest predictor of performance deficits. IIV metrics were sensitive indicators of both concussion and mental health issues. Univariable analyses yielded AUC values of 0.944–0.806 all of which were statistically significant (p ≤ 0.001), and multivariable analyses produced AUCs of 0.950–0.870 all of which were also statistically significant (p ≤ 0.001). Incongruent movements and longer LT values were especially discriminative. Conclusions: Veterans with concussion and mental health histories demonstrated quantifiable perceptual-motor impairments in VR environments. Findings support VR assessment as a feasible, sensitive tool for detecting subtle residual effects of concussion.

Background/Objectives: Suicides among U.S. military veterans are alarmingly high, driven by factors such as mental health issues, combat exposure, and history of mild traumatic brain injury (mTBI)/concussion. This study aims to examine the relationship between concussion history, combat experience, and their effects on mental health issues and suicide ideation among military veterans. Additionally, this study investigates the impact of post-traumatic stress disorder (PTSD) on these variables. Methods: A total of 78 veterans (62 males, 16 females) participated in this study. Participants completed a demographic survey and the Global Well-being Index (GWI) to assess concussion history and residual symptoms. A licensed social worker interviewed the veterans using the 9-Item Patient Health Questionnaire (PHQ-9) for depression, the Generalized Anxiety Disorder survey (7 Items) (GAD-7) for anxiety, and the Columbia-Suicide Severity Rating Scale (C-SSRS) for suicide ideation. A 2 × 2 cross-tabulation analysis examined the relationships between concussion history, combat experience, and outcomes of anxiety, depression, and suicide ideation. PTSD was also assessed as both a predictor and an outcome. Statistical analyses yielded odds ratios (OR) with 95% confidence intervals (CI), Chi-square, and Cramer’s V (V) correlations along with associated p-values. Results: The combination of concussion history and combat experience strongly predicted either anxiety, depression, or suicide ideation (OR = 7.97, 95% CI: 1.70, 37.44; V = 0.334, (p = 0.003)), more than either factor alone. Combat experience was the strongest predictor of PTSD (OR = 11.12, 95% CI: 3.30, 37.47; V = 0.485, p ≤ 0.001), both individually and when combined with concussion history. PTSD strongly influenced mental health issues and suicide ideation (OR = 8.16, 95% CI: 1.74, 38.25; V = 0.339, p = 0.003). Stratification by PTSD status (positive or negative) affected the relationships between independent and dependent variables. Small cell counts resulted in a wide 95% CI for some ORs, though some statistically significant Fisher’s Exact Test results were observed. Credibility analysis using the critical prior interval (CPI) metric confirmed the intrinsic credibility of the results. Conclusions: This study provides insights into the relationships between concussion history, combat experience, and their impacts on mental health issues and suicide ideation among military veterans.

Purpose This study explored how typically developing 1st grade African American English (AAE) speakers differ from mainstream American English (MAE) speakers in the completion of 2 common phonological awareness tasks (rhyming and phoneme segmentation) when the stimulus items were consonant–vowel–consonant–consonant (CVCC) words and nonwords. Method Forty-nine 1st graders met criteria for 2 dialect groups: AAE and MAE. Three conditions were tested in each rhyme and segmentation task: Real Words No Model, Real Words With a Model, and Nonwords With a Model. Results The AAE group had significantly more responses that rhymed CVCC words with consonant–vowel–consonant words and segmented CVCC words as consonant–vowel–consonant than the MAE group across all experimental conditions. In the rhyming task, the presence of a model in the real word condition elicited more reduced final cluster responses for both groups. In the segmentation task, the MAE group was at ceiling, so only the AAE group changed across the different stimulus presentations and reduced the final cluster less often when given a model. Conclusion Rhyming and phoneme segmentation performance can be influenced by a child's dialect when CVCC words are used.

Palilalia is a fairly rare speech disorder characterized by repetitions of words, phrases, and/or sentences. The repetitions are often produced with an increasing rate and decreasing intensity. Palilalia has been associated with a variety of etiologies including Parkinson’s disease, stroke, and epilepsy. Because of the rare nature of this disorder, the literature involving the characteristics is limited and somewhat contradictive. Although the original definition involves increasing rate and decreasing intensity, some researchers have found different characteristics such as decreasing rate and increasing intensity when examining individual cases. This study adds to the literature regarding characteristics of palilalic speech in terms of rate and fundamental frequency changes taking place between the original utterance and the repeated trains. A single-subject design was utilized which involved a 42-year-old male who suffered an anoxic brain injury. Spontaneous speech samples were collected and analyzed. The results indicated significant differences in terms of rate but not fundamental frequency (f₀) when comparing the first repeated train to the original utterance. Subsequent reiterated utterances showed no significant differences in terms of either f₀ or duration.