• Uthappa, V., Wolgemuth, K., and Becerra, B. (2021). Lexical and sub-lexical auditory phonological priming effects on word reading in grades 4 and 5. Journal of Child Language Acquisition and Development, 9, 394-412. Abstract There is emerging evidence that phonology contributes to visual word recognition independent of orthography in the upper elementary grades, more so when reading less frequent words. It is unclear how lexical and different sub- lexical phonological units influence familiar word reading; therefore, we investigated the priming effects of the phonological word (repetition), syllable, rime, and phoneme units on word reading in fourth and fifth grades. We used an auditory primed and timed word reading task to determine whether different phonological units influenced the speed of reading familiar words. To examine their relationship with reading ability, we compared primed reading speeds with word and pseudo-word reading measures. The results revealed a significant lexical phonological priming effect of facilitation by repetition primes, and a difference between the direction of phoneme and rime priming. Lexical phonological priming did not relate with word or pseudo-word reading. Sub- lexical syllable priming, on the other hand, had a significant relationship with word reading. These findings show the influence of primed auditory phonological units during word reading without any overlapping orthographic prime in fourth- and fifth-grade children. Overall, lexical phonology has a definitive role of facilitation regardless of word reading ability whereas the sub-lexical phonological units appear to have a variable impact. Syllable influenced reading speed has a direct relationship with word reading. Keywords: auditory phonological priming, phoneme, syllable, rime, word reading 1. Introduction Phonological processing is an integral part of reading (Ashby, 2010; Cataldo & Ellis, 1988; Mattingly, 1972; Wagner & Torgesen, 1987). In learning to read, the ability to convert letters into their corresponding sounds, blend and later access the phonological lexicon is crucial. There is consensus that direct orthographic access to the lexicon gradually replaces the reliance on 1 Bio: Dr. Varun Uthappa A. G. is a practicing speech-language pathologist at Pristine Rehab Care, LLC., California. His research interests are in the areas of speech and language processing in typical and atypical populations. e-mail: 2 Bio: Dr. Keith S. H. Wolgemuth is a pediatric and rehabilitative audiologist who is a professor, researcher, clinical supervisor, and speech-language pathology doctoral program director at Loma Linda University in southern California. e-mail: 3 Bio: Dr. Benjamin J. Becerra is an Assistant Professor in the Department of Information & Decision Sciences at California State University, San Bernardino. He is also the co-Director for the Center for Health Equity on campus and uses data analytics, research methods, and statistics to perform research in health-related areas. e-mail: (12/2021)
  • Keck, T. and Wolgemuth, K.S. (2020).  American Sign Language phonological awareness and English reading proficiency: Exploring new relationships. Sign Language Studies, 20, 334-354.   The present study was conducted to investigate the relationship between American Sign Language (ASL) phonological awareness skills and English reading abilities in both DOD (ASL Early Learners) and DOH (ASL Later-Learners) school-age children. This study evalu- ated subjects’ ASL phonological awareness skills as measured by the ASL Phonological Awareness Test (ASL PAT) and compared those scores to performances on the Test of Early Reading Ability for the Deaf and Hard of Hearing (TERA D-HH; Reid et al. 1991), a stan- dardized test normed on children who are hard of hearing or deaf, and to the Measures of Academic Progress (MAP). Previous research has suggested that Deaf children with Deaf parents (DOD) tend to have stronger English literacy skills than deaf children with hearing parents (DOH), suggesting that early and strong foundational ASL skills may enhance the development of English reading proficiency for Deaf children using ASL as their primary language (Hermans et al. 2008; McQuarrie and Abbot 2013). Both ASL Early Learners and Later-Learners underwent ASL PAT, TERA-DHH, and MAP reading comprehension testing. All participants were tested using the Test of Nonverbal Intelligence (TONI-4) using nonverbal IQ as inclusionary criteria. Parents completed a demographic questionnaire to determine parental hearing status and the age the child was first exposed to ASL. Positive correlations between all test scores (ASL PAT,TERA- DHH, and MAP) were found for the ASL Early-Exposure Group. For the ASL Early-Exposure Group, a moderately strong positive correlation (** p ≤ .01) was found between the MAP Reading Assessment and the ASL PAT scores, and a mildly significant cor- relation between TERA-DDH and ASL PAT scores (**p ≤ .05). No positive correlations were observed for the ASL Later-Learner group on these measures. ASL Early-Exposure children (DOD) had overall stronger Eng- lish literacy skills than ASL Later-Learner children (DOH). Prior studies have established that having a strong foundation in one oral language will help in the development of a second oral language. However, research is now suggesting that this phenomenon can be cross-modal (sign language to oral language) in nature. Future studies with larger numbers of children in the ASL Later-Learner group are needed to further examine the relationship between ASL phonological awareness and English literacy skills. Tamara Keck is the director of therapy at the Sensibilities Therapy Group in Riverside, CA. Keith Wolgemuth is an associate professor in the Department of Communication Sciences and Disorders at Loma Linda University in California (02/2020)
  • Individuals with traumatic brain injury may suffer chronic cognitive–linguistic deficits in areas such as verbal working memory, which impede attainment of long-term rehabilitation goals. The purpose of this study was to determine whether individual rehabilitation programs focusing on cognitive skill building of memory and attention inthe verbal domain may provide comparable outcomes to traditional compensatory, mnemonics-based training approaches. Individuals with traumatic brain injury may suffer chronic cognitive–linguistic deficits in areas such as verbal working memory, which impede attainment of long-term rehabilitation goals. The purpose of this study was to determine whether individual rehabilitation programs focusing on cognitive skill building of memory and attention in the verbal domain may provide comparable outcomes to traditional compensatory, mnemonics-based training approaches.Method: Rhythmic language training is presented as a novel therapeutic tool for targeting discrete cognitive skills that may provide specific benefits for chronic traumatic brain injury symptoms that conventional therapy programsmay not. Standardized testing with the California Verbal Learning Test–Second Edition (Delis, Kramer, Kaplan, & Ober, 2000) was used for pre- and posttest comparisons in 2 cases presented as a series. Electroencephalography was employed concurrently with behavioral testing to examine changes in working memory for each case. Results: Posttest measurements indicated positive changes in verbal working memory occurred, but to different degrees for each participant. Conclusion: The preliminary positive effects observedin standardized testing for the experimental method of rhythmic language training warra (11/2019)

Scholarly Journals--Accepted

  • Kawasaki-Knight, L. and Wolgemuth, K. Integrated approach on the acquisition of phonological targets in 4-to-6 year old children to be published in August 2021 in the Journal of Childhood Language Acquisition and Development.   Abstract Purpose: The purpose of this study was to examine the effects of an integrated approach on the acquisition of phonological targets in 4-to-6-year-old children enrolled in maximum oppositional therapy (MOT). MOT is an alternative approach to traditional phonological intervention designed to promote systemic changes to untreated phonemes from the same or different manner class. Method:  Two groups of children 4 to 6 years of age underwent MOT treatment, with one of the groups also receiving concurrent training in the use of self-cueing strategies (using tactile gestures phonemic cues) to promote self-generated feedback. MOT targeted phonemes with maximal contrasts in placement, manner and voicing in two groups of children. One group also received instruction in the use of two tactile cues to self-monitor production of phonological targets. A comparison of therapy duration required to meet target acquisition criteria was made between the two groups. Results: MOT and tactile self-cues demonstrated larger gains in phonological target acquisition over a 10-week period. The tactile self-cueing MOT group achieved target accuracy in less time across three phonemic contexts. The integrated approach using MOT resulted in an increase in phonological accuracy, including untreated phonemes across manner of classes. Conclusions: This study offers preliminary support and extends prior research of a novel integrated phonological intervention approach in clinical practice. The results suggest potential increases in phonological self-awareness and accuracy, reduced duration of intervention, and an increase in phonological target acquisition. Further research in this area is merited.   Key words: cues, self-cueing, integrated intervention, maximal opposition treatment approach, phonological processes (08/2021)

Scholarly Journals--Published

  • Wood, T. and Wolgemuth, K.S. (2020). Top-Down vs. Bottom-Up: A Case Series in Verbal Working Memory Treatments for Chronic Traumatic Brain Injury Deficits. Perspectives of the ASHA Special Interest Groups (SIG 19), 4, 199-1213. (02/2020)
  • Wolgemuth, K.S., Hughes, L.H., Fothergill, D.F., and Lapsley Miller, J. (2009).  Effects of Carbon Dioxide and Oxygen Levels on Auditory Sensitivity and Frequency Tuning as Measured by the Stimulus Frequency Otoacoustic Emission Test.  Naval Submarine Medical Research Laboratory Technical Report NSMRL /50204/TR-2009-1274.   This research has both scientific and Naval significance.  All Navy divers are at risk for carbon dioxide toxicity during diving operations.  Navy special forces and explosive ordnance disposal divers, however, can potentially be affected by both hyperoxia (increased amount of oxygen in bodily tissues), and hypercapnia (increased amount of carbon dioxide in bodily tissues), or a combination of the two, when using closed circuit diving systems breathing 100% oxygen.  Animal studies have shown that significant increases in arterial oxygen levels result in significantly higher oxygen levels in the inner ear, potentially causing an increase in reactive oxygen species (ROS) within this organ.  Exposure to hazardous noise levels in air has also been shown to cause a significant increase in ROS within the inner ear, which directly damages the outer hair cells in the inner ear.  However, there is virtually nothing known about the single and combined effects of hyperoxia and hypercapnia on the sensitivity and tuning capabilities of the human inner ear.  This study used an objective (physiological) test to better understand the effects of hyperoxia and hypercapnia on the sensitivity and tuning capabilities of the human inner ear.   Gas mix conditions high in oxygen and carbon dioxide appear to have an effect on cochlear processing as measured by the stimulus frequency otoacoustic emission test (SFOAE).  In eight of the 10 participants tested, 29% of SFOAE amplitudes decreased greater than two standard deviations (SDs) from control (air) mean amplitudes and in two of the participants SFOAE amplitudes increased greater than 2 SDs.  These deviations from normal mean SFOAE amplitudes in normal hearing participants suggests that increased oxygenation secondary to hyperoxia and hypercapnia in the cochlea does have an effect on outer hair cells.  Increased oxygenation did not appear to have a significant effect on SFOAE phase delay or auditory tuning.  The effect seen was for individual participants serving as their own controls and SFOAE response amplitude was highly correlated with end tidal carbon dioxide (FETCO2) measurements.  This implies that the greater the oxygenation of the cochlea, the greater the effect, incremental or decremental, on the amplitude of the SFOAE.  There were only 10 participants in this study, which limited interpretation and generalization of the results.  Further study of the effects of increased oxygenation on the cochlea is recommended since Navy Special Forces divers, saturation divers, and diving medical technicians are exposed to high levels of oxygen in the performance of their missions.          (06/2009)
  • Marshall, L., Lapsley Miller, J., Heller, L., Wolgemuth, K., Hughes, L., Smith, S., and Kopke, R. (2009).  Detecting incipient inner-ear damage from impulse noise with otoacoustic emissions. Journal of the Acoustical Society of America, 125 (2), pp. 995-1013. Audiometric thresholds and otoacoustic emissions OAEs were measured in 285 U.S. Marine Corps recruits before and three weeks after exposure to impulse-noise sources from weapons’ fire and simulated artillery, and in 32 non-noise-exposed controls. At pre-test, audiometric thresholds for all ears were 25 dB HL from 0.5 to 3 kHz and 30 dB HL at 4 kHz. Ears with low-level or absent OAEs at pre-test were more likely to be classified with significant threshold shifts STSs at post-test. A subgroup of 60 noise-exposed volunteers with complete data sets for both ears showed significant decreases in OAE amplitude but no change in audiometric thresholds. STSs and significant emission shifts SESs between 2 and 4 kHz in individual ears were identified using criteria based on the standard error of measurement from the control group. There was essentially no association between the occurrence of STS and SES. There were more SESs than STSs, and the group of SES ears had more STS ears than the group of no-SES ears. The increased sensitivity of OAEs in comparison to audiometric thresholds was shown in all analyses, and low-level OAEs indicate an increased risk of future hearing loss by as much as ninefold. © 2009 Acoustical Society of America. DOI: 10.1121/1.3050304 PA (02/2009)
  • Wolgemuth, K.S., Cudahy. E., and Schwaller, D. (2008).  Underwater and dive station work-site noise surveys.  Naval Submarine Medical Research Laboratory Technical Report, NSMRL/50204/TR-2008-1255. Previous work performed by the Naval Submarine Medical Research Laboratory (NSMRL) had developed in-water permissible continuous noise exposure guidance.  Work performed by the Navy Experimental Diving Unit (NEDU) measuring in-water noise levels produced by in-water tools to develop permissible exposure levels based upon applying in-air guidance and temporary threshold shift (TTS) data.  This study extends this previous work by obtaining in-water and in-air noise measurements and a total noise dose for Navy divers during actual diving operations using a portable sound level meter system capable of both in-water and in-air measurements.  Noise measurements were used to calculate Navy Occupational  Exposure Limits (NOEL) and doses for both helmeted and Self-Contained Underwater Breathing Apparatus (SCUBA) divers.  The results of both in-water and in-air measurements were used to calculate total noise dose and these dosages were compared to existing guidance. In-water measurements were obtained for several tools/equipment both in water and in air during diving operations. The results showed that in some instances in-water noise dose was substantially higher than in-air dose for the work-shift, whereas in other instances both in-water and in-air noise doses were high and both of these scenarios placed the diver at risk for hearing loss.  There were also instances where in-water noise dose was negligible and in-air dose was very high.  Valid and reliable NOEL and Total Noise Doses were calculated for several different types of diving operations and in two instances (one salvage, one ship’s husbandry) on-site, in-water permissible exposure limits were provided to Diving Supervisors for non-Navy tested tools to be used during the diving operations.  Divers from two different dive lockers were trained to perform measurements independently using the portable sound level meter system to demonstrate that working divers could perform valid and reliable measurements using the same procedures carried out by research personnel.    CONCLUSIONS: A valid and reliable procedure that Navy divers can be trained to perform has been established to measure and sum in-water and in-air noise levels to obtain a total noise dose, and these measurements can be easily compared to existing in-water and in-air guidance. The results indicate that Navy divers are potentially at risk for suffering noise-induced hearing loss from in-water and in-air exposure, both individually and in combination during existing diving operations.  In air, topside noise exposures can be mitigated substantially by the use of hearing protection.  Previous work has also established that the MK-21 diving helmet does provide effective sound attenuation in the water, particularly in the high frequency range of human hearing.  (03/2008)
  • Wolgemuth, K.S., Lutrell, W., Kamhi, A.S., and Wark, D.J. (1995).  The effectiveness of the Navy’s hearing conservation program.  Military Medicine, 160, (5): 219-222. (06/1995)

Non-Scholarly Journals

  • Bible, M., Wolgemuth, K.S., and Rogers, B. (2000).  Navy hearing conservation in action:  Mitigating risk.  Navy Medicine, 92, 4, 16-21. (06/2000)