The objectives of the present dissertation were: (1) determine the relationships between time use in physical vs social leisure activities (PLA - SLA), and cognitive vs emotional leisure activities (CLA - ELA) by older adults age cohort (60-69, 70-79 and 80-plus yrs.); (2) ascertain the role of sex in moderating the relationship between time use in PLA-SLA and CLA-ELA by older adults age cohort; and (3) assess how employment status mediates the relationship between time use in PLA-SLA and CLA-ELA by older adults age cohort with moderation by sex. Secondary data was obtained from the 2019 American Time Use Survey database. Applying a cross-sectional design, data were analyzed using a linear regression model in SPSS version 27 and PROCESS Macro with Hayes Model 1 and 59. We identified the extent of the conditional indirect moderation effect of sex and the indirect employment status mediation effect moderated by sex in the relationship between PLA-SLA and CLA-ELA by older adult age cohorts. An index of moderated mediation was used to test the significance of each effect. The 80-plus yrs. cohort SLA time use was greater than in PLA across cohorts. Sex moderation showed a stronger effect in men by substantially decreasing their …

Tinnitus, or the perception of sound in the absence of external acoustic stimuli, is a common condition that impacts approximately 10-15% of the United States population, with similar prevalence rates reported in other countries. Current diagnosis of tinnitus relies on case history and audiometric testing, which depend on responses provided by the patient. To date, there is no objective test that can be used for tinnitus diagnosis, despite the high prevalence and significant financial impacts of this condition. Cortical auditory evoked potentials have shown promise in their ability to assess not only the integrity of the auditory system, but also higher level preattentional and cognitive processing. For this study, the pitch-matched tinnitus frequency was used to evoke an auditory late response. Double oddball paradigms with the tinnitus frequency as the deviant stimuli were also used to evoke a mismatch negativity and P300 to determine where along the auditory pathway biomarkers of tinnitus may exist. The results of this study suggest that when the tinnitus frequency is incorporated into paradigms designed to produce cortical auditory evoked potentials, differences exist between participants with tinnitus and matched controls without tinnitus. Individuals with tinnitus exhibit smaller MMN amplitudes and area under the curve and …

Individuals diagnosed with autism spectrum disorder often experience difficulty during speech-in-noise (SIN) processing tasks. However, it remains unclear how behavioral and cortical mechanisms of auditory processing explain variability in SIN performance in adults with ASD and their neurotypical counterparts. The proposed research explored variability in SIN as it relates to behavioral, perceptual, and objective measures of auditory processing. Results showed significant differences between groups in SIN thresholds. In addition, neurotypicals outperformed the ASD group on measures of sustained auditory attention characterized by reduced impulsivity, increased inhibition, and increased selective auditory attention. Individuals with ASD showed decreased acceptance of noise as compared to neurotypical peers. Overall, results highlighted auditory processing deficits in individuals with ASD that contribute to SIN performance.

To meet the growing demand for community-based adult services (CBAS) adult day health care (ADHC) programs, it is important these programs make the necessary modifications in their systems of care to embrace a person-centered care (PCC) model. This study was designed to create an assessment to determine a community-based CBAS/ADHC program's readiness to meet the new federal standards as determined by the program's current operational evidence and by center participants', their families' as well as staff's perspectives. This was measured by self-report of access to the community, choice of setting, individual rights, autonomy and independence, choice of services and supports, center accessibility as well as their needs and preferences in the practice. Results will assist similar CBAS/ADHCs in identifying the necessary modifications within their own program to continue as a certified licensed entity and remain a viable agency.

Postlingually deafened cochlear implant (CI) adults have large variability in speech perception abilities. While CIs are one of the most successful neural prosthetic devices, they are not able to adequately provide fine structure cues which results in a degraded signal for the listener to interpret. While behavioral measures remain the gold standard for determining speech perception abilities, an objective measure is needed for patients who are unable to provide reliable behavioral responses. Behavioral, cognitive, and neural measures were collected in this study to identify potential neural biomarkers that correlate with speech perception performance. Behavioral experiments evaluated participants' abilities to identify, discriminate, and recognize words as well as sentences in quiet and in noise. Cognitive measures were assessed to determine the roles of attention, impulse control, memory, and cognitive flexibility on speech recognition. Auditory event-related potentials (ERP) were obtained with a double oddball paradigm to produce the mismatch negativity (MMN) response, which has been shown to have associations with phonetic categorical perception at the group level. The results indicated that executive function is highly predictive of speech performance and that the MMN is associated with categorical perception at the individual level. These findings are clinically relevant to determining appropriate follow-up care …

Loss is an inevitable part of life. The actual process of grieving is unique and can be hard to quantify. Grief interventions can address the relationship quality and attachment status between the griever and the deceased and how memories are interpreted and carried into the present and future. This three-essay dissertation explores variations of loss and the factors that contribute to a resilient recovery.

There remains a dearth of literature that explains with no ambiguity, the complex relationships that exist between adverse childhood experiences (ACEs) and resilience, as well as school engagement and school in individuals with a co-occurring diagnosis of autism spectrum disorder (ASD) and attention deficit hyperactive disorder (ADHD). This study seeks to fill this missing gap in the literature. These research questions were answered using a retrospective cross-sectional study design of national secondary data from the National Survey of Children's Health (NSCH). The findings revealed that the more ACEs an individual had, the less they were likely to engage and succeed in school. A similar finding was obtained for resilience as individuals with more ACEs showed less resilience. However, counterintuitively to the hypothesis of the project, having both ASD and ADHD does not necessarily make these outcomes worse compared to having a singular diagnosis of either ASD or ADHD. The significance of this study is that it informs rehabilitation counselors as well as educators on the need for early identification of individuals with ASD and ADHD with a background of ACEs and commence interventions early enough to ensure they are more resilient and obtain improved success in school-related activities as well …