SOURCE: Samuelsson, C. (2011). Prosody intervention: A single subject study of a Swedish boy with prosodic problems. Child Language Teaching and Therapy, 27 (1), 56-67.
DATE: 7.03.12 ASSIGNED OVERALL GRADE: C+
TAKE AWAY: promising support for prosodic intervention (in Swedish) with a child at the word and phrase level.
1. What was the focus of the research? Clinical Research
2. What type of evidence was identified?
2a. What type of single subject design was used?: Single Subject Experimental Design with Specific Client: Multiple Baseline–(SSED-MB)
2b. What was the level of support associated with the type of evidence? A-
3. Was phase of treatment concealed?
3a. from participants? No
3b. from clinicians? No
3c. from data analyzers? Yes
4. Were the participants adequately described? Yes
4a. How many participants were involved in the study? 1
4b. Were the characteristics/variables actively controlled or described?
The following characteristics were described:
• age: 4 years-6 months
• gender: M
• expressive language: WNL (nonprosodic aspects)
• receptive language: WNL (nonprosodic aspects)
4c. Were the communication problems adequately described?
Yes: prosodic disorder
5. Was membership in treatment maintained throughout the study? Yes
5a. If there was more than one participant, did at least 80% of the participants remain in the study? NA
5b. Were any data removed from the study? No
6. Did the design include appropriate controls?
6a. Were baseline data collected on all behaviors? Yes; 3 behaviors 3 times over 9 weeks; acoustic and perceptual measures from spontaneous samples: single pre-intervention sample
6b. Did probes include untrained data? Yes
6c. Did probes include trained data? No
6d. Was the data collection continuous? No
6e. Were different treatment counterbalanced or randomized? NA
7. Were the outcomes measure appropriate and meaningful? Yes
7a. List the outcome of interest (dependent variable):
1. word level scores from author’s comprehensive assessment of prosody measure
2. phrase level scores from author’s comprehensive assessment of prosody measure
3. discourse level scores from author’s comprehensive assessment of prosody measure
4. perceptual rating of spontaneous speech using an adaptation of Darley et al. (1969)
5. acoustic measures of spontaneous speech: Fo and pitch range.
Note: it is not clear if #1 & 2 were statistically analyzed independently
7b. Are the outcome measures subjective? Yes for outcomes #1-4
7c. Is the outcome measure objective. Yes for outcome #5
7d. Are the outcome measure reliable? Yes
• for outcome #1-3: 0.95
• for outcome #4: 0.94
• for outcome #5: NA
8. Did the target behavior improve when it was treated? Yes
9. Overall quality of improvement, if any: Limited
9a. Was baseline low and stable? Variable
• Outcomes #1, 2: yes
• Outcome #3: no
• Outcomes #4-5: NA
9b. What was the percentage of nonoverlapping data (PND)? NA
9c. Does inspection of data suggest that the treatment was effective? Yes
10. What was the magnitude of the treatment effect? [check measure, list results (r), provide interpretation(i)]
• results: magnitude of effect datanot provided
• significance: Significant differences (p≤ 0.05): word level, phrase level; mean Fo,; small N for t-tests
• interpretation: clinical significance is not clear because there were no EBP measures
11. Was information about treatment fidelity adequate? Yes
SUMMARY OF INTERVENTION PROCEDURES
PURPOSE: to investigate the effectiveness of a program to improve the prosody of a child.
POPULATION: child (4-06 years); diagnosed as having a prosody problems (word, phrase, discourse levels) in Swedish (his native language). He was WNL on other measures of language
ELEMENTS OF PROSODY TARGETED: Invention focused on producing meaning prosodic contrasts at the word and phrase level by modifying:
• vowel length/duration
• word accent/stress
• word stress placement (early vs. late)
• phrasal stress and intonation
OTHER ASPECTS OF LANGUAGE TARGETED (Dependent variable): none
OTHER NONLANGUAGE TARGETS: none
DOSAGE: 6 weeks; 6 sessions, 60-minutes a session
STIMULI: auditory and visual
GOAL ATTACK STRATEGY: not clear
• Techniques: imitation, modeling, discrimination, real and nonsense words, minimal pairs, self-monitoring, responding to questions; homework
• P listens to C’s model of Swedish words and imitates acceptable rhythm and intonation
• C records P’s productions and P identifies the word he was attempting.
• C presents P with pictures minimal pair words that differ only in prosodic pattern. P attempts to produce the words contrastively and correctly.
• P imitates C’s production of nonsense phrases in which C varies the placement of stress and intonation. P listens to and judges the accuracy of his productions.
Example (stressed syllable is In bold):
• P imitates C’s production of (real) phrases in which C varies the placement of stress and intonation. P listens judges the accuracy of his productions.
Example (stressed syllable/syllables in bold):
1. I found your book in the box.
2. I found your book in the box.
3. I found your book in the box
4. I found your book in the box.
5. I found your book in the box.
6. I found your book in the box.
• C asks questions to elicit the sentences practiced in the previous step. P listens to and judges the accuracy of his productions.
QUESTION #1: Who found the book? TARGET: I found your book in the box.
QUESTION #2: You what the book? TARGET: I found your book in the box.
QUESTON #3: Whose book did you find? TARGET: I found your book in the box.
QUESTION #4: What did you find of mine in the box? TARGET: I found your book in the box.
QUESTION #5: You found the book under the box? TARGET: I found your book in the box.
QUESTION #6: What did you find the book in? TARGET: I found your book in the box.
• C regularly assigned homework.