Shea & Tyler (2001)

EBP THERAPY ANALYSIS for

Single Subject Design

 

SOURCE:  Shea, R. L., & Tyler, A. A. (2001).  The effectiveness of a prosodic intervention on children’s metrical patterns. Clinical Teaching and Therapy, 17, 55-76.

 

REVIEWERS:  Jessica Jones (Minnesota State University, Mankato), Amy Anderson (Minnesota State University, Mankato), pmh

DATE: 10.28.12

ASSIGNED OVERALL GRADE:   C

 

TAKE AWAY:  Limited support for this cognitive-linguistic approach to teaching  w-S stress patterns in multisyllable words and in phrases.

 

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:  Multiple Baseline

2b.  What was the level of support associated with the type of evidence? 

Level = A-

                                                                                                           

3.  Was phase of treatment concealed?

a.  from participants? No

b.  from clinicians? No

c.  from data analyzers? No

 

4.  Were the participants adequately described?  Yes

a.  How many participants were involved in the study?  2

b.  Were the following characteristics/variables actively controlled or described?

NOTE:  The authors referenced selection criteria.  They seem to be the following:

–  at least 1 SD below the mean of the Preschool Language Scale

     –  MLU from 1.5-2.5

–  severe phonological problems based on Percent Consonants Correct

–  produced articles in less than 15% of the obligatory contexts

They also described the characteristics of the Ps:

•  age:  3;7 and 3;1

•  cognitive level:  WNL for both   

•  overall language score: (Preschool Language Scale standard score)  85; 66

•  receptive language:  (Preschool Language Scale standard score for comprehension)  at least 1 SD below the mean

•  MLU: 1.6 and 1.7

•  language/dialect:  Standard American English                                            

c.  Were the communication problems adequately described? Yes

•  List the disorder types:  SLI and phonological impairments

•  List other aspects of communication that were described:

–  Percent Consonants Correct:  18%; 45%

–  occurrence of articles in obligatory contexts:  8%; 10%

–  severity level of phonological impairment:  severe—both

–  speech patterns:  P1 = multiple substitution errors due to phonological processes;  P2 = multiple phonological processes and excessive jargon

5.  Was membership in treatment maintained throughout the study:  Yes

a.  If there was more than one participant, did at least 80% of the participants remain in the study?  Yes

b.  Were any data removed from the study?  No

 

6.  Did the design include appropriate controls?  Yes

a.  Were baseline data collected on all behaviors?  Yes

b.  Did probes include untrained data?  Yes.  They were clearly generalization probes.

c.  Did probes include trained data?  No

d.  Was the data collection continuous?  No

e.  Were different treatment counterbalanced or randomized?  NA

 

7.  Were the outcomes measure appropriate and meaningful?  Yes

7a.  List the outcome(s) of interest (dependent variable) next to a number; add numbers as appropriate:   (S = strong syllable; w = weak syllable)

1.  production of Sw and SwS words and phrases

2.  production of wS and wSw words

3.  production of wS and wSw phrases

b.  List numbers of the outcomes that are subjective:  all

c.  List numbers of the outcomes that are objective:  none

d.  List the number of the outcome measures that are reliable: all (phrases were not analyzed for P2 due to intelligibility issues)

e.  Data supporting reliability outcome measures; overall interobserver reliability:  .89

 

8a.  Did the target behavior improve when it was treated?  Variable

 b.   For each of the outcomes, list the overall quality of improvement as strong, moderate, limited, ineffective, contraindicated:  (The numbers should match the numbers in item 7a.)

#1 for P1 limited; for P2 moderate

#2 for P1 strong; for P2 moderate after treatment, at 1 week follow up, ineffective

#3 for P1 moderate; for P2 ineffective

9.  Description of baseline:

a.  Were baseline data provided? Yes, for P1 there were 2 data collections prior to initiation of therapy for each outcome and for P2 there were 3 data collections prior to initiation of therapy for each outcome.  Subset generalization probes also were collected.

b.  Was baseline low (or high, as appropriate) and stable?  For outcome

#1 baseline was low and stable for both Ps

#2 baseline was low and stable for both Ps

#3 baseline was low and stable for both Ps

c.  What was the percentage of nonoverlapping data (PND)?  Not provided

10.  What was the magnitude of the treatment effect? NA

 

11.  Was information about treatment fidelity adequate? Not Provided

  

OVERALL RATING OF THE QUALITY OF SUPPORT FOR THE INTERVENTION:  C

 

                                                                        SUMMARY OF INTERVENTION

Cognitive Linguistic Approach to Teaching Stress

 

PURPOSE:  to produce wS multiple words and phrases

POPULATION:  children with SLI and phonological problems

 MODALITY TARGETED:  expression

 ELEMENTS/FUNCTIONS OF PROSODY TARGETED:  stress

DOSAGE: 3 times a weeks, 45 minute individuals sessions, for 4 months

 ADMINISTRATOR:  SLP 

STIMULI: picture cards, manipulatives, children’s literature, flannel board cutouts, drum, auditory cues, tactile cues

GOAL ATTACK STRATEGY:  vertical; each phase worked on for 4 sessions

 

MAJOR COMPONENTS:  each phase worked on for 4 sessions; phase 3 could be repeated

Phase I—Conceptualization of Big/Loud and Small/Little

•  C introduced the concept of big and little as analogies for loud and soft.  C used felt board stories with big and little characters.

•  C arranged felt characters in varying patterns of big/loud and little/small

•  P produced vocalizations associated with the size of the felt representation (i.e., big item = loud; small item = soft)

Phase II– SwS

•  C displayed a picture card with representations of a big item, followed by a small item, followed by a big item

•  C and P talked about the SwS patterns as well other patterns.

•  C and P used a drum to represent SwS and other patterns.

•  C presented action+ object  picture card (roll the ball, push the chair, etc.)

•  C and P discussed the action + object picture cards.

•  C modeled a SwS phrase associated with action picture cards.

•  (The procedures did not mention that that P imitated the C’s models.)

Phase III – wS

•  C and P reviewed the concepts of big and little associated with vocalizations, items, and pictures of wS patterns representing article + noun (the cat, the girl, the boy).

•  C presented a variety of activities designed to elicit production of the Sw stress pattern for article + noun.

•  C provided auditory bombardment to facilitate production of the target and encouraged the P to produce the target.

Phase III Repeat –wS

•  If P did not achieve 90% accuracy during Phase III and time allowed, Phase III was repeated.

——————————————————————————————- 

NOTE:  The investigators  provided word and phrase stimuli in the appendix.

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