Bellon-Harn (2011)

EBP THERAPY ANALYSIS

Single Subject Design

 

SOURCE:  Bellon-Harn, M.  (2011).  Targeting prosody:  A case study of an adolescent.  Communication Disorders Quarterly, 2 (2), 109-117.

 

REVIEWER(S):   pmh

 

DATE: 7.09.12

 

ASSIGNED OVERALL GRADE:  C-

 

TAKE AWAY:  The results of this case study indicate that the intervention, which involves explicit targets and meta awareness procedures, has promise for adolescents with prosodic problems.         

                                                                                                           

1.  What was the focus of the research? Clinical Research

 

2.  What type of evidence was identified?                              

a.  What  type of single subject design was used?  Case Study:  Description with Pre and Post Test Results (SSD-PPT)

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

                                                                                                           

3.  Was phase of treatment concealed?                                 

a.  from participants?  No                             

b.  from clinicians?  No                                 

c.  from data analyzers?  No                        

 

 

4. Was the participant adequately described?  Yes           

a.  How many participants were involved in the study?  1      

b.  The following characteristics/variables described:

•  age:   13 years                                                  

  •  gender:  male                                                                          

•  language skills:  see 4c below

•  history:  history of severe speech/language problems but no other diagnosis

c.  Were the communication problems adequately described?  Yes          

List: atypical prosody, residual articulation errors, atypical transitions between syllables, inconsistent use of to and selected morphosyntactic forms,  social/communication problems

                                                                                                                       

5.  Was membership in treatment maintained throughout the study?  Not applicable

 

6.  Did the design include appropriate controls? No, this was a case study.

a.  Were baseline data collected on all behaviors?  There were pre-intervention probes but they were administered only 1 time and were not baselines.

b.  Did probes include untrained data?  Yes                        

c.  Did probes include trained data?  No

d.  Was the data collection continuous?  No  

e.  Were different treatment counterbalanced or randomized?  Not appllcable                          

 

7.  Were the outcomes measure appropriate and meaningful?  Yes

a.  List the outcomes of interest (dependent variable):

Outcome #1.  Receptive and expressive performance on Prosodic

     Protocol

  Outcome #2.  Words per utterance in conversational sample

  Outcome #3.  PCC during conversational sample

  Outcome #4.  % of occurrence of increased speaking rate

  Outcome #5.  % of occurrence of reduced/equal stress

  Outcome #6.  % of occurrence of denasal speech

  Outcome #7.  % of occurrence of inappropriate loudness

  Outcome #8.  Number of morphosyntactic errors

b.  The outcome measures that are  subjective are #1-8                  

c.  The outcome measures that are objective:  none              

d.  The outcome measure reliable data are

  Outcome #1 =  raters achieved consensus

  Outcome #2 = 95%

  Outcome #3 = 92%

  Outcome #4 = 87%

  Outcome #5 = 92%

  Outcome #6 = 95%

  Outcome #7 = 100%

                                     

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

Yes:   #1, 2, 4, 5, 7

No:  #3, 6

Unclear #8

                                                           

9.  Overall quality of improvement, if any: moderate           

a.  Was baseline low and stable? NA

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

c.  Does inspection of data suggest that the treatment was effective?  Yes, moderately effective                              

                                                                                                                

10.  What was the magnitude of the treatment effect? Not provided

                                           

11.  Was information about treatment fidelity adequate?  Not Provided

 

                                              SUMMARY OF INTERVENTION PROCEDURES

 

PURPOSE:  to investigate the effectiveness of an explicit approach to improving prosody

 

POPULATION:  adolescent with atypical prosody

 

MODALITY:   expressive

 

ELEMENTS OF PROSODY TARGETED:  pitch, loudness, stress, resonance, tempo/rate

  

OTHER ASPECTS OF LANGUAGE TARGETED:  articulation (PCC), resonance (denasality); morphosyntax

 

DOSAGE:  24  sessions over 2 semesters,  2 times a week, each session of Semester1—30 minutes explicit prosody therapy, 20 minutes  group therapy; Semester2— 40 minutes of Summer program devoted to explicit prosody intervention,  group therapy  for 1 hour (rest of time language, literacy, social interaction)

 

ADMINISTRATOR:  SLP

 

STIMULI:  auditory, visual,

 

GOAL ATTACK STRATEGY:  cyclic  with each prosodic component/feature (pitch, loudness, stress, resonance, tempo/rate) targeted for 4 consecutive sessions

 

MAJOR COMPONENTS:

 

•           See appendixes provided by Bellon-Harn for numerous activities for each of the prosodic features/components

 

•           Techniques:  meta-awareness of prosody (defining/describing, linking the features/components to communication), discrimination

 

 

 

 

 

 

DEPENDENT VARIABLE(S)/OUTCOME(S):

 

1.  Receptive and expressive performance on Prosodic Protocol

2.  Words per utterance in conversational sample

3.  PCC during conversational sample

4.  % of occurrence of increased speaking rate

5.  % of occurrence of reduced/equal stress

6.  % of occurrence of denasal speech

7.  % of occurrence of inappropriate loudness

8.  Number of morphosyntactic errors

 

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