Jones et al. (2009)




Single Subject Design


SOURCE:  Jones, H. N., Plowman-Prine, E. K., Rosenbek, J. C., Shrivastay, R., & Wu, S. S.  (2009).  Fundamental frequency and intensity mean and variability before and after two behavioral treatments for aprosodia.  Journal of Medical Speech-Language Pathology, 17 (1), 45-52.


REVIEWER(S):   pmh


DATE: 7.08.12                                              ASSIGNED OVERALL GRADE:  C+


TAKE AWAY:  Provides acoustic evidence supporting change in emotional prosody using either of Rosenbek’s 6 step continuum programs:  Imitative or Cognitive-Linguistic.



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?  Single Subject Experimental Design with Specific Client:  ABAC(A)

•  involved retrospective data analysis from  14 SSED studies presented in Rosenbek et al. (2006)

•  investigatore selected these 3 Ps because good audios were available and perceptual analysis revealed progress for both treatments.  It was not clear if these were the only Ps who met criteria.

b.  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 analyzer?  No



4. Were the participants adequately describedYes

a.  How many participants were involved in the study?  3      

b.  The following characteristics/variables were described

•  age:  55-87 years

•  gender:  1m, 2f                                                                                        

•  educational level of participant:  G12- Associate Degree


•  right handed:  all

•  occupations:  varied

•  medications:  1 no; 2 yes

•  right cerebral hemisphere damage:  all

•  time post-onset:  9 months- 2 years

c.  Were the communication problems adequately described?  Yes          

•   disorder type:  expressive aprosodia; noted that expressive aprosodia was more severe than receptive aprosodia



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

a.  If there was more than one participant, did at least 80% of the participants remain in the study?  No

b.  Were any data removed from the study?  No:  but this was a retrospective analysis of acoustic data in which only 3 of 14 Ps were selected.


6.  Did the design include appropriate controls?  Yes

a.  Were baseline data collected on all behaviors?  Yes                   

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?  Yes in the original study



7.  Were the outcomes measure appropriate and meaningful? Yes

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

•  Outcome #1:  Fo mean

•  Outcome #2:  Fo variability

•  Outcome #3:  Intensity mean

•  Outcome #4:  Intensity variability                                               

NOTE: #2 and #4:  Investigators used # of different measures for each.  See paper for specific information

b.  Which outcome measures are subjective:  None

c.  Which outcome measures are objective:   #1-4

d.  Are the outcome measures reliable?  Not provided



8.  Did the target behavior improve when it was treated?  Yes all 4 outcomes improved for both intervention approaches

•  for Imitative Approach:  #1, 2 were better than Cognitive-Linguistic Approach

•  similar for both Imitative and Cognitive-Linguistic Approaches:  #3

•  for Cognitive-Linguistic Approach:  #4 was better than Imitative


9.  Overall quality of improvement, if any:  Limited

a.  Was baseline low (or if appropriate high) and stable?  Unclear, only 2 baselines provided

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

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



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



11.  Was information about treatment fidelity adequate?  Not Provided



NOTE:  Data were also provided regarding acoustic differences in the four sentence types (neutral, happy, sad, angry).

                                            SUMMARY OF INTERVENTION PROCEDURES



PURPOSE:  to investigate acoustic measures of change in response to Rosenbek’s 6 step continuum


POPULATION:  expressive aprosodia


MODALITY: expressive


ELEMENTS OF PROSODY TARGETED:  emotional/affective prosody


DOSAGE:  Each treatment consisted of 20  1-hour sessions administered over a month



STIMULI:  Not provided.  See Rosenbek et al. (2006)


GOAL ATTACK STRATEGY:  Not provided.  See Rosenbek et al. (2006)


MAJOR COMPONENTS:  Not provided.  See Rosenbek et al. (2006)




1.  Fo mean

2.  Fo variability

3.  Intensity mean

4.  Intensity variability


•           #2 and 4:  # of different measures for each.  See paper for specific information.




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