Samuelsson (2010)

Single Subject Research

Source: Samuelsson, C. (2010) Prosody intervention for children. In H. Roddam & J. Skeat (eds.) Embedding evidence-based practice in speech and language therapy: International examples (pp. 189-194). Chichester, UK: Wiley-Blackwell .

 

Reviewer(s):   pmh

 

Date:  8.16.13

 

Overall Assigned Grade:  C (The brevity of chapter resulted in the omission of much information.)

Level of Evidence:  A-

 

Take Away:  This very brief chapter consists of a description of a strategy for decision-making about prosodic intervention in a context of having little or no evidence supporting a particular approach. A brief presentation of a single subject experimental design study was provided illustrating the process.

 

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  – Multiple Baseline       

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 analyzers?  No

 

4.  Were the participants adequately described?  Yes

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

b.  The following characteristics were described

•  age:  4 years

•  gender:  m

•  expressive language:  WNL

•  receptive language:  WNL

•  Language:  Swedish

c.  Were the communication problems adequately described?  Yes          

•  The disorder types were  phonological disorder, prosodic disorder

•  Other aspects of communication were

–  problems with prosodic production at the word level, phase level, and discourse level on an instrument designed to assess Swedish prosody.

  –  prosodic perception was stronger than prosodic production 

                                                                                                                       

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?  Not  applicable

b.  Were any data removed from the study?  No. Data were not removed. However, due to the brief nature of the chapter, only summary statements were made. No specific data were reported.

 

6.  Did the design include appropriate controls?  Unclear. This was only a brief presentation.

a.  Were baseline/preintervention data collected on all behaviors?  Yes

b.  Did probes/intervention data include untrained data?  Yes

c.  Did probes/intervention data include trained data?  No

d.  Was the data collection continuous?  No

 

7.  Were the outcomes measure appropriate and meaningful?  Yes

a.  The outcomes were

  OUTCOME #1:  To improve prosody at the word level on a specific assessment instrument

  OUTCOME #2:  To improve prosody at the phrase level on a specific assessment instrument

  OUTCOME #3:  To improve prosody at the discourse level on a specific assessment instrument

b.  All of the outcomes were subjective.

c.  None of the outcomes were objective.

d.  None of the outcomes were associated with reliability data.

 

8.  Results:

a.  Did the target behavior improve when it was treated?  Yes. No specific data were reported. The characterizations were descriptive and provided in the prose of the chapter.

b.  The  overall quality of improvement was

OUTCOME #1:  To improve prosody at the word level on a specific assessment instrument  Effective

OUTCOME #2:  To improve prosody at the phrase level on a specific assessment instrument  Effective

OUTCOME #3:  To improve prosody at the discourse level on a specific assessment instrument  Slight improvement

9.  Description of baseline:

 

a.  Were baseline data provided? Yes

  OUTCOME #1:  To improve prosody at the word level on a specific assessment instrument:  3 times over 9 weeks

OUTCOME #2:  To improve prosody at the phrase level on a specific assessment instrument:  3 times over 9 weeks

OUTCOME #3:  To improve prosody at the discourse level on a specific assessment instrument:  3 times over 9 weeks

(continue numbering as needed)

 b.  Was baseline low and stable?

NOTE:  Data were not provided, but in the prose, the investigator described nature of baseline data.  The investigator described the prosodic problems as stable over the baseline period.

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

 

11.  Was information about treatment fidelity adequate?  Not Provided

 

12.  Were maintenance data reported?  Yes. Follow up administration of the assessment instrument revealed that the results were stable with some slight improvement.

 

13.  Were generalization data reported?  No. However, the assessment instrument involved word, phrase, and discourse contexts.

 

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

 

 

SUMMARY OF INTERVENTION

 

PURPOSE:  To investigate the effectiveness of a prosodic intervention designed to improve the prosodic skills of a child who speaks Swedish

POPULATION:  phonological disorder, prosodic disorder (Swedish)

 

MODALITY TARGETED:  comprehension and production

 

ELEMENTS/FUNCTIONS OF PROSODY TARGETED: lexical stress, phrasal stress, intonation

DOSAGE:  6 one-hour sessions plus homework

 

ADMINISTRATOR:  SLP and family

 

STIMULI:  auditory and visual

 

MAJOR COMPONENTS:

•  Basic Goal:  improve prosody at the word, phase, and discourse level

•  Intermediate Goal:  to produce prosodic contrasts at the word, phrase, and discourse level

WORD LEVEL

•  This was the main focus of intervention.

•  Intervention involved perception and production. Because P had stronger perception, perception was used to facilitate production.

•  C presented P with minimal pairs in Swedish. The two Swedish words differed in pitch direction (tonal word accent) and/or stress.  (The investigator provided illustrations of Swedish minimal pairs.)

PHRASAL LEVEL

•  Target: phrasal stress and intonation of real and nonsense sentence

•  P imitated C’s production of a real or nonsense sentences

DISCOURSE LEVEL
•  C recorded P’s discourse.

•  P listened to the recordings focusing on prosody.

•  It is assumed P discussed his production of prosody.

 

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