Rodriquez et al. (2011)

EBP THERAPY ANALYSIS

Treatment Groups

 

SOURCE:  Rodriguez, A. D., Patel, S., Bashiti, N., Shrivastav, R., & Rosenbek, J. (2011, May June).
The effect of incorporating knowledge of performance in the treatment of aprosodia. Paper presented at the 41st Clinical Aphasiology Conference (Fort Lauderdale, FL).  http://aphasiology.pitt.edu/archive/00002290/

REVIEWER(S):  PMH

 

DATE:  February 18, 2014

ASSIGNED GRADE FOR OVERALL QUALITY:  C-

 

TAKE AWAY:  This summary of a small single group investigation provides initial support for an intervention for aprosodia using cognitive-linguistic, imitative, and knowledge of performance (auditory and visual feedback) procedures.

 

1.  What type of evidence was identified?

a.  What was the type of evidence? (bold the appropriate design)  Prospective, Single Group with Pre- and Post-Testing

b.  What was the level of support associated with the type of evidence?  Level = B-

                                                                                                           

2.  Group membership determination:

a.  If there were groups, were participants randomly assigned to groups?  N/A

b.  If there were groups and participants were not randomly assigned to groups, were members of groups carefully matched?  N/A

3.  Was administration of intervention status concealed?

a.  from participants?  No

b.  from clinicians?  No

c.  from analyzers?  Yes

 

4.  Were the groups adequately described?  Yes for the most part but see communication description judgment.

a.         How many participants were involved in the study?

•  total # of participant:  1

•  # of groups:  1

•  # of participants in each group:  4

b.  The following variables were described: 

•  age: 69-81 years

•  gender:  all male

•  handedness:  all right

•  native language:  English

•  etiology:  unilateral right hemisphere stroke

•  emotional status:  unmanageable depression ruled out

•  educational level of clients:  14 – 22 years of education

•  months post onset:  7 – 60  months

c.   Were the groups similar before intervention began?  Not Applicable

d.  Were the communication problems adequately described?  Yes. They were adequate but I would have liked more information about communication skills.

  disorder type:  (List)  expressive and receptive aprosodia

•  functional level:  varied from mild to severe for expressive aprosodia and mild to moderate receptive aprosodia.

•  other (list)  dysarthria had been ruled out by oral motor exam

 

5.  Was membership in groups maintained throughout the study?

a.  Did the group maintain at least 80% of their original members?  Yes

b.  Were data from outliers removed from the study?  No 

 

6.   Were the groups controlled acceptably?  NA, there was only one group.

 

NOTE:  If there was only one group, go to #7.

                                                                                                             

                                                                                                             

7.  OUtCOMES

a.  •  OUTCOME #1:  Number of sentences with correct depictions of targeted affect on 96-sentence test battery

b.  Outcome #1 was subjective.

c.  Outcome #1 was not objective.

 

8.  Were reliability measures provided? 

a.  Interobserver for analyzers?  No 

b.  Intraobserver for analyzers?  No 

c.  Treatment fidelity for clinicians?  No 

 

9.  The results of the statistical (inferential) testing?

                                                                                                             

a.  Results for PRE VS POST TREATMENT

•  OUTCOME #1:  Number of sentences with correct depictions of targeted affect on 96-sentence test battery–  Post intervention scores were significantly higher than pre-intervention scores (p= 0.008).  Inspection of the data for the individual emotions indicated that there were improvements for happy, angry, fearful emotions but not for sad.

b.  What was the statistical test used to determine significance?  List the outcome number after the appropriate statistical test: ANOVA.

c.  Were confidence interval (CI) provided?  No

 

10.  What is the clinical significance?  Not provided

 

 

11.  Were maintenance data reported?  No

 

12.  Were generalization data reported? Yes. The test battery performance could be considered a generalization because the test was not part of the intervention.

 

ASSIGNED GRADE FOR QUALITY OF EXTERNAL EVIDENCE:  C-

 

 

SUMMARY OF INTERVENTION

 

PURPOSE:  To determine if an intervention combining cognitive-linguistic and imitative components of a previous treatment and knowledge of performance (auditory feedback plus visual feedback) procedures will improve the production of prosodic affect.

POPULATION:  expressive and receptive aprosodia; adults

 

MODALITY TARGETED:  production and comprehension

DOSAGE:  1 hour sessions; 3 times a week; 10 weeks (30 sessions)

 

ADMINISTRATOR:  SLP

 

STIMULI: auditory and visual; VisiPitch IV ®

 

MAJOR COMPONENTS:  (the description provided by the investigators is brief;  I have made some assumptions that may be wrong)

 

Criterion to Move to Next Step:  80% correct on at least 20 sentences

Number of Sentences:  60 per session

 

Step 1:

•  C provides a written description of the prosodic representation of the target emotion.

•  C presents a written sentence and an audiorecorded model of the targeted emotion when producing the sentence.

•  P produces the targeted sentence and emotion.

•  P and C discuss the adequacy of P’s production.

•  C provides feedback which includes the use of the VisiPitch.

Step 2:

•  C presents a written sentence and an audiorecorded model of the targeted emotion when producing the sentence.

•  P produces the targeted sentence and emotion.

•  P and C discuss the adequacy of P’s production.

•  C provides feedback which includes the use of the VisiPitch.

Step 3:

•  C presents a written sentence and an audiorecorded model of the targeted emotion when producing the sentence.

•  P produces the targeted sentence and emotion.

•  P and C discuss the adequacy of P’s production.

•  C provides feedback which includes the use of the VisiPitch first for every second sentence.

Step 4:

•  C presents a written sentence and an audiorecorded model of the targeted emotion when producing the sentence.

•  P produces the targeted sentence and emotion.

•  P and C discuss the adequacy of P’s production.

•  C provides feedback which includes the use of the VisiPitch for every third sentence.

Steps 5 -7:

•  C does not provide feedback.

•  The rest of the procedures are not described

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