Geist et al. (2008)


Single Subject Designs


Note: The summary can be viewed by scrolling about two-thirds of the way down on this page.


SOURCE: Geist, K., McCarthy, J., Rodgers-Smith, A., & Porter, J. (2008). Integrating music therapy services and speech-language therapy services for children with severe communication impairments: A co-treatment model. Journal of Instructional Psychology, 35





DATE:  May 14, 2014


ASSIGNED OVERALL GRADE:   D-(Highest possible grade was D+.)


TAKE AWAY: The authors explained the rationale for co-treatment of communication disorders by music therapists (MT) and speech-language pathologists (SLP) and described the strategy used with a single case.



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


2. What type of evidence was identified? Case Study – Program Description(s) with Case Illustration(s)

• What was the level of support associated with the type of evidence?

Level = D+                                                      


3. Was phase of treatment concealed?                                             

a. from participants? No                             

b. from clinicians? No                                 

c. from data analyzers? Yes                      


4. Was the participants adequately described? Yes

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


b. P characteristics

– The following characteristics were controlled:

• age: between 2 and 12 years

• communication skills: severe communication impairment

• responsive to music

• parental consent


– The following characteristics were described:

• age: 4 years

• gender: m

• expressive language: 9-12 months (Rossetti Infant Toddler Language Scale)

• receptive language: 9-12 months (Rossetti Infant Toddler Language Scale)

• gesture functional level: 15-18 months (Rossetti Infant Toddler Language Scale)

• medical diagnoses/challenges: preterm; on respirator up to 7 weeks; tracheotomy from 8-21 months; bronchopulmonary dysplasia (therefore, highly susceptible to illness)

• previous therapy: yes, speech language therapy; no music therapy (MT)

• responsiveness to music: attended to book sung to him, increased engagement during music activity


c. Were the communication problems adequately described? Yes

• The disorder type: severe language impairment; child

• Other aspects of communication that were described:

– used gestures to request

– no intelligible speech

– comprehension problems (words and commands)

– familiar with social routines

– used pictures to request items (target in previous therapy)

– signed to continue activity (target in previous therapy)

– did not greet classmates


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


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

a. Were baseline/preintervention data presented on all behaviors? No

b. Did probes/intervention data include untrained data? No data

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

d. Was the data collection continuous? No data

e. Were different treatment counterbalanced or randomized? Not Applicable


7. Was the outcome measure appropriate and meaningful? Yes

a. The outcome was:

OUTCOME #1: to increase classroom participation as represented by greetings and participation during story time

b. Was the outcome subjective? Yes

c. Was the outcome objective? N

d. Was the outcome measure reliable:? Yes  

e. The support for the reliability of the outcome measure was 10 blind assessors video pre and post intervention videos; all identified the post video as more engaged



8. Results:

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

b. The overall quality of improvement was unclear—no data were provided.



9. Description of baseline:

• Were baseline data provided? No



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



11. Was information about treatment fidelity adequate? No



12. Were maintenance data reported? No



13. Were generalization data reported? No









PURPOSE: To describe a strategy for integrating music and speech-language therapy and to provide documentation for its success in an illustrative case study.


POPULATION: Language impairment; Child






OTHER ASPECTS OF LANGUAGE/COMMUNICATION TARGETED: Increased participation in classroom interactions


ADMINISTRATOR: music therapist (primary administrator); SLP served as consultant; teacher



• The overall strategy included:

1. assessment of communication status

2. assessment of responsiveness to music

3. coordination of team meetings (including parents) to identify goals and targets

4. development of procedures for collaboration between music therapist and speech-language pathologist

5. administration and evaluation the intervention strategy


• Phases of treatment:

1. 1:1 MT sessions (3 initial sessions)

2. Small group (4 -5 of classmates; 4 sessions)

3. Large group(20 classmates)


• 1:1 MT sessions

– C introduced activities such as

• greeting songs

• listening to songbook activities

• playing instruments

•  closing songs


• Small group

– Teacher observed

– SLP observed and consulted on the use of AAC (Augmentative/Alternative Communication)

– same activities as 1:1 MT sessions

– C also worked on waiting his turn

– P used AAC to participate; it could be faded as he progressed.

• Large Group

– MT and SLP taught the teacher strategies to facilitate P’s engagement, including the use of the AAC device.



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