Rinta & Welch (2008)



Source:  Rinta, T., & Welch, G. F. (2008). Should singing activities be included in speech and voice therapy for prepubertal children. Journal of Voice, 22, 100- 112.


Reviewer(s): pmh


Date:  June 29, 2014


Overall Assigned Grade: D-  (The highest possible grade was D.)


Level of Evidence:  D


Take Away:  The authors summarized evidence from previous research that supports the use of singing in speech and voice therapy with children.  This was not a comprehensive review as the authors only reviewed sources supporting their arguments. However, the authors did make a logical argument that was supported by the evidence.


What type of secondary review?  Narrative Review


1.  Were the results valid? Yes

a.  Was the review based on a clinically sound clinical question?  Yes

b.  Did the reviewers clearly describe reasonable criteria for inclusion and exclusion of literature in the review (i.e., sources)?  No

c.  Authors noted that they reviewed the following resources: The authors did not describe the resources that they reviewed.

d.  Did the sources involve only English language publications? Unclear.  Although all the titles were in English, some of the references were published in countries in which English is not the first/official language.

e.  Did the sources include unpublished studies?  Yes

f.  Was the time frame for the publication of the sources sufficient?  Yes

g.  Did the reviewers identify the level of evidence of the sources?  No

h.  Did the reviewers describe procedures used to evaluate the validity of each of the sources?  No

i.  Was there evidence that a specific, predetermined strategy was used to evaluate the sources?  No

j.  Did the reviewers or review teams rate the sources independently?  No

k.  Were interrater reliability data provided?  No

l.  If the reviewers provided interrater reliability data, list them:  NA

m.  If there were no interrater reliability data, was an alternate means to insure reliability described?  Not Applicable

n.  Were assessments of sources sufficiently reliable?  Not Applicable

o.  Was the information provided sufficient for the reader to undertake a replication?  No

p.  Did the sources that were evaluated involve a sufficient number of participants?  Unclear

q.  Were there a sufficient number of sources?  Yes


2.  Description of outcome measures:  Not applicable. Specific procedures were not described as the authors were making the case for including singing (in general) in speech and voice therapy with children.


3.  Description of results:  Not applicable

a.  What evidence-based practice (EBP) measures were used to represent the magnitude of the treatment/effect size?  (Not applicable. No data were provided.


b.  Summarize overall findings of the secondary review:

The authors summarized evidence from previous research that supports the use of singing in speech and voice therapy with children.  This was not a comprehensive review as the authors only reviewed sources supporting their arguments. The 3 arguments were

1.  There are neurological links between speech/language, emotion (including emotional prosody) and music/singing. Tapping these links can facilitate speech and voice interventions.

2.  Singing can be linked to psychological well being which in turn can indirectly influence voice.

3.    Although there is marked variability among cultures, there is a link between communication and musical development. This supports the use of singing/music during the earliest stages of speech/vocal development.


c.  Were the results precise?  No 

d.  If confidence intervals were provided in the sources, did the reviewers consider whether evaluations would have varied if the “true” value of metrics were at the upper or lower boundary of the confidence interval? Not Applicable

e.  Were the results of individual studies clearly displayed/presented?  Yes   

f.  For the most part, were the results similar from source to source?  Yes.  The authors only reviewed sources supporting their contention. 

g.  Were the results in the same direction?  Yes.  The authors only reviewed sources supporting their contention. 

h.  Did a forest plot indicate homogeneity?  Not Applicable

i.  Was heterogeneity of results explored?  No

j.  Were the findings reasonable in view of the current literature?  Yes

k.  Were negative outcomes noted?  No



4.  Were maintenance data reported?  No



5.  Were generalization data reported?  No






Population:   Speech impairment, language impairment, voice disorders; Child


Note:  This article was an expository that made the case for adding singing to interventions for speech impairment, language impairment, and voice disorders in prepubertal children. The authors did not address specific intervention procedures although they provided several examples of how  singing could be incorporated into interventions.




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