EBP THERAPY ANALYSIS
Note: Scroll about two-thirds of the way down the page to read the summary of the procedure(s).
C = Clinician
EBP = evidence-based practice
NA = not applicable
MT = music therapist/therapy
P = Patient or Participant
pmh = Patricia Hargrove, blog developer
SLP = speech–language pathologist
ST = speech therapy
SOURCE: Seybold, C. D. (1971). The value and use of music activities in the treatment of speech delayed children. Journal of Music Therapy, 8, 102-110.
DATE: October 5, 2014
ASSIGNED GRADE FOR OVERALL QUALITY: D (Due to the design of the investigation, the highest possible overall quality grade for this investigation was C-.)
TAKE AWAY: Although there were problems with the data, some of which was not the investigator’s fault (see the review), both groups [traditional speech therapy (ST) and music therapy (MT)] performed similarly. Additionally, the investigator provides a clear description of music activities designed to facilitate spontaneous communication in preschoolers diagnosed as speech delayed.
- What type of evidence was identified?
- What was the type of evidence? Prospective Randomized Group Design with Post-testing
- What was the level of support associated with the type of evidence? Level = C. We do not have a listing for this design because it is unusual. (The investigator lost the pretests due to thief.)
- Group membership determination:
- If there were groups, were participants randomly assigned to groups? Yes
- Was administration of intervention status concealed?
- from participants? No
- from clinicians? No
- from analyzers? No
- Were the groups adequately described? No
- How many participants were involved in the study?
- total # of participant: 8
- # of groups: 2
- # of participants in each group: 4, 4
- List names of groups: Music Therapy (MT) group (n =4); ; Speech Therapy (ST) group (n = 4)
- The following variables were described
- age: mean age MT group = 5-2; mean age ST group = 5-1
- gender: all make
- educational level of clients: all preschoolers
- Were the groups similar before intervention began? Unclear
- Were the communication problems adequately described? No _x__
- disorder type: all participants (P) were diagnosed as speech delayed but this was not defined
– all Ps were currently in therapy at a Midwest US university clinic
– all Ps were considered to have functional (i.e., nonorganic) impairments
- Was membership in groups maintained throughout the study?
- Did each of the groups maintain at least 80% of their original members? Yes
- Were data from outliers removed from the study
- Were the groups controlled acceptably? No
- Was there a no intervention group? No
- Was there a foil intervention group? No
- Was there a comparison group? Yes
- Was the time involved in the foil/comparison and the target groups constant? Yes
- Were the outcomes measure appropriate and meaningful? Unclear
- List outcome:
- OUTCOME #1: Performance on the Houston Test of Language Development
- The outcome measures is subjective:
- The outcome measures is not objective?
- Were reliability measures provided?
- Interobserver for analyzers? No
- Intraobserver for analyzers? No
- Treatment fidelity for clinicians? No
- What were the results of the statistical (inferential) testing?
- TREATMENT VERSUS COMPARISON GROUP
- OUTCOME #1: Performance on the Houston Test of Language Development
- significance level = 0.10
- MT improved more than the ST group
- What statistical test was used to determine significance? Mann-Whitney U
- Were confidence interval (CI) provided? No
- What is the clinical significance? NA
- Were maintenance data reported? No
- Were generalization data reported? No
ASSIGNED GRADE FOR QUALITY OF EXTERNAL EVIDENCE: D
SUMMARY OF INTERVENTION
PURPOSE: To investigate the effectiveness of music activities in improving the expressive language of preschool children diagnosed as speech delayed
POPULATION: Speech Delay; Children (preschool)
MODALITY TARGETED: expression
ELEMENTS/FUNCTIONS OF PROSODY TARGETED (do not list the specific dependent variables here):
ELEMENTS OF PROSODY USED AS INTERVENTION: rhythm, intonation, stress (music activities)
OTHER ASPECTS OF LANGUAGE/COMMUNICATION TARGETED: performance on a standardized test of language development
DOSAGE: individual sessions, 50 minute sessions, 2 times a week, 8 weeks
ADMINISTRATOR: male music therapist MT for MT group; female speech-language pathologist (SLP) for ST group.
STIMULI: auditory, visual, gestural/motoric
- There were 2 interventions: MT and ST. The MT intervention involved administering the same procedures to all the MT Ps. The ST intervention involved the administration of different procedures for the ST Ps. The procedures listed in the ST section are the one that are common to all ST Ps.
- Each activity began with a music activity. When the P produced the musical target, the clinician (C) presented a nonmusical activity.
- The following schedule represents a typical session:
- C and P sang a “Good Morning” song (tune = “Happy Birthday.”)
- C and P sang “The Alphabet” song accompanied by musical instruments (e.g., piano, autoharp). Following a musical response, C encouraged P to talk about letters of the alphabet while playing with lettered blocks or while copying letters on the chalkboard.
- C and P sang “Old MacDonald” or the “Farmer in the Dell.” Then P played with toy animals, colored pictures of animals, or looked at pictures of animals while C stimulated conversation.
- C and P engaged in a game entitled the “Bumblebee” while playing kazoos or similar instruments. When P created a buzzing sound with the kazoo and then touched one of C’s body parts with the kazoo, C named the body part. C and P then reversed roles. C and P also sang and acted out “If You are Happy and You Know It, Clap Your Hands”
- C and P sang the song the “Wheels on the Bus Go Round and Round” to teach a variety of concepts (e.g., “open” and “close”, colors, “in” and “out”). Once P completed the singing and acting out of the song with C, she/he was encouraged say and act out the action words.
- C and P sang narrative songs such as “Little Rabbit Foo Foo” or “Down by the Station” to introduce imagination, language concepts, and singular/plural distinctions. C played sound effects and encouraged P to play “tone clusters” and glissandos.
- C and P sang narrative songs such as “Little Rabbit Foo Foo” or “Down by the Station” to teach numbers. Following the song, C introduced activities that encouraged play and spontaneous language.
- C allowed P 5 to 10 minutes per session to play with an instrument and musical activity (marching, jumping, singing, etc.) of choice.
- C and P sang a “Goodbye” song (tune = “Frere Jacques.”)
- C modeled sentences based on P’s functional level of communication for P to imitate. Then P was required to use the target sentence in a noncompetitive, nonturn taking (e.g., “Cootie”) activity in order to obtain an item.
- C and P participated in a competitive, turn taking activity in which turns were earned by making requests with a targeted language structure.
- C asked P to identify colors, clothing, and body parts during games.
- C introduced action pictures representing letters of the alphabet (e.g., a boy blowing bubbles represented “buh”.) C said “buh” and P (or perhaps C, it is not clear) produced a corresponding word and progressed to producing the word in a phrase/sentence.
- C stimulated spontaneous speech during games. The targets could be producing speech about colors, body parts, “basic language concepts” or encouraging the use of the imagination.