Lacava et al. (2010)

February 28, 2015

EBP THERAPY ANALYSIS for
Single Subject Designs

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

Key:
ASD = Autism Spectrum Disorder
C = Clinician
CAM-C Faces = Faces subtest of the Cambridge Mindreading Face-Voice Battery for Children
CAM-C Total Concepts = Total from the Cambridge Mindreading Face-Voice Battery for Children
CAM-C Voices = Voices subtest of the Cambridge Mindreading Face-Voice Battery for Children
EBP = evidence-based practice
NA = not applicable
P = Patient or Participant
pmh = Patricia Hargrove, blog developer
SLP = speech–language pathologist
T or Tutor = school staff or investigator who monitored the Ps use of the computer program throughout the intervention

SOURCE: Lacava, P. G., Rankin, A., Mahlios, E., Cook, K., & Simpson, R. L. (2010). A single case design evaluation of a software and tutor intervention addressing emotion recognition and social interaction in four boys with ASD. Autism, 14 (3), 161- 178.

REVIEWER(S): pmh

DATE: February 21, 2010

ASSIGNED OVERALL GRADE: B (The highest possible overall grade based on the design of the investigation was A-.)

TAKE AWAY: Four single subject experimental design investigations revealed that a computer based intervention administered by a “tutor” was associated with moderate improvements on formal tests of prosodic and facial affect recognition. However, there only was limited support for generalization to social interaction with peers.

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

2. What type of evidence was identified? Single subject evidence
• What type of single subject design was used? Single Subject Experimental Design with Specific Client – Multiple Baseline across participants (Ps)
• What was the level of support associated with the type of evidence? Level = A-

3. Was phase of treatment concealed?
• from participants? No
• from clinicians? No
• from data analyzers? No

4. Were the participants adequately described? No
• How many participants were involved in the study? 8 (4 with Autism Spectrum Disorder, ASD. diagnosis; 4 typically developing matched peers)

– The following characteristics/variables were CONTROLLED: (only the Ps diagnosed with ASD were listed)
• age: 7 to 11 years
• cognitive skills: no cognitive disability confirmed by file review or parents
• literacy: text and computer literate
• educational of participant: attended public school
• Autism Spectrum Disorder Diagnosis (ASD): ASD with no cognitive disability confirmed by file review or parents
• Experience with the independent variable—Mind Reading computer software: No experience

– – The following characteristics/variables were DESCRIBED: (only the Ps diagnosed with ASD were listed)
• age: mean age 8-6; range 7-8 to 9-8
• gender: all male
• cognitive skills: no cognitive disability
• paraprofessional support: 0% (1P); 64% (2Ps); 100% (1P)
• diagnosis: PDD-NOS (2Ps); autism (2Ps)
• educational level of participant: 2nd grade (1P) ; 3rd grade (2Ps); 4th grade (1P)
• time in general education classes: 24% to 91%

• Were the communication problems adequately described? No
– The disorder type was ASD with no cognitive disability; communication but skills were not described.

5. Was membership in treatment maintained throughout the study? Yes

• If there was more than one participant, did at least 80% of the participants remain in the study? Yes
• Were any data removed from the study? Yes, but there was missing data because 1 P could not complete voice/auditory (prosodic) measures.

6. Did the design include appropriate controls? Yes
• Were baseline/preintervention data collected on all behaviors? Yes

• Did probes/intervention data include untrained data? Yes. Probes administered during intervention were only for the social interaction outcome, these were untrained.

• Did probes/intervention data include trained data? No

• Was the data collection continuous? Yes, for the social interaction outcome only. _x__ No ___

• Were different treatment counterbalanced or randomized? NA

7. Were the outcomes measure appropriate and meaningful? Yes

• The outcomes
OUTCOME #1: Percentage of correct responses on the Faces subtest of the Cambridge Mindreading Face-Voice Battery for Children (CAM-C Faces) –pre and post test data only
OUTCOME #2: Percentage of correct responses on the Voices subtest of the Cambridge Mindreading Face-Voice Battery for Children (CAM-C Voices)– pre and post test data only
OUTCOME #3: Overall percentage of total concepts passed on the Cambridge Mindreading Face-Voice Battery for Children (CAM-C- Total Concepts)- pre and post test data only
OUTCOME #4: Percentage of correct naming of emotions from colored pictures from the training material Library (Color Pictures)- pre and post test data only
OUTCOME #5: Percentage of correct naming of emotions from black and white pictures that were not part of the training procedure (Black and White Pictures)– pre and post test data only–
OUTCOME #6: Percentage of correct naming of emotions from cartoons that were not part of the training procedure (Cartoons) –pre and post test data only
OUTCOME #7: Percentage of Positive Social Interactions observed with peers at school –continuous data
OUTCOME #8: Rating of parental and teacher perception of the social validity of the intervention –only collected post intervention
OUTCOME #9: Comparison of each P’s performance to a matched typically developing peer on CAM-C and the Positive Social Interactions with peers measure—pre and post or continuous data, as appropriate.
• All of the outcomes were subjective.

• None of the outcomes were objective.

• The outcome measures associated with reliability data were

PRE-EXISTING RELIABILITY:
• The investigators cited extant data supporting the reliability of CAM-C
for Outcomes #1to #3 as well as for the CAM-C portion of Outcome #9. For easier reference, the outcomes with pre-existing outcome data were
OUTCOME #1: Percentage of correct responses on the Faces subtest of the Cambridge Mindreading Face-Voice Battery for Children (CAM-C Faces)
OUTCOME #2: Percentage of correct responses on the Voices subtest of the Cambridge Mindreading Face-Voice Battery for Children (CAM-C Voices)
OUTCOME #3: Overall percentage of total concepts passed on the Cambridge Mindreading Face-Voice Battery for Children (CAM-C- Total Concepts)
OUTCOME #9: Comparison of each P’s performance to a matched typically developing peer on CAM-C and the Positive Social Interactions with peers measure (the reliability data were fro CAM-C, only)

CURRENT INVESTIGATION’S RELIABILITY DATA
• Reliability data were provide for Outcome #7 only. In Table 3 he investigators reported
– overall mean interobserver reliability was 94.7%
– the overall mean range of interobserver was 91.2% to 97.3%

• For easier reference, OUTCOME #7 was Percentage of Positive Social Interactions observed with peers at school –continuous data

8. Results:
• Did the target behavior improve when it was treated? Yes
• The overall quality of improvement for each of the outcomes was

OUTCOME #1: Percentage of correct responses on the Faces subtest of the Cambridge Mindreading Face-Voice Battery for Children (CAM-C Faces) –moderate
OUTCOME #2: Percentage of correct responses on the Voices subtest of the Cambridge Mindreading Face-Voice Battery for Children (CAM-C Voices)–limited
OUTCOME #3: Overall percentage of total concepts passed on the Cambridge Mindreading Face-Voice Battery for Children (CAM-C- Total Concepts)- moderate
OUTCOME #4: Percentage of correct naming of emotions from colored pictures from the training material Library (Color Pictures)- moderate
OUTCOME #5: Percentage of correct naming of emotions from black and white pictures that were not part of the training procedure (Black and White Pictures) pre and post test data only—moderate (3Ps); ineffective (1P)
OUTCOME #6: Percentage of correct naming of emotions from cartoons that were not part of the training procedure (Cartoons) –moderate (3Ps); ineffective (1P)
OUTCOME #7: Percentage of Positive Social Interactions observed with peers at school –continuous data–—limited (3Ps); ineffective (1P)
OUTCOME #8: Rating of parental and teacher perception of the social validity of the intervention –moderate
OUTCOME #9: Comparison of each P’s performance to a matched typically developing peer on CAM-C and the Positive Social Interactions with peers measure—ineffective

9. Description of baseline:
• Were baseline data provided? Yes, but they were provided for only one outcome:
OUTCOME #7: Percentage of Positive Social Interactions observed with peers at school. The number of baseline session varied:
– P1: 5 sessions
– P2: 9 sessions
– P3: 7 sessions
– P4: 4 sessions

• Was baseline low (or high, as appropriate) and stable?
– P1: moderate and stable
– P2: low and stable
– P3: variable and unstable
– P4: low and stable

• What was the percentage of nonoverlapping data (PND)?
– P1: 46%– unreliable/ineffective
– P2: 27%– unreliable/ineffective
– P3: 0%– unreliable/ineffective
– P4: 25%– unreliable/ineffective
– PND was not calculated but visual inspection suggests it also would be low.

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

11. Was information about treatment fidelity adequate? Yes. Treatment fidelity checks were administered for an average of 18% of treatment sessions. The overall fidelity was 94.1% with the range of averaging from 82% to 98.6%.

12. Were maintenance data reported? No

13. Were generalization data reported? Yes. Several of the measures could be considered to be generalizations:

• Outcome #7 (Percentage of Positive Social Interactions observed with peers at school) Overall, improvement was limited.

• Outcomes #1 through #3 and #5 and #6 could be considered generalizations because the pictures were different in teaching and testing. The improvement for these outcomes was variable ranging from ineffective to moderate. For easier understanding the outcomes in question are listed below.

OUTCOME #1: Percentage of correct responses on the Faces subtest of the Cambridge Mindreading Face-Voice Battery for Children (CAM-C Faces)
OUTCOME #2: Percentage of correct responses on the Voices subtest of the Cambridge Mindreading Face-Voice Battery for Children (CAM-C Voices)
OUTCOME #3: Overall percentage of total concepts passed on the Cambridge Mindreading Face-Voice Battery for Children (CAM-C- Total Concepts)
OUTCOME #5: Percentage of correct naming of emotions from black and white pictures that were not part of the training procedure (Black and White Pictures)
OUTCOME #6: Percentage of correct naming of emotions from cartoons that were not part of the training procedure (Cartoons)

14. Brief description of the design:

• Multiple baseline across participants single subject experimental design.
• There were 4 participants.
• Investigators administer pre and post tests as well as regular probes throughout the intervention.
• Outcomes included
– formal/informal tests of emotion recognition (Outcomes #1- #6)
– observation of social interactions with peers (pre-post testing and weekly probes)
– parental/teacher perception of effectiveness and use (post testing only)
– a typically developing match peer for each of the Ps who was administered pre-post tests and probes

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

SUMMARY OF INTERVENTION

PURPOSE: To continue the investigation of the effectiveness of computer software in improving emotion recognition of children with ASD

POPULATION: ASD

MODALITY TARGETED: comprehension

ELEMENTS/FUNCTIONS OF PROSODY TARGETED: affect

OTHER ASPECTS OF LANGUAGE/COMMUNICATION TARGETED: social interaction with peers

OTHER TARGETS: perception of outcome effectiveness

DOSAGE: individual sessions; 1 to 2 hours per week; 7 to 10 weeks

ADMINISTRATOR: “tutor” = school staff (3Ps); investigator (1P)

STIMULI: auditory, visual

MAJOR COMPONENTS:

• The investigators installed the computer program (Mind Reading: The Interactive Guide to Emotions) onto the computer at the schools where the treatments were administered.
• The Mind Reading consisted of 3 components:
– The Library— contained audiorecordings, videos, descriptions, narrative, and pictures that represented a wide variety of emotions
– The Learning Center— contained graded lessons of levels of difficulty (preschool to adult) designed to teach the emotions, quizzes designed to provide positive feedback (e.g., access to reward items) for correct responses
– The Game Zone—contained interactive games designed to continue teaching emotion recognition in a game format
• The investigators explained the Mind Reading and all procedures to parents, teacher, appropriate staff, and Ps at the first meeting and at pre-test sessions.
• The investigators demonstrated and explained how to use the computer and the Mind Reading program to Ps and tutors (T) prior to the beginning of intervention.
• Ts were adult staff (or in one case, an investigator) who monitored Ps’ use of the computer program and facilitated the use of the program. Investigators monitored Ts and Ps during the intervention phase of the investigation and were available to and Ts’ questions/concerns.
• Ts’ responsibilities included:
– to sit next to Ps while they were using Mind Reading,
– to provide guidance regarding the use of Mind Reading,
– to ensure that Ps used all 3 components of Mind Reading,
– to limit use of the Game Zone to no more than 33% of time P used the computer program,
– to view all videos,
– to listen to all audio recordings,
– to discuss emotions that occur during activities of daily living,
– to “mime” emotions with Ps (p. 170), and
– to focus on emotions that had been identified as problematic during pretesting.
• Ps (with the Ts) were to use the computer program for 1 to 2 hours per week for 7 to 10 weeks in a quite location in their schools.

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Lacava et al. (2007)

February 17, 2015

EBP THERAPY ANALYSIS

Treatment Groups

 

Note: Scroll about two-thirds of the way down the page to read the summary of the procedure(s).

 

Key:

AS = Asperger syndrome

ASDS = Asperger Syndrome Diagnostic Scale

C = Clinician

CAM-C Faces = Cambridge Mindreading Face-Voice Battery for Children – Faces Subtest

CAM-C Voices = Cambridge Mindreading Face-Voice Battery for Children –Voices Subtest

C-FAT = Child Feature-Based Auditory Task (C-FAT)

EBP = evidence-based practice

NA = not applicable

P = Patient or Participant

pmh = Patricia Hargrove, blog developer

RMF = Performance on the Reading the Mind in Films Test—Children’s Version

SLP = speech–language pathologist

WNL = within normal limits

 

 

SOURCE: Lacava, P., Golan, O., Baron-Cohen, S., & Myles, B. S. (2007). Using assistive technology to teach emotion recognition to students with Asperger syndrome: A pilot study. Remedial and Special Education, 28, 174-181.

 

REVIEWER(S): pmh

 

DATE: February 13, 2015

ASSIGNED GRADE FOR OVERALL QUALITY: C   (Highest possible grade was B-.)

 

TAKE AWAY: This pilot investigation compared the pre- and post-tests scores of a group of children with Asperger syndrome (AS.) The investigators determined that a self-administered computer based program (Mind Reading software) has potential for improving the recognition of prosodic affect.

 

 

  1. What type of evidence was identified?
  • What was the type of evidence? Prospective, Single Group with Pre- and Post-Testing

                                                                                                           

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

                                                                                                           

 

  1. Group membership determination:
  • If there was more than one group, were participants randomly assigned to groups? Not applicable (NA), there was only one group.
  • If there were groups and participants were not randomly assigned to groups, were members of groups carefully matched? NA
  1. Was administration of intervention status concealed?
  • from participants? No
  • from clinicians? No
  • from analyzers? No

                                                                    

 

  1. Were the groups adequately described? No

How many participants were involved in the study?

  • total # of participant:   8
  • # of groups: 1

 

The following variables controlled or described:                     

  • age: 8 -11 years
  • gender: 6m; 2f
  • diagnosis: all Ps diagnosed as having Asperger syndrome (AS); scores on the Asperger Syndrome Diagnostic Scale (ASDS) were interpreted as Possibly (1), Likely (2), or Very Likely (%.)
  • cognitive skills: not described but due to diagnosis can be assumed to be within normal limits (WNL)
  • educational status of clients: home schooled (5); private school for children with learning disabilities (2); public elementary school (1)

 

– Were the groups similar before intervention began? NA

                                                         

– Were the communication problems adequately described? No

  • disorder type: Not provided but all Ps had been diagnosed with AS.

 

 

  1. Was membership in groups maintained throughout the study?
  • Did each of the group maintain at least 80% of its original members? Yes
  • Were data from outliers removed from the study? No

 

  1. Were the groups controlled acceptably? NA

 

  1. Were the outcomes measure appropriate and meaningful? Yes
  • The outcomes were

OUTCOME #1: Improved performance on the Cambridge Mindreading Face-Voice Battery for Children –Faces Subtest   (CAM-C Faces )

OUTCOME #2: Cambridge Mindreading Face-Voice Battery for Children –Voices Subtest   (CAM-C Voices)

OUTCOME #3: Improved performance on the Child Feature-Based Auditory Task (C-FAT)

OUTCOME #4: Performance on the Reading the Mind in Films Test—Children’s Version (RMF)

OUTCOME #5: Parent and P perception of the social validity of the intervention

 

  • All outcome measures were subjective.

 

  • None of the outcome measures were objective.

 

                                         

  1. Were reliability measures provided?
  • Interobserver for analyzers? No
  • Intraobserver for analyzers? No
  • Treatment fidelity for clinicians? No, but the investigators did describe “Treatment Integrity” which tallied the hours P used the software and the portions of the software they accessed. (See Major Components section of the Summary for a description of the software.)

 

 

  1. What were the results of the statistical (inferential) testing and/or descriptions of the results?

NOTE: Outcomes # 1 to #4 were subjected inferential testing; Outcome #5 was analyzed descriptively.

  • PRE VS POST TREATMENT

OUTCOME #1: Improved performance on the Cambridge Mindreading Face-Voice Battery for Children –Faces Subtest   (CAM-C Faces ) – post test scores were significantly higher than pre test scores

OUTCOME #2: Cambridge Mindreading Face-Voice Battery for Children –Voices Subtest   (CAM-C Voices) – post test scores were significantly higher than pre test scores

OUTCOME #3: Improved performance on the Child Feature-Based Auditory Task (C-FAT) – post test scores were significantly higher than pre test scores

OUTCOME #4: Performance on the Reading the Mind in Films Test—Children’s Version (RMF) – the investigators only administered RMF as a post test and compared P performances to the results of previous research. The Ps in this investigator did not differ significantly from previous research in which children with ASD who did and those who did not receive the intervention.

OUTCOME #5: Parent and P perception of the social validity of the intervention—Although the investigators reported that they administered pre and post measures to assess social validity, they did not compare the pre and post test scores. Rather they provided several insights or comments from parents or Ps reflection their evaluation of the intervention procedure. The reported results did not strongly support progress in recognizing affect.

  • What was the statistical test used to determine significance? Wilcoxan:

 

  • Were confidence interval (CI) provided? No

                                   

  1. What is the clinical significance? NA, the investigators did not provide these data.

 

 

  1. Were maintenance data reported? No
  2. Were generalization data reported? Yes. Since the CAM-C faces, CAM-C voice, and C-FAT were not taught in the software program their associated outcomes could be considered evidence of generalization. However, the same speaker was used for C-FAT and the software program.

 

ASSIGNED GRADE FOR QUALITY OF EXTERNAL EVIDENCE: C

 

 

SUMMARY OF INTERVENTION

 

PURPOSE: To present pilot information about the effectiveness of a computer based strategy for teaching the comprehension of prosodic and facial affect

POPULATION: ASD

 

MODALITY TARGETED: Comprehension

 

ELEMENTS/FUNCTIONS OF PROSODY TARGETED: Affective prosody

 

OTHER ASPECTS OF LANGUAGE/COMMUNICATION TARGETED: facial representations of affect

OTHER TARGETS: Perception of the intervention

DOSAGE: Ps had access to the software for 10 weeks, on the average use was about 1 hour per week.

 

ADMINISTRATOR: self-administered with supervision by parent or teacher

 

STIMULI: auditory, visual

 

MAJOR COMPONENTS:

 

  • The intervention involved the use of a computer program (i.e., Mind Reading) designed to teach the comprehension of facial and prosodic affect in a systematic manner.
  • The Mind Reading software had 6 levels of difficulty and included the following:

– Emotions Library

– Learning Center

– Games Zone

  • The EMOTIONS LIBRARY contained illustrations of emotions in context using photographs, film clips, and audio recordings.
  • The LEARNING CENTER involved lessons, matching activities, and quizzes. The program imbedded rewards in the lessons and quizzes.
  • The GAME ZONE consisted of interactive games focusing on the recognition of emotions.
  • Ps were free to use all aspects of Mind Reading software with the restriction that only 33% of their time could be devoted to the GAME ZONE.
  • Interventions were self- administered by Ps in homes (5P) or the school (3P) under the supervision of a parent or teacher.
  • The investigators instructed parents/teachers regarding how to use the Mind Reading software for instruction, monitoring P’s usage, and data collection. Throughout the intervention the investigators contacted the parents/teachers to insure adherence to the protocol.
  • Intervention lasted for 10 weeks. Over that time, the average usage by Ps was 10.5 hours.
  • A more thorough description of the Mind Reading software can be found at

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2247465/

 


Behrman (2014)

February 11, 2015

EBP THERAPY ANALYSIS for

Single Subject Designs

 

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

 

Key:

AE = American English

C = Clinician

EBP = evidence-based practice

L1 – first language

L2 = second language

L2 learner = learning American English as a second language

NA = not applicable

P = Patient or Participant

pmh = Patricia Hargrove, blog developer

SLP = speech–language pathologist

 

 

SOURCE: Behrman, A. (2014). Segmental and prosodic approaches to accent management. American Journal of Speech-Language Pathology, 23, 546-561.

 

REVIEWER(S): pmh

 

DATE:  February 3, 2015

ASSIGNED OVERALL GRADE:   B+ (Based on the design of the investigation, the highest possible grade was A-.)

 

TAKE AWAY: This investigation employed segmental and prosodic treatment approaches to increase the use of American English (AE) among nonnative speakers of AE. Because it was not clear which approach was superior, both approaches will be reviewed here. The results of 4 single subject experimental design investigation revealed that (1) prosody improved when the treatment target was prosody, (2) segmentals improved when segmentals were the treatment focus and (3) ratings of accentedness and ease of understanding (comprehensibility) improved following the treatment that included both prosody and segmental targets.

                                                                                                           

 

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

                                                                                                           

 

  1. What type of evidence was identified?
  2. What type of single subject design was used? Single Subject Experimental Design with Specific Client Multiple-baseline across participants with alternating treatments

 

  1. What was the level of support associated with the type of evidence?

Level = A-                                                       

 

                                                                          

  1. Was phase of treatment concealed?
  • from participants? No
  • from clinicians? No
  • from data analyzers? Yes

 

  1. Were the participants (Ps) adequately described? Yes

How many participants were involved in the study? 4

– P characteristics :

 

CONTROLLED:

  • age: adult
  • gender: male
  • first language (L1) = Hindi
  • P’s perception of English language skills = All Ps considered themselves proficient in English
  • P’s report of daily use of English = All Ps reported at least 50% usage.
  • P’s perception of communication status = No Ps reported communication disorders
  • performance on selected subtests of the Proficiency in Oral English Communication (POEC) = All Ps performed at the 50% level or below

DESCRIBED:

  • age: 28- 43 years
  • language status: All Ps were multilingual
  • began learning English: All Ps began by 10 year
  • educational level of participants: All Ps were college graduates.
  • familiarity with American Engish (AE) = All considered themselves as familiar with AE due to its presence in the media. In addition, all had met at least one American but none had significant interactions with Americans.
  • Language used at work: Indian English (4)
  • residence: India (3), London (1)

                                                 

  •  Were the communication problems adequately described? NA, the Ps did no have communication disorders.

                                                                                                                       

  1. Was membership in treatment maintained throughout the study? Yes

 

  • If there was more than one participant, did at least 80% of the participants remain in the study? Yes
  • Were any data removed from the study? No

 

 

  1. Did the design include appropriate controls?
  • Were baseline/preintervention data collected on all behaviors? Yes
  • Did probes/intervention data include untrained data? Yes
  • Did probes/intervention data include trained data? No
  • Was the data collection continuous? Yes
  • Were different treatment counterbalanced or randomized? Yes, counterbalanced ,

 

  1. Were the outcomes measure appropriate and meaningful? Yes
  • The outcomes were

OUTCOME #1: improved performance on randomly selected items from intonation and contrastive stress subtests of the POEC

OUTCOME #2: improved accuracy of words created from P specific articulatory targets

OUTCOME #3: improved rating of accentedness (in this rating scale 1= no foreign accent and 7 = very strong foreign accent)

OUTCOME #4: improved ratings of ease of understanding or comprehensibility (in this rating scale 1= easy to understand and 7 = very hard to understand)

  • All the outcomes were subjective.
  • None of the outcomes were objective.
  • Outcomes with reliability data

OUTCOME #3: improved rating of accentedness (in this rating scale 1= no foreign accent and 7 = very strong foreign accent)

OUTCOME #4: improved ratings of ease of understanding or comprehensibility (in this rating scale 1= easy to understand and 7 = very hard to understand)

           

INTEROBSERVER AGREEMENT

  • better than 80% interobserver agreement for each P for both Outcomes #3 and #4

INTRAOBSERVER AGREEMENT

  • overall, for Outcomes #3 and #4, ranged from 74%-87%.

 

 

  1. Results:
  •  Did the target behavior improve when it was treated? Yes__
  • Based on visual inspection, the quality of improvement was

OUTCOME #1: improved performance on randomly selected items from intonation and contrastive stress subtests of the POEC– strong

OUTCOME #2: improved accuracy of words created from P specific articulatory targets–strong

OUTCOME #3: improved rating of accentedness (in this rating scale 1= no foreign accent and 7 = very strong foreign accent)— moderate

OUTCOME #4: improved ratings of ease of understanding or comprehensibility (in this rating scale 1= easy to understand and 7 = very hard to understand)–moderate

  1. Description of baseline:
  • Were baseline data provided? Yes. Because of the design, some of the baselines were staggered. The range of baseline sessions were either 5 or 10.

OUTCOME #1:

OUTCOME #2:

OUTCOME #3:

 

  • Description of baseline:

NOTE: The investigator’s a priori definition of “stable” was no more than 2 points difference over 5 initial baseline sessions.

OUTCOME #1: improved performance on randomly selected items from intonation and contrastive stress subtests of the POEC – low and stable

OUTCOME #2: improved accuracy of words created from P specific articulatory targets –low and stable

OUTCOME #3: improved rating of accentedness (in this rating scale 1= no foreign accent and 7 = very strong foreign accent) – moderately high and stable

OUTCOME #4: improved ratings of ease of understanding or comprehensibility (in this rating scale 1= easy to understand and 7 = very hard to understand) – moderately high and stable

  • What was the percentage of nonoverlapping data (PND)? The investigator did not calculate PND.

 

 

  1. What was the magnitude of the treatment effect?.”

NOTE: The investigator provided a rationale for not interpreting the effect size metric in single-subject experimental design research. She did, however, offer a criterion of 1.00 as an indicator of effectiveness.

OUTCOME #3: improved rating of accentedness (in this rating scale 1= no foreign accent and 7 = very strong foreign accent)

  • magnitude of effect: 5.0 to 11.2
  • measure calculated: modified standard mean difference
  • interpretation: exceeds criterion

OUTCOME #4: improved ratings of ease of understanding or comprehensibility (in this rating scale 1= easy to understand and 7 = very hard to understand)

  • magnitude of effect: 3.4 to 9.7
  • measure calculated: modified standard mean difference
  • interpretation: exceeds criterion

 

  1. Was information about treatment fidelity adequate? Not Provided

 

 

  1. Were maintenance data reported? Yes. There were 5 withdrawal data collection sessions following the termination of treatment. This could be considered a form of maintenance. For the most part, Ps maintained their progress.

 

 

  1. Were generalization data reported? Yes. Since all probes (items from the POEC and single word articulation probes) were on untrained items, this could be considered to be generalization. All Ps improved their performance on probes.

 

 

  1. Brief description of the design:
  • The single-subject experimental design was a multiple baseline across participants with alternating treatment.
  • Two of Ps received prosody therapy first and segmental therapy second.
  • The order of procedures for the prosody first Ps was baseline (A)- prosody therapy (C)- withdrawal (A)- prosody therapy (C) – segmental therapy (B)- withdrawal (A) – segmental therapy (B) – withdrawal (A)
  • Although the order of administration of procedures of the prosody first participants was identical, the length of the baseline was staggered with one P receiving 5 sessions and the other P receiving 10 sessions.
  • Two of Ps received segmental therapy first and segmental therapy second.
  • The order of procedures for the prosody first Ps was baseline (A)- segmental therapy (B)- withdrawal (A)- segmental therapy (B) – prosody therapy (C)- withdrawal (A) – prosody therapy (C) – withdrawal (A)
  • Although the order of administration of procedures of the segmental first participants was identical, the length of the baseline was staggered with one P receiving 5 sessions and the other P receiving 10 sessions.

 

OVERALL RATING OF THE QUALITY OF SUPPORT FOR THE INTERVENTION: B+

 

 

SUMMARY OF INTERVENTION

 

 

PURPOSE: To investigate the effectiveness of segmental and prosodic approaches to the improving the production of AE in nonnative speakers.

POPULATION: nonnative learners of AE

 

MODALITY TARGETED: production

 

ELEMENTS/FUNCTIONS OF PROSODY TARGETED: lexical stress, phrasal stress, reduction of vowels, overall intonation, terminal contour

 

ELEMENTS OF PROSODY USED AS INTERVENTION: intonation, stress, pause, rhythm, phonemic changes (vowel reduction)

 

OTHER ASPECTS OF LANGUAGE/COMMUNICATION TARGETED: production of selected AE consonants, comprehensibility (ease of understanding), accentedness

DOSAGE: the prosodic and segmental treatment sessions each lasted: 10 sessions (in 2 five-session blocks, 1 hour in length, sessions were administered every 3rd day via Skype)

 

ADMINISTRATOR: Speech-Language Pathologist

 

STIMULI: auditory, visual

 

MAJOR COMPONENTS:

 

  • The investigator recommended that P’s native language should be considered when determining treatment targets. Therefore, she provided background information about Hindi.
  • All probes and treatment procedures were administered via Skype.

PROSODY TREATMENT

  • Prosodic targets included

– lexical and phrasal stress (prominence)

– intonation contour

– terminal contous

– rhythm

  • C discussed the prosodic target with the P and highlighted the differences between AE and Hindi.
  • Treatment procedures involved:

– focused stimulation

– auditory discrimination

– production training included sentence completion, role-playing, work-based conversational practice, modeling, and feedback from C.

  • C provided visual cues to P including

– written sentences

– staircases, arrows, curves (intonation changes)

– bolding (stress)

  • C provided motoric cues such as tapping to facilitate the teaching of rhythm
  • C recommended that P pause after phrases to increase comprehensibility (ease of understanding).
  • C assigned 30 minutes of homework after each prosody session. Ps recorded their homework and uploaded the audios to C. Homework consisted of reading aloud narrative and text materials.

SEGMENTAL TREATMENT

  • C focused on the production of P specific AE consonants.
  • Treatment procedures involved:

– focused stimulation

– auditory discrimination

– articulation placement

– sound production training did not include the production of sounds in isolation because Hindi consonants are produced with vowels. Sound production training did include production of the consonant in initial, medial, and final positions of words; the reading aloud of simple sentences; production of the target sound in conversation involving sentences of increasing complexity; picture description; work-based conversational practice.

  • C assigned 30 minutes of homework after each prosody session. Ps recorded their homework and uploaded the audios to C. Homework consisted of reading aloud narrative and text materials.