Hoskins (1988)

FORM #2

EBP THERAPY ANALYSIS

Treatment Groups

 

(Hints for completing this form can be found in “Directions for the Use of Collaboration Forms” section of the Dashboard.)

 

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

 

Key:

C = Clinician

EBP = evidence-based practice

EOWPVT = Performance on the Expressive One-Word Picture Vocabulary Test

f = female

m = male

MT = music therapist

NA = not applicable

P = Patient or Participant

pmh = Patricia Hargrove, blog developer

PPVT = Peabody Picture Vocabulary Test

SLP = speech–language pathologist

 

 

SOURCE: Hoskins, C. (1988). Use of music to increase verbal response and improve expressive language abilities of preschool language delayed children. Journal of Music Therapy, 25 (2), 73-84.

 

REVIEWER(S): pmh

 

DATE: October 16, 2015

ASSIGNED GRADE FOR OVERALL QUALITY: C- (The highest possible grade, based on the design of the investigation, is B+.)

 

TAKE AWAY: Although the results of this small group investigation suggest that a music-based intervention to improve expressive language in preschool children who had been categorized as developmentally delayed or ‘mentally retarded’* was not successful, receptive vocabulary scores improved significantly when the stimuli were presented melodically (i.e., Outcome #2) during pre and post testing.

* This investigation was published in 1988. The terminology used by the investigator will be used throughout the review.

 

 

  1. What type of evidence was identified?

                                                                                                           

–  What was the type of evidence? Prospective, Nonrandomized Group Design with Controls

                                                                                                           

– 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 (Ps) randomly assigned to groups? No

– If there were groups and Ps were not randomly assigned to groups, were members of groups carefully matched? No. Groups were sorted by CA and functioning level (p. 77.) No other description of matching of group was provided.

                                                                    

– Describe the assignment strategy: The authors claimed that the groups were sorted by chronological age (CA) and functional level but 2 young participants (Ps) with IQs of 100 and 96 were in the lowest group, presumably because they were young. There was no other description of matching of groups.

  1. Was administration of intervention status concealed?

                                                                                                           

– from participants? No

                                                                    

– from clinicians? No

                                                                    

– from analyzers? Unclear

                                                                    

 

  1. Were the groups adequately described? No

 

– How many Ps were involved in the study?

  • total # of Ps: 16
  • # of groups: 3
  • List names of groups and the # of participants in each group:

     – Group #1 (high functioning): 4

– Group #2 (moderate functioning):

– Group #3 (low functioning): 6

NOTE: This information was derived from Table 1 by the reviewer. It was not directly provided by the investigator.

 

– List the described P characteristics:

  • age:

     – Group #1: 3:0 to 5:5

     – Group #2: 2:5 to 4:0

     – Group #3: 2:0 to 2:9

NOTE: This information was derived from Table 1 by the reviewer. It was not directly provided by the investigator. There is overlap between Groups 1 and 2.

  • gender:

     – Group #1: 3m, 1f

     – Group #2: 3m, 3f

     – Group #3   2m, 4f

NOTE: This information was derived from Table 1 by the reviewer. It was not directly provided by the investigator.

  • cognitive skills:

     – Group #1: 44 – 97 IQ

     – Group #2: 50- 86 IQ

     – Group #3: 70- 100 IQ

NOTE: This information was derived from Table 1 by the reviewer. It was not directly provided by the investigator. Several of the participants (Ps) should not be considered cognitively impaired.

all Ps were enrolled in a program for ‘developmental delay or mental retardation”

 

  • expressive language: “some speech” (p.75);
  • overall language skills: “some language lag or delay”
  • hearing status: no known hearing loss
  • ability to play rhythms: all Ps could play rhythms

 

–  Were the groups similar before intervention began? No. Note the results of statistical testing on pretest measures in item #9.

                                                         

– Were the communication problems adequately described? No

  • disorder type: no information
  • functional level: “some language lag or delay” (p. 75)

 

 

  1. 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? No

 

 

  1. 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? No

– Was the time involved in the groups (i.e., Groups 1, 2, and 3) constant? Yes

 

 

  1. Were the outcomes measure appropriate and meaningful? Yes

 

The outcomes (dependent variables) were

  • OUTCOME #1: Performance on a spoken version of the Peabody Picture Vocabulary Test (PPVT)
  • OUTCOME #2: Performance on a melodic version of the PPVT
  • OUTCOME #3: Performance on the Expressive One-Word Picture Vocabulary Test (EOWPVT)

All the 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

 

 

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

– Summary Of Important Results

 

— What level of significance was required to claim significance?

p = 0.05

TREATMENT AND FOIL/COMPARISON/NO TREATMENT GROUP ANALYSES

NOTE: The results are concerned only with significantly different scores. In this case, pre and post treatment aspects of the outcomes will be marked with an asterisk (*)

  • OUTCOME #1: Performance on a spoken version of the Peabody Picture Vocabulary Test (PPVT)

– Between group measures using ANOVA:

  • significant difference among the 3 groups

– Post hoc test using Scheffé:

  • significant difference between the high and low groups

– Between trial (pre vs post) measures using ANOVA:

  • None

– Between group measures using Kruskal-Wallis on all 6 measures (pre and post for the 3 outcomes)

  • significant difference among the measures

– Post hoc test using Mann-Whitney U:

  • significant difference for
  • Group 2 vs Group 3 on the pretest
  • Group 1 vs Group 3 on the pretest
  • Group 1 vs Group 2 on the posttest
  • Group 1 vs Group 3 on the posttest

– Between trial (pre vs post) measures using Wilcoxon

  • None
  • OUTCOME #2: Performance on a melodic version of the PPVT

– Between group measures using ANOVA:

  • significant difference among the 3 groups

– Post hoc test using Scheffé:

  • significant difference for
  • Group 1 vs Group 2
  • Group 1 vs Group 3

 

– Between trials (pre vs post) using ANOVA

  • overall post scores were significantly higher than pretest scores*

– Between group measures using Kruskal-Wallis on all 6 measures (pre and post for the 3 outcomes):

  • significant differences among measures

– Post hoc test using Mann-Whitney U:

  • significant difference for
  • Group 1 vs Group 2 on the pretest
  • Group 1 vs Group 3 on the pretest
  • Group 1 vs Group 3 on the posttest

– Between overall trial (pre vs post) measures using Wilcoxon

  • significant*
  • OUTCOME #3: Performance on the Expressive One-Word Picture Vocabulary Test (EOWPVT)

– Between group measures using ANOVA:

  • significant difference among the 3 groups

– Post hoc test using Scheffé:

  • significant difference for
  • Group 1 vs Group 2
  • Group 1 vs Group 3

– Between trial (pre vs post) measures using ANOVA:

  • None

– Between group measures using Kruskal-Wallis on all 6 measures (pre and post for the 3 outcomes):

  • significant differences among measures

– Post hoc test using Mann-Whitney U:

  • significant differences for
  • Group 1 vs Group 2 on pretest and posttest
  • Group 1 vs Group 3 on pretest and posttest

– Between trial (pre vs post) measures using the Wilcoxon

  • None

– What was the statistical test were used to determine significance?

  • ANOVA
  • Mann-Whitney U
  • Wilcoxon
  • Scheffé
  • Kruskal-Wallis

 

– Were confidence interval (CI) provided? No

  1. What is the clinical significanceNot Applicable (NA); not provided

 

  1. Were maintenance data reported? No

 

  1. Were generalization data reported? No

 

 

  1. Describe briefly the experimental design of the investigation.

 

  • The investigation involved 16 children who were enrolled in classes for developmentally delayed or “mentally retarded” preschoolers.
  • The 16 Ps were divided into 3 groups purportedly based on CA and level of functioning.
  • All Ps received the same pretest, posttest, and interventions.
  • The difference among the groups (Groups 1, 2, and 3) and trials (pretest, posttest) were analyzed using ANOVA (3×2) and nonparametric statistics.

 

 

ASSIGNED OVERALL GRADE FOR QUALITY OF EXTERNAL EVIDENCE: C-

 

 

 

SUMMARY OF INTERVENTION

 

PURPOSE: To determine

– if a music-based intervention improved expressive language skills (it did not but some aspect of receptive vocabulary improved)

– if there is a relationship between spoken and melodic versions of the PPVT (this was not described in this review but the finding were that there was a strong correlation)

POPULATION: Cognitive Impairment, Developmental Delay; Children- preschool

 

MODALITY TARGETED: Expression, Reception

 

ELEMENTS OF PROSODY USED AS INTERVENTION: music (rhythm, pitch, melody/intonation)

 

OTHER ASPECTS OF LANGUAGE/COMMUNICATION TARGETED (Dependent variable): Expressive and receptive vocabulary

DOSAGE: Group, 3 days a week, 30 minute sessions, 10 weeks (the plan was for 12 weeks but the investigator terminated the interventions when she perceived no further progress)

 

ADMINISTRATOR: Music therapist (MT)

 

STIMULI: gestures, music (singing), speech, visual (pictures)

 

MAJOR COMPONENTS:

 

  • Throughout the sessions, Ps were encouraged to speech spontaneously.
  • Sessions:

– Group sang familiar songs

– The clinician (C), in this case a MT, modeled hand and arm movements during the songs and encouraged the Ps to imitate words and motions.

– Singing activities also focused on body parts, colors, numbers, etc.

– C displayed a picture of an item and sang a 3 to 5 word phrase about the item. This was repeated for 20 pictures a session selected from a core of 60 pictures.

– The Ps and the C then repeated the name of the object in unison

_______________________________________________________________

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