CRITIQUE OF UNSUPPORTED PROCEDURAL DESCRIPTIONS
(also known as Expert Opinion)
C = clinician
NA = not applicable
MIT = Melodic Intonation Therapy.
P = patient or participant
pmh = Patricia Hargrove, blog developer
SLP = speech-language pathologist
Source: Goldfarb, R. (2015). Modifying Melodic Intonation Therapy. Journal of Communication Disorders, Deafness & Hearing Aids, 3 (2). ARTICLE: http://dx.doi.org/10.4172/2375-4427.1000132 REVIEW:
Date: December 24, 2015
Overall Assigned Grade: F (because there are no supporting data, the highest grade is F)
Level of Evidence: F = Expert Opinion, no supporting evidence for the effectiveness of the intervention although the author may provide secondary evidence supporting components of the intervention.
Take Away: This article was designed to be comment; there was no attempt to provide original data. The author thoughtfully described problems he noted in a previously published case study involving the administration of Melodic Intonation Therapy (MIT) by a spouse and provided potential solutions for the problems. The changes could result in increasing effectiveness of MIT by easing protocol delivery strategies of volunteers (e.g., family members) and SLP assistants as well as by facilitating generalization.
- Was there a review of the literature supporting components of the intervention? No
- Were the specific procedures/components of the intervention tied to the reviewed literature? No
- Was the intervention based on clinically sound clinical procedures? Yes
- Did the author(s) provide a rationale for components of the intervention? Yes
- Description of outcome measures:
- Are outcome measures suggested? No
- Was generalization addressed? Yes. The author noted that the context of MIT is artificial. He recommended that procedures be included that facilitate the transfer of skills from the artificial context to more natural contexts.
- Was maintenance addressed? No
SUMMARY OF INTERVENTION
PURPOSE: To describe MIT and some of its modifications and to explain some of the music theory that serves as a basis for MIT.
POPULATION: Aphasia (Broca’s, nonfluent); Adult
MODALITY TARGETED: Production
ELEMENTS/FUNCTIONS OF PROSODY TARGETED (do not list the specific
ELEMENTS OF PROSODY USED AS INTERVENTION: music (intonation/melody, rhythm)
OTHER ASPECTS OF LANGUAGE/COMMUNICATION TARGETED: expressive language
DOSAGE: for original MIT 75-90 hours of intervention were recommended; Goldfarb’s earlier case study appeared to involve the recommended number of hours, 2 times a week for 1 hour sessions at the university with spouse as administrator and up to 5 one-hour sessions per week at home administered by the spouse. The spouse was observed 1 time per week at home and all home sessions were recorded to insure treatment fidelity.
ADMINISTRATOR: for original MIT—SLP; for Goldfarb’s earlier case study administrator was the spouse
- This audience for this article is clinicians (Cs) with a working knowledge of MIT.
- The author described problems he noted in a previously published case study and provided potential solutions for the problems. The solutions involved (1) changing selected melodic patterns, (2) changing selected intoned questions directed to P, and (3) adding generalization procedures.
CHANGING OF SELECTED MELODIC PATTERNS
– For Level I, Step 4 the melodic pattern was changed because the prescribed pattern elicited a stereotyped response from the P. Instead the administrator replicated the stress patterns that would be observed in conversational speech.
CHANGING SELECTED INTONED QUESTIONS
– For I, Step 5 the elicitation questions were changed to conversational speech because when the administrator intoned the questions, the P responded by imitating the intoned questions rather than answering them.
ADDING GENERALIZATION PROCEDURES
– The original MIT procedures do not focus on transferring skills from structured contexts to more natural, conversational contexts. The authors recommended that procedures be added that focus on responding to verbal stimuli and internal stimuli that are observed in home contexts.