Michel & May (1974)

SECONDARY REVIEW CRITIQUE

(To view summaries of procedures, scroll down approximately one-way down the page.)

 

KEY:

 

C = clinician

NA = not applicable

MT = music therapy/music therapist

P = patient or participant

pmh = Patricia Hargrove, blog developer

SLP = speech-language pathologist

SR = Systematic Review

SLT = speech-language therapy

 

 

Source: Michel, D. E., & May, N. H. (1974). The development of music therapy: Procedures with speech and language disorders. Journal of Music Therapy, 11,

74-80.

 

Reviewer(s): pmh

 

Date: April 15, 2016

 

Overall Assigned Grade: D- (The highest possible grade for this investigation is D because this was a Narrative or Traditional Review of the Literature. This should not be construed to indicate that the ideas presented in the review are of low value. It merely indicates that the quality of evidence supporting the ideas/intervention is minimal because it is a narrative review of the literature.)

 

Level of Evidence: D

 

Take Away: This Narrative (or Traditional) review of the literature provides historic information regarding views about the links between music therapy (MT) and speech-language therapy (SLT) as evidenced by research conducted at Florida State University in the 1960s and early 1970s. The authors reviewed several investigations involving children with a variety of clinical conditions. Overall, the results of these investigations suggest that the inclusion of music/singing in intervention directed toward the development of language, production of speech sounds, intonation, rhythm, attention, discrimination, and coordination can be associated with improvement.

 

What type of secondary review? Narrative Review

 

 

  1. Were the results valid? Yes

 

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

 

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

 

  • The authors of the secondary research did not describe the resources they used to identify sources for review.

 

  • Did the sources involve only English language publications? Yes

 

  • Did the sources include unpublished studies? Yes

 

  • Was the time frame for the publication of the sources sufficient? Yes

 

  • Did the authors of the secondary research identify the level of evidence of the sources? Variable

 

  • Did the authors of the secondary research describe procedures used to evaluate the validity of each of the sources? No

 

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

 

  • Did the authors of the secondary research or review teams rate the sources independently? No

 

  • Were interrater reliability data provided? No

 

  • If there were no interrater reliability data, was an alternate means to insure reliability described? No

 

  • Were assessments of sources sufficiently reliable? Not Applicable (NA)

 

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

 

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

 

  • Were there a sufficient number of sources? Yes

 

  1. Description of outcome measures:

 

NOTE: The references at the end of the outcomes identify the source(s) that were concerned with the specific outcome.

 

  • Outcomes #1: Improved speech, muscle coordination, self-expression, and socialization (Stadsklev, 1966)
  • Outcome #2: Increased singing range, improved articulation, improved rhythm, improved playing of musical instruments, improved early language skills, improved inflection/intonation, increased attention span (Davis, Slonin, & Walker, 1967)
  • Outcome #3: Improved word discrimination (Madsen et al., in press in 1974)
  • Outcome #4: Improved production of target words containing blends (Irwin, 1969)
  • Outcome #5: Improved production of consonants (Irwin, Plumb, & Walker, 1969; Walker, 1970; Irwin, 1971; Marsh, 1969; Marsh & Fitch, 1970)
  • Outcome #6: Improved early language, attention, discrimination, coordination (Greenfield, 1971)

 

 

  1. Description of results:

 

– What measures were used to represent the magnitude of the treatment/effect size? No measure of the magnitude of the treatment effect/effect size were reported

 

– SUMMARY OF THE FINDINGS:

 

  • Outcome #1: Improved speech, muscle coordination, self-expression, and socialization (Stadsklev, 1966)

– reported “noticeable improvement” (p. 75) in

  • speech
  • coordination
  • self expression
  • socialization

 

  • Outcome #2: Increased singing range, improved articulation, improved rhythm, improved playing of musical instruments, improved early language skills, improved inflection/intonation, increased attention span (Davis, Slonin, & Walker, 1967)

– reported

  • improved singing
  • improved matching of pitches
  • improved articulation
  • improved “ability to respond appropriately to rhythm in music” (p. 75)
  • improved ability to play the autoharp
  • improved ability to interact with others in a group
  • improved early language interaction
  • improved inflection/intonation and voice projection/loudness?
  • improved following directions
  • increased attention

 

  • Outcome #3: Improved word discrimination (Madsen et al., in press in 1974)

– reported improvement in

  • discrimination
  • reading readiness skills

 

  • Outcome #4: Improved production of target words containing blends (Irwin, 1969)

– reported improvements in

  • the production of target words containing blends

 

  • Outcome #5: Improved production of consonants (Irwin, Plumb, & Walker, 1969; Walker, 1970; Irwin 1971; Marsh, 1969; Marsh & Fitch, 1970)
  • reported improvement in
  • production of /s/ and /r/
  • production of /b/, /p/, and /m/

 

  • Outcome #6: Improved early language, attention, discrimination, coordination (Greenfield, 1971)
  • reported positive outcomes but improvements were noted only generally.

 

 

– Were the results precise? No

 

– 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? NA

 

– Were the results of individual studies clearly displayed/presented? Variable

 

– For the most part, were the results similar from source to source? Yes

 

– Were the results in the same direction? Yes

 

– Did a forest plot indicate homogeneity? NA

 

– Was heterogeneity of results explored?           No

 

– Were the findings reasonable in view of the current literature? Yes

– Were negative outcomes noted? No

           

                                                                                                                   

  1. Were maintenance data reported? No

 

 

  1. Were generalization data reported? Yes. Generalization was noted for one of the sources that were reviewed.

 

 

SUMMARY OF INTERVENTION

 

 

STADSKLEY (1966)—Source #1

 

Population: Cerebral Palsy; Children

 

Nonprosodic Targets: speech, coordination, self-expression, socialization (p. 75)

 

Aspects of Prosody Used in Treatment of Nonprosodic Targets: music (pitch, rhythm)

 

Description of Source #1: Stadskley (1966)

 

  • Dosage: 7 weekly sessions, 45 minutes

 

  • Administrator: Music Therapist (MT) and class teacher

 

Evidence Supporting Source #1— Stadskley (1966)

 

  • “Noticeable improvement” (p. 75) was reported but the progress was not quantified.

 

Evidence Contraindicating Source #1— Stadskley (1966)

 

  • progress not quantified

 

  • descriptive case

 

 

============

 

DAVIS, SLONIN, & WALKER (1967)—Source #2

 

Population: Hearing loss; Children

 

Prosodic Targets: singing, matching pitches, intonation, loudness

 

Nonprosodic Targets: producing speech sounds, playing an instrument, interacting in a group, producing early language , attention span

 

Aspects of Prosody Used in Treatment of Nonprosodic Targets: music/singing (pitch, rhythm)

 

Description of Source #2—Davis, Slonin, & Walker (1967)

 

  • Residential speech and language summer clinic.

 

  • Sessions were combined MT and speech-language therapy (SLT.)

 

  • The author of the review noted improvements but did not quantify in all of the targets.

 

Evidence Contraindicating Source #2— Davis, Slonin, & Walker (1967)

 

  • The author of the review noted improvements but did not quantify progress for all of the targets.

 

Evidence Contraindicating Source #2— Davis, Slonin, & Walker (1967)

 

  • case studies, descriptive

 

  • outcomes and procedures were not well described

 

 

======================

 

MADSEN, MADSEN, AND MICHEL, IN PRESS at the time of the publication of the Narrative Review—Source #3

 

Population: Disadvantaged; Children

 

Nonprosodic Targets: discrimination, reading readiness (p. 76)

 

Aspects of Prosody Used in Treatment of Nonprosodic Targets: singing/music (pitch, rhythm)

 

Description of Source #3— Madsen, Madsen, & Michel (in press)

 

  • 216 children enrolled in a Head Start program

 

  • Teachers used “practice songs” and “tonal cures paired with words” (p. 76.)

 

Evidence Supporting Source #3— Madsen, Madsen, & Michel (in press)

 

  • The investigators compared the effectiveness of this approach to 4 other interventions and found this approach resulted in significantly more improvement.

 

Evidence Contraindicating Source #3— Madsen, Madsen, & Michel (in press)

 

  • outcomes and procedures were not well described

 

 

=========================

 

 

IRWIN (1969) – Souce #4

 

Population:  Cleft Palate; Children

 

Nonprosodic Targets: production of blends in target words

 

Aspects of Prosody Used in Treatment of Nonprosodic Targets: music/songs (rhythm, pitch)

 

Description of Source #4—Irwin (1969)

 

  • stories with targets (words with blends) were set to music

 

  • 5 sessions for each group.

 

  • The 20 Ps were divided into 3 groups: stories presented as songs, stories presented while speaking, traditional speech therapy.

 

Evidence Supporting Source #4—Irwin (1969)

 

  • Statistical analysis revealed that the Story in Songs and the Spoken Story Groups performed significantly better than the conventional therapy group on the outcomes.

 

Evidence Contraindicating Source #4—Irwin (1969)

 

  • Procedures and outcomes were not clearly described.

 

=

========================

 

 

IRWIN ET AL. (1969); WALKER (1970)—Sources #%

 

Population: Speech Sound/Articulation Problems; Children

 

Nonprosodic Targets: production of /s/ and /r/

 

Aspects of Prosody Used in Treatment of Nonprosodic Targets: music/singing (rhythm, pitch)

 

Description of Source #5—Irwin et al. (1969); Walker (1970)

 

  • Ps were divided into 3 groups: Ps receiving treatment in the public schools, Ps receiving treatment in campus clinic, Ps receiving treatment in a state hospital. All Ps received therapy using music therapy procedures.

 

  • Clinicians (C, could be SLP or MT graduate students.)

 

  • Cs selected or composed songs with the target sound in the final position of words.

 

Evidence Supporting Source #5— Irwin et al. (1969); Walker (1970)

 

  • Using graphs the investigators reported progress on the targets compared to baseline.

 

  • The investigators reported that Ps had improved their production of /s/ and /r/.

 

Evidence Contraindicating Source #5— Irwin et al. (1969); Walker (1970)

 

  • Procedures and evidence were not clearly reported.

 

===========================

 

MARSH (1969); MARSH & FITCH (1970)—Source #6

 

 

Population: Disadvantaged; Children

 

Nonprosodic Targets: /s/ in the final position (as measured by a spectrogram)

 

Aspects of Prosody Used in Treatment of Nonprosodic Targets: music/singing (rhythm, pitch, rhythmic chanting)

 

Description of Source #6—Marsh (1969); Marsh & Fitch (1970)

 

  • The targeted behavior was the production of final /s/ in the Pledge of Allegiance.

 

  • The investigators divided Ps into 3 groups: the Pledge in song format; the Pledge in a rhythmic chanting format; no treatment

 

Evidence Supporting Source #6— Marsh (1969); Marsh & Fitch (1970)

 

  • There was a trend indicating that there was improvement in the Pledge in Song group but there were no significant differences.

 

Evidence Contraindicating Procedure/Source #6— Marsh (1969); Marsh & Fitch (1970)

 

  • There were no significant differences.

 

  • Treatment procedures and outcomes were not clearly described.

 

======================

 

GREENFIELD (1971)—Source #7

 

Population:  Speech and Language Problems; Children

 

Nonprosodic Targets: discrimination, attention, coordination, early language skills

 

Aspects of Prosody Used in Treatment of Nonprosodic Targets: music (rhythm, pitch)

 

Description of Source #7— Greenfield (1971)

 

  • Music therapy for 7-22 sessions.

 

  • Total of 9 Ps.

 

Evidence Supporting Source #7— Greenfield (1971)

 

  • General reports of improvement

 

Evidence Contraindicating Source #7— Greenfield (1971)

 

  • Treatment procedures and outcomes were not clearly described.

 

 

=======================

 

 

IRWIN (1971)—Source #8

 

Population: Down syndrome; Children

 

Nonprosodic Targets: production of speech sounds: /p/, /b/, and /m/

 

Aspects of Prosody Used in Treatment of Nonprosodic Targets: music (rhythm, pitch)

 

Description of Source #8— Irwin (1971)

 

  • Treatment lasted “several months” (p. 78)

 

  • The C composed music and used it in therapy.

 

Evidence Supporting Source #8— Irwin (1971)

 

  • Ps significantly increased their production of /b/ and /p/ (the targets) and the production of a generalization target /m/ also improved.

 

Evidence Contraindicating Source #8— Irwin (1971)

 

  • Progress did not generalize to spontaneous speech.

 

  • The description of intervention procedures was limited.

 

==================

 

 

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