Grossman et al. (2013)

July 30, 2016

 

ANALYSIS

Comparison Research

 

NOTE: No summary of intervention is included in the review.

 

 

KEY:

 

AA = Acoustic analysis

ADOS = Autism Diagnostic Observation Scale

AFA = Auditory and Facial Analysis

ASD = Autism spectrum disorders

E = experimenter

eta =   partial eta squared

f = female

HFA = High –Functioning Autism

m = male

MLU = mean length of utterance

NA = Not Applicable

P = participant or patient

pmh = Patricia Hargrove, blog developer

SLP = speech-language pathologist

TD = typically developing

 

 

SOURCE: Grossman, R. B., Edelson, L. R., & Tager-Flusberg, H. (2013). Emotional facial and vocal expressions during story retelling by children and adolescents with high-functioning autism. Journal of Speech, Language, and Hearing Research, 56, 1035-1044.

 

REVIEWER(S): pmh

 

DATE: July 22, 2016

 

ASSIGNED GRADE FOR OVERALL QUALITY: no grade. This is not an intervention investigation; it is concerned with the nature of prosodic problems associated with clinical conditions.

 

TAKE AWAY: This preliminary investigation is concerned with prosodic and facial affect associated with autism spectrum disorders (ASD); it is not an intervention or assessment investigation. Nevertheless, it has application to the practice of speech-language pathology. The accuracy of participants (Ps) with HFA and their typically developing (TD) peers in representing emotion using facial gestures was similar. However, Ps with HFA are more accurate then TD peers when using prosody to represent emotion. The investigators suggested that because TD peers’ prosody was rated as being closer to neutral expressively, they may have been more difficult to interpret. There was positive correlation between judges’ perception of Ps with HFA facial and prosodic awkwardness with their social communication skills on the Autism Diagnostic Observation Scale (ADOS.) The results cannot be used to describe behavior of females with HFA because there were no females with HFA in the sample.

 

 

  1. What type of evidence was identified?

                                                                                                           

  • What was the type of design? Comparison Research- Prospective, Nonrandomized Group Design with Controls

 

  • What was the focus of the research? Clinically Related

                                                                                                           

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

 

                                                                                                           

  1. Group membership determination:

                                                                                                           

  • If there were groups, were participants randomly assigned to groups? No, the Ps were either diagnosed with HFA or were TD peers.
  • If there were groups and Ps were not randomly assigned to groups, were members of groups carefully matched? Yes

                                                                    

 

  1. Were experimental conditions concealed?

                                                                                                           

– from participants? Unclear

                                                                    

– from administrators of experimental conditions? No

                                                                    

– from analyzers/judges? Yes

                                                                    

 

  1. Were the groups adequately described? Yes

 

  • How many participants were involved in the study?

 

– Because of technical difficulties, there were, in effect, 2 phases of this investigation:

  • Participants (Ps) whose recordings were acoustically analyzed for auditory depiction of affect (Acoustic Analysis group; AA group)
  • Participants (Ps) whose recordings were coded perceptually for auditory and facial depiction of affect (Auditory and Facial Analysis group; AFA group)
  • Apparently, some Ps were analyzed in both the AA group and the AFA group.

 

  • Did all groups maintain membership throughout the investigation? Yes, there was only one session.

 

 

AA GROUP:

 

  • total # of Ps:  29
  • # of groups: 2
  • List names of groups and the number of Ps in each group:

     – High-Functioning Autism (HFA) = 18

– Typically Developing (TD) = 11

                                                                                

— CONTROLLED CHARACTERISTICS                                                

  • cognitive skills: within normal limits for HFA and TD
  • reading: : within normal limits for HFA and TD
  • native and primary language: English
  • receptive vocabulary: within normal limits for HFA and TD (1 HFA and 2 TD Ps were not administered the PPVT; it was not clear if these from AA and/or AFA groups)

 

— DESCRIBED CHARACTERISTICS

  • age:

     HFA = mean 13;10

     TD = mean 15

     Overall range for combined AA, AFA, HFA, TD = 8;2 to 19;9

  • gender:

     HFA = 17m; 1f

     TD = 11m; 0f

  • cognitive skills:

     HFA = mean 109.17

     TD = mean 116.09

  • verbal IQ:

     HFA = mean 108.44

     TD = mean 117.09

  • nonverbal IQ:
    HFA = mean 106.94

     TD = mean 110.64

  • receptive vocabulary:

     HFA = mean 117.65

     TD = mean 119.09

  • literacy:

     HFA = mean 109.39

     TD = mean 110.36

 

AFA GROUP:

 

  • total # of Ps: 26
  • # of groups: 2
  • List names of groups and the number of Ps in each group:

     HFA = 14

TD = 12

  • Did all groups maintain membership throughout the investigation?  

Yes _x___   No   _____   Unclear _________

 

 

— CONTROLLED CHARACTERISTICS                                                

  • cognitive skills: within normal limits for HFA and TD
  • reading: : within normal limits for HFA and TD
  • native and primary language: English
  • receptive vocabulary: within normal limits for HFA and TD (1 HFA and 2 TD Ps were not administered the PPVT; it was not clear if these from AA and/or AFA groups)

 

DESCRIBED CHARACTERISTICS

  • age:

     HFA = mean 14

     TD = mean 14

     Overall range for combined AA, AFA, HFA, TD = 8;2 to 19;9

  • gender:

     HFA = 14m; 0f

     TD = 11m; 1f

  • cognitive skills:

     HFA = mean 108.57

     TD = mean 116.25

  • verbal IQ:

     HFA = mean 109.43

     TD =   mean 113.67

  • nonverbal IQ:
    HFA = mean 104.86

     TD = mean 114.25

  • receptive vocabulary:

     HFA = mean 115.57

   TD = mean 115.20

  • literacy:

     HFA = mean 111.36

     TD = mean 112.08

 

– Were the groups similar? Yes

                                                         

– Were the communication problems adequately described? No

  • Mean scores for all groups on tests of verbal IQ, receptive vocabulary, and literacy were within normal limits. Ranges and individual scores were not provided.

 

 

  1. What were the different conditions for this research?

                                                                                                             

  • Subject (Classification) Groups? Yes

Diagnostic status:

  • HFA
  • TD

                                                               

  • Experimental Conditions?

– Emotion state (including happy, fearful, angry, positive surprise)

 

  • Criterion/Descriptive Conditions? Yes

– Nature of data analysis:

  • AA
  • AFA

 

 

  1. Were the groups controlled acceptably? Yes

 

 

  1. Were dependent measures appropriate and meaningful? Yes

 

– Dependent measures:

 

  • OUTCOME #1: Accuracy of expressed emotion
  • OUTCOME #2: Perceived Intensity of expressed emotion
  • OUTCOME #3: Awkwardness/naturalness of expressed emotion
  • OUTCOME #4: Maximum Fo associated with the production of a targeted emotion
  • OUTCOME #5: Minimum Fo associated with the production of a targeted emotion
  • OUTCOME #6: Mean Fo associated with the production of a targeted emotion
  • OUTCOME #7: Minimum intensity associated with the production of a targeted emotion
  • OUTCOME #8: Maximum intensity associated with the production of a targeted emotion
  • OUTCOME #9:   Mean intensity associated with the production of a targeted emotion
  • OUTCOME #10: Intensity range   associated with the production of a targeted emotion
  • OUTCOME #11: Pitch range associated with the production of a targeted emotion

 

– The dependent measures that are subjective:

  • OUTCOME #1: Accuracy of expressed emotion
  • OUTCOME #2: Perceived Intensity of expressed emotion
  • OUTCOME #3: Awkwardness/naturalness of expressed emotion

 

– The dependent measures that are objective:

  • OUTCOME #4: Maximum Fo associated with the production of a targeted emotion
  • OUTCOME #5: Minimum Fo associated with the production of a targeted emotion
  • OUTCOME #6: Mean Fo associated with the production of a targeted emotion
  • OUTCOME #7: Minimum intensity associated with the production of a targeted emotion
  • OUTCOME #8: Maximum intensity associated with the production of a targeted emotion
  • OUTCOME #9: Mean intensity associated with the production of a targeted emotion
  • OUTCOME #10: Intensity range associated with the production of a targeted emotion
  • OUTCOME #11: Pitch range associated with the production of a targeted emotion

 

 

  1. Were reliability measures provided?

                                                                                                            

  • Interobserver for analyzers? Yes

 

– The interobserver reliability for Outcomes 1, 2, and 3 was at least 0.85 (Cohen’s kappa.)

 

  • Intraobserver for analyzers?   No

 

  • Treatment or test administration fidelity for investigators?

 

 

  1. Description of design:

 

  • Forty Ps with the diagnosis of HFA (N = 22) and TD (N = 18) peers were enrolled in the investigation. The age range of the participants was 8;2 t0 19;9 years.
  • Ps sat in a quiet room and individually viewed a video of an actor telling a narrative with sentences representing 4 different emotions. Ps were told was they were to retell the narrative as if to children.
  • There were 4 brief narratives about a character who was taking pictures on a wildlife safari. Each of the narratives contained at least one sentence with each of the targeted emotions

– happy

– fearful

– angry

– positive surprise

  • The experimenter (E) stopped the video and directed P to retell the narrative after P had viewed it. E provided a script to assist P and recorded P’s production.
  • Due to technical problems with the recording instrumentation, the video of some the Ps was of not sufficient quality for the accurate coding of facial representation of emotion. When the recording instrumentation was changed, although it was possible to code perceptually facial and prosodic production for most of the Ps, some of the audio was not sufficient to allow for acoustic analysis. Therefore, the Ps responses were analyzed in 2 different ways:

– Acoustic analysis only (total 29 Ps)

– Perceptual coding of facial and prosodic representation of targeted emotion (total 26 Ps.)

 

 

  1. What were the results of the statistical (inferential) testing?

 

RESULTS

 

  • OUTCOME #1: Accuracy of expressed emotion
  • AFA – using video as the data

∞ HFA was significantly more accurate in prosodically producing emotion than TD peers.

 

  • OUTCOME #2: Perceived Intensity of expressed emotion
  • AFA

∞ using Freeze frames as the data—there were no significant differences between HFA and TD in the intensity of facial productions of emotion

∞ using video as the data

– There was not a significant difference between HFA and TD in the intensity of facial production of emotion.

– HFA was significantly more intense when prosodically producing emotion than TD peers.

 

  • OUTCOME #3: Awkwardness/naturalness of expressed emotion
  • AFA –

∞ using Freeze frame as the data—there were no significant differences between HFA and TD in awkwardness/naturalness of facial production of emotion

∞ using video as the data –HFA was significantly more awkward in the facial production of emotion.

 

  • OUTCOME #4: Maximum Fo associated with the production of a targeted emotion
  • AA – HFA produced a significantly higher maximum Fo

 

  • OUTCOME #10: Intensity range   associated with the production of a targeted emotion
  • AA – HFA produced a significantly wider intensity range than TD.

 

  • OUTCOME #11: Pitch range associated with the production of a targeted emotion
  • AA – HFA produced a significantly larger pitch range than TD

 

– What were the statistical tests used to determine significance? ANOVA, MANOVA:

 

– Were effect sizes provided? Yes

 

  • OUTCOME #1: Accuracy of expressed emotion – Ps diagnosed with HFA were more accurate in the prosodic expression of emotion than TD peers. Eta = .201 (large)

 

  • OUTCOME #2: Perceived Intensity of expressed emotion– HFA were more intense when prosodically producing emotion than TD peers– Eta = 0.213 (large)

 

  • OUTCOME #3: Awkwardness/naturalness of expressed emotion– HFA Ps significantly more awkward in the facial production of emotion–   Eta = 0.179 (large)

 

  • OUTCOME #4: Maximum Fo associated with the production of a targeted emotion- HFA produced a significantly higher maximum FoEta = 0.134 (moderate)

 

  • OUTCOME #10: Intensity range associated with the production of a targeted emotion– HFA produced a wider intensity pitch range than TD– Eta = 0.133 (moderate)

 

  • OUTCOME #11: Pitch range associated with the production of a targeted emotion – HFA produced a significantly larger pitch range than TD — Eta = 0.65 (large)

 

Were confidence interval (CI) provided? No

 

 

  1. Summary of correlational results:

 

  • No significant correlations for any of the acoustic measures with the social communication scores (on ADOS) of Ps with HFA.

 

  • Significant correlations for HFA Ps between social communication scores on ADOS and
  • video rating of awkwardness of facial production of emotion (r = 0.67)
  • video rating of awkwardness of prosodic production of emotion (r = 0.60)

 

 

 

  1. Summary of descriptive results: Qualitative research —NA

 

 

  1. Brief summary of clinically relevant results:

 

  • The accuracy of Ps with HFA and TD Ps in representing emotion using facial gestures is similar; however, Ps with HFA are more accurate then TD peers when using prosody to represent emotion.

 

  • HFA Ps were also rated as being more expressive than TD peers. This led the investigators to suggest that with the TD peers being closer to neutral expressiveness, they may have been more difficult to interpret.

 

  • Although Ps with HFA were more awkward facially than TD peers, their prosody was not judged to be more awkward.

 

  • The results cannot be used to describe behavior of females with HFA because there were no females with HFA in the sample.

 


Dupis & Pichora-Fuller (2015)

July 19, 2016

 

ANALYSIS GUIDELINES

Comparison Research

 

NOTE:

  • The investigation is not on intervention. Accordingly, no summary of an intervention is included in the review.

 

KEY:

DF = Difference Limen

eta =   partial eta squared

f = female

Fo = Fundamental Frequency

HFPTAB = high frequency pure tone average

m = male

MLU = mean length of utterance

NA = Not Applicable

P = participant or patient

PTAB = standard pure-tone average

pmh = Patricia Hargrove, blog developer

SLP = speech-language pathologist

 

 

SOURCE: Dupis, K., & Pichora-Fuller, M. K. (2015.) Aging affects identification of vocal emotions in semantically neutral sentences. Journal of Speech, Language, and Hearing Research, 58, 1061- 1076.

 

REVIEWER(S): pmh

 

DATE: July 13, 2015

 

ASSIGNED GRADE FOR OVERALL QUALITY: No grade assigned because this in not intervention research

 

TAKE AWAY: This investigation involved the comparison 2 groups of typical speakers and, therefore, should not be considered to be intervention research. Nevertheless, it is informative for the practice of speech-language pathology. Two experiments revealed that there are age related differences in the ability to recognize emotion using prosody with younger Ps outperforming older Ps. These differences cannot be explained by hearing acuity as measured by pure tone averages or by auditory processing (Fo DL, gap detection, Intensity DL.)

 

 

 

  1. What type of evidence was identified?

                                                                                                           

  • What was the type of design?  Comparison Research

 

  • What was the focus of the research? Essential Research

                                                                                                           

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

 

                                                                                                           

  1. Group membership determination:

                                                                                                           

  • If there were groups, were participants randomly assigned to groups? No, the groups were age-based.

 

EXPERIMENT #1

 

  1. Were experimental conditions concealed?

                                                                                                           

  • from participants? No

                                                                    

  • from administrators of experimental conditions? No

                                                                    

  • from analyzers/judges? Unclear

                                                                    

 

  1. Were the groups adequately described? Yes

 

– How many participants were involved in the study?

 

  • total # of participants (Ps): 84
  • # of groups: 2
  • List names of groups and the number of Ps in each group:.

 

CONTROLLED CHARACTERISTICS

                                                                                                             

  • language: all Ps had acquired English by 5 years of age
  • educational level of participants (Ps):

Younger group = all university students (mean years of education = 13.5)

     Older group = completed at least Grade 10

  • Hearing: Clinically normal hearing

 

– DESCRIBED CHARACTERISTICS

 

  • age:

Younger group: mean 19.7 years

     – Older group: mean 68.9 years

  • gender:

Younger group: f (70%); m (30%)

     – Older group: f (71%); m (29%)

  • vocabulary:

Younger group = mean score on Mill Hill Vocabulary Test = 12.4 (of 20)

     Older group = mean score on Mill Hill Vocabulary Test = 14.9 (of 20)

     – mean score on Mill Hill Vocabulary Test was significantly different for the 2 groups

  • educational level of Ps:

Younger group = mean years of education = 13.5; all university students

     Older group = mean years of education = 15.3; 75% had at least some postsecondary education

     – the mean years of education was significantly different for the 2 groups

 

– Were the groups similar? No

                                                         

– Were the communication problems adequately described? NA, all Ps were within normal limits

 

 

  1. What were the different conditions for this research?

                                                                                                             

  • Subject (Classification) Groups? Yes

– Age (Younger, Older)

                                                               

  • Experimental Conditions? Yes

– Emotion (anger, disgust, fear, sadness, neutral, happiness, pleasant suprise)

     – Talker of the sentence stimuli (younger, older)

     – Test list (7 different lists of neutral sentences)

 

  • Criterion/Descriptive Conditions? Yes

     – Hearing acuity level: pure tone averages

 

 

  1. Were the groups controlled acceptably?

Yes ___     No ___     Unclear _x__     Not Applicable ____

 

 

  1. Was the dependent measure appropriate and meaningful? Yes

 

                                                                                                             

– The dependent measure was

 

  • OUTCOME #1: Accuracy of identification of prosodically presented emotions represented

 

– The dependent measures was NOT subjective.

 

– The dependent measure was objective. Ps used a touch screen to indicate choices.

 

 

  1. Were reliability measures provided?

                                                                                                            

  • Interobserver for analyzers? No

 

  • Intraobserver for analyzers? No
  • OUTCOME #3:

 

  • Treatment or task administration fidelity for investigators? No

 

 

  1. Description of design:
  • Hearing acuity was tested prior to the experiment.
  • Individually, Ps listened to 140 sentences (20 exemplars of 7 emotions) read by a younger speaker or an older speaker.
  • The sentences were semantically neutral.
  • Ps were directed to indicate on a touch screen which of 7 emotions were represented by the prosody: anger, disgust, fear, sadness, neutral, happiness, pleasant surprise.)

 

 

  1. What were the results of the statistical (inferential) testing?

 

 

  • OUTCOME #1: Accuracy of identification of prosodically presented emotions

– Design :

  • emotion was a within subjects factor
  • age, talker (of sentence lists), and sentence list
  • hearing acuity issues

 

–   Significant main effects:

 

  • Emotion:

∞ easiest emotions: anger and sadness

∞ most difficult: disgust and pleasant surprise

 

  • Age: younger better than older listeners

 

–   Significant interaction:   Emotion x Talker

  • Anger sentences read by Older talker were easier to interpret.
  •       Happiness and sadness sentences read by the Younger talker were easier to interpret.

– Hearing Acuity

  • Older Ps had significantly poorer PTAB ad HFPTAB scores.

 

  • What statistical tests were used to determine significance? t-test, ANOVA, Tukey, Huynh-Geldt estimate of sphericity, Bonferroni correction; Mauchly’s test

 

  • Were effect sizes provided? Yes

–  OUTCOME #1: Accuracy of identification of prosodically presented emotions

 

  • MAIN EFFECTS

          – Emotion = 0.20 (large)

          – Listener Age = 0.29 (large)

 

  • INTERACTION

         – Emotion x Talker Age = 0.12 (medium)

 

 

  • Were confidence intervals (CI) provided? No

 

 

  1. Summary of correlational results:

 

  • OUTCOME #1: Accuracy of identification of prosodically presented emotions represented

– Design :

  • hearing acuity and pure tone averages (standard pure tone average, PTAB, and high frequency pure tone average, HFPTAB) compared for both age groups
  • hearing acuity and pure tone averages (PTAB and HFPTAB) compared

– for both age groups

– for each sentence types

 

– There were no significant correlations.

 

 

  1. Summary of descriptive results: Qualitative research – Not applicable (NA)

 

 

  1. Brief summary of clinically relevant results:

 

  • There are age related differences in the ability to recognize emotion using prosody with younger Ps outperforming older Ps.
  • These differences cannot be explained by hearing acuity.

 

ASSIGNED GRADE FOR QUALITY OF EXTERNAL EVIDENCE: B

 

 

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

 

 

EXPERIMENT #2

 

 

  1. Were experimental conditions concealed?

                                                                                                           

  • from participants? No

                                                                    

  • from administrators of experimental conditions? No

                                                                    

  • from analyzers/judges? Unclear

                                                                    

 

  1. Were the groups adequately described? Yes

 

–   How many participants were involved in the study?

 

  • total # of participants (Ps): 56
  • # of groups: 2
  • List names of groups and the number of Ps in each group:

     Younger = 28

Older = 28

  • Did all groups maintain membership throughout the investigation? Yes, there were only two sessions.

                                                                                

– CONTROLLED CHARACTERISTICS

  • language: all Ps had acquired English by 5 years of age
  • educational level of participants (Ps):

Younger group = all university students

     Older group = completed at least Grade 10

  • Hearing: Clinically normal hearing

 

– DESCRIBED CHARACTERISTICS

  • age:

Younger group: mean 21.6 years

     – Older group: mean 70.7 years

  • gender:

Younger group: f (61%); m (39%)

     – Older group: f (43%); m (57%)

  • vocabulary: Older group reported to have higher mean score on Mill Hill Vocabulary Test.
  • educational level of Ps: the mean years of education was reported to be similar for the 2 age groups

 

–  Were the groups similar? Yes _

                                                         

– Were the communication problems adequately described? Not Applicable (NA), the participants (Ps) were typical speakers.

 

 

  1. What were the different conditions for this research?

                                                                                                             

  • Subject (Classification) Groups? Yes

– Age: Younger, Older

                                                               

  • Experimental Conditions? Yes

– Emotion (anger, disgust, fear, sadness, neutral, happiness, pleasant suprise)

     – Talker (younger, older)

     – Test list (7 different lists of neutral sentences)

 

  • Criterion/Descriptive Conditions? Yes
  • Hearing Acuity: pure tone averages

          – PTAB

         – HFPTAB

 

  • Suprathreshold Auditory processing

         – Vowel Fundamental Frequency (Fo ) Difference Limen (DF)

          – Gap detection in speech

          – Intensity DL

 

 

  1. Were the groups controlled acceptably? Yes

 

 

  1. Were dependent measures appropriate and meaningful? Yes

 

The dependent measure was

 

  • OUTCOME #1: Accuracy of identification of prosodically presented emotions

 

 

– The dependent measure was NOT subjective.

 

– The dependent measure WAS objective. It was measured electronically.

 

 

  1. Were reliability measures provided?

                                                                                                            

  • Interobserver for analyzers? No

 

  • Intraobserver for analyzers? NO

 

  • Treatment or test administration fidelity for investigators? No

 

 

  1. Description of design:
  • There were 2 sessions:

– Session #1: pretesting including audiometric testing

– Session #2: mainly experimental testing preceded by some audiometric testing

  • Hearing was tested prior to the experiment.
  • Hearing acuity testing involved testing for 2 forms of pure tone average:

– PTAB

– HFPTAB

  • In addition, 3 forms of suprathreshiold auditory processing were measured:

– Vowel Fo DL

– Gap detection in speech

– Intensity DL

  • Individually, Ps listened to 140 sentences (20 exemplars of 7 emotions) read by a younger speaker or an older speaker.
  • The sentences were semantically neutral.
  • Ps were directed to indicate on a touch screen which of 7 emotions were represented by the prosody: anger, disgust, fear, sadness, neutral, happiness, pleasant surprise.)

 

 

  1. What were the results of the statistical (inferential) testing?

 

  • OUTCOME #1: Accuracy of identification of prosodically presented emotions represented

– Design :

  • emotion (7 emotons)
  • age, talker (of sentence lists), and sentence list
  • hearing acuity issues

 

 

–   Significant main effects: Emotion; Listener Age; Talker Age

  • Emotion:

∞ easiest emotions: anger, sadness, fear

∞ most difficult: disgust and pleasant surprise

 

  • Listener Age: younger better than older listeners

 

  • Talker Age: younger talker resulted in more correct responses by listeners

 

–   Significant interactions:

  • Emotion x Talker Age: There was no significant differences in listener’s responses to the 2 different talkers for disgust, fear, neutral, anger, sadness. Listeners responded better to the following emotions spoken by the younger listeners: happiness and pleasant surprise.

 

  • Emotion x Listener Age: The Younger P group produced significantly higher scores for all emotions with the exception of fear and pleasant surprise.

 

– Hearing Acuity

  • Older Ps had significantly poorer PTAB and HFPTAB scores.

 

– Suprathreshold Auditory Processing

  • Younger Ps produced significantly better scores on 2 of the 3 measures of suprathreshold auditory processing (Fo DL, gap detection threshold)
  • for 1 P in the Younger group, emotional detection was more than 3 standard deviations below the mean. That P’s data were removed from the data analysis.

 

  • What statistical tests were used to determine significance? t-test, ANOVA, Tukey, Bonferroni correction, Mauchly’s test, Greenhouse-Geiser estimates of sphericity

 

  • Were effect sizes provided? Yes _x___ No____

 

   OUTCOME #1: Accuracy of identification of prosodically presented emotions

 

–   Significant main effects: Emotion; Listener Age; Talker Age

 

  • Emotion = 0.40 (large)
  • Listener Age = 0.46   (large)
  • Talker Age = 0.012 (small)

 

 

 

  • Were confidence interval (CI) provided? No

 

 

  1. Summary of correlational results:

 

  • OUTCOME #1: Accuracy of identification of prosodically presented emotions

 

– Design: The investigators correlated emotion accuracy scores with hearing acuity and suprathreshold auditory processing scores.

 

– Hearing Acuity Correlations:

  • no significant correlations for either of the pure tone averages with overall emotion identification scores or individual emotion identification scores.

 

– Suprathreshold Auditory Processing

  • 1 P from the Younger group had been eliminated from the analysis due to emotion identification 3 standard deviations below the mean.
  • When correlations were calculated on either the Younger or Older group, no significant correlations were identified.
  • When the data from the Younger and Older groups were combined, there was a correlation between Emotion Identification and Fo DL (r = -0.41; moderate-small negative correlation.)

 

 

  1. Summary of descriptive results: Qualitative research NA

 

 

  1. Brief summary of clinically relevant results:

 

  • Accuracy was higher for the younger Ps. For the most, auditory acuity and auditory processing was not a factor in the accuracy of interpreting emotion prosodically.

 

ASSIGNED GRADE FOR QUALITY OF EXTERNAL EVIDENCE: B

 

 

 

 

 


Thaut et al. (2001)

July 7, 2016

 

ANALYSIS GUIDELINES

Comparison Research

 

NOTE: A summary of the “treatment” can be found by scrolling approximately two-thirds down this page.

 

KEY:

 

eta = partial eta squared

f = female

m = male

MLU = mean length of utterance

NA = Not Applicable

P = participant or patient

PD = Parkinson’s disease

pmh = Patricia Hargrove, blog developer

SLP = speech-language pathologist

 

SOURCE: Thaut, M. H., McIntosh, K. W., McIntosh, G. C., & Hoemberg, V. (2001). Auditory rhythmicity enhances movement and speech motor control in patients with Parkinson’s disease. Functional Neurology, 16(2), 163-172.

 

REVIEWER(S): pmh

 

DATE: July 7, 2016

 

ASSIGNED GRADE FOR OVERALL QUALITY: No assigned grade because this was clinically related research, not intervention research.

 

TAKE AWAY: This is clinically related research; it is not intervention research. Nevertheless, its finding have relevance to treatment. Both metered and patterned rhythmic speech resulted in improved word accuracy in participants (Ps) with Parkinson’s disease (PD.) Neither form of rhythmic speech cueing was more effective. However, rhythmic cueing was most effective with Ps who were classified as severely impaired speakers and the optimum rate of speech was the habitual speaking rate or 60% of habitual speaking rate.

 

 

  1. What type of evidence was identified?

                                                                                                           

  • What was the type of design? Comparison Research: Alternating Treatments; Prospective, Single Group, Within-subject, Rxperimental design

 

  • What was the focus of the research? Clinically Related

 

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

 

                                                                                                           

  1. Group membership determination:

                                                                                                           

  • Were participants randomly assigned to groups? Not Applicable (NA), there was only one group.

 

 

  1. Were experimental conditions concealed?

                                                                                                           

  • from participants? No

                                                                    

  • from administrators of experimental conditions? No

 

  • from analyzers/judges? Unclear

                                                                    

 

  1. Were the groups adequately described? Variable

 

–   How many participants were involved in the study?

 

  • total # of Ps:  20
  • # of groups:  1
  • Did the group maintain membership throughout the investigation? Yes

 

The CONTROLLED CHARACTERISTICS included                        

 

  • cognitive skills: : adequate to read aloud, no report of cognitive change in preceding 6 months
  • severity of Parkinson’s disease (PD): Stage III (Hoehn & Yahr scale)
  • receptive language: could follow verbal directions
  • motor skills: ability to tap rhythmic beat with finger
  • medication status: stable
  • Hearing: adequate to read aloud
  • Vision: adequate to read aloud

 

– The DESCRIBED CHARACTERISTICS included

  • age: mean age = 69.5 years
  • gender: m = 16; f = 4
  • duration of PD = mean was 8.9 years

 

–  Were the groups similar? NA, there was only one group

                                                         

– Were the communication problems adequately described? No

 

  • disorder type:  speech problems related to PD (not sure who judged this)
  • other: Ps were assessed using Assessment of Intelligibility of Dysarthric Speech (AIDS)

 

 

  1. What were the different conditions for this research?

                                                                                                             

  • Subject (Classification) Groups? No

                                                               

  • Experimental Conditions? Yes

Cueing conditions: Metered, Patterned

     – Speaking rate (syllables per minute): Habitual, 80% of Habitual, 60% of Habitual

 

  • Criterion/Descriptive Conditions? Yes

     – Severity Level based on Intelligibility: Severe (less than 60% intelligibility), Moderate (60% to 80% intelligibility), Mild (80% to 90% intelligibility) impairment

 

 

  1. Were the groups controlled acceptably? Not Applicable, there was only one group.

 

 

  1. Was the dependent measure appropriate and meaningful? Yes

 

  • OUTCOME #1: Percentage of accurate word production

 

  • The outcome was subjective.

 

  •  The outcome was not objective

 

 

  1. Were reliability measures provided?

                                                                                                            

–  Interobserver for analyzers? Yes

 

  • OUTCOME #1: Percentage of accurate word production r = 0.91

 

–  Intraobserver for analyzers? No

 

– Treatment or test administration fidelity for investigators?

 

 

  1. Description of design:

 

  • Twenty adult participants (Ps) with PD participated in 2 experimental sessions.

 

  • Session #1 included

– assessments (motor speech and intelligibility),

– reading 36 sentences aloud with no rhythmic pacing cues (i.e., the baseline condition), and

– a training portion. During the training portion of the session, P practiced using rhythmic cues (i.e., a metronome beat) while tapping, counting, and reading aloud.

 

  • Session #2 included

– Some practice time.

– P reading sentences in the 2 experimental conditions (metered rhythmic cueing; patterned rhythmic cueing) in which the order was counterbalanced across Ps.

– There were 6 blocks of sentences with 3 blocks of sentences for each of the 2 experiment conditions (i.e., metered rhythmic cueing; patterned rhythmic cueing.) Within the 3 blocks of sentences for each experimental condition:

  • one block was cued at P’s habitual rate
  • one block was cued at 80% of P’s habitual rate (based on syllables per minute), and
  • one block was cued at 60% of P’s habitual rate (based on syllables per minute.)

 

  • All cues were delivered using a computer.

 

  • The outcome measure was mean intelligibility rate derived from judges’ transcriptions of Ps’ readings.

 

 

  1. What were the results of the statistical (inferential) testing?

 

  • OUTCOME #1: Percentage of accurate word production

– Overall, there was no significant difference between metered and patterned rhythm cueing conditions, both conditions improved significantly over baseline (pretesting during Session #1.)

 

– A subgroup analysis based on the intelligibility levels of the Ps revealed that

  • Ps with baseline (pretesting during Session #1) with intelligibility below 60% (severely impaired) improved significantly.
  • Ps with initial intelligibility between 60% and 80% (moderately impaired) and between 80% to 90% (mildly impaired) did not improve significantly.

 

– Another subgroup analysis that explored if either of the conditionss was better based on intelligibility levels found

  • Ps with mild intelligibility problems performed more poorly in the metered condition than in the patterned condition.
  • For the Ps with moderate and severe intelligibility problems, performance was similar for both conditions (metered or patterned.)

 

– A third subgroup analysis revealed that relative to the rate of speech in the condition,

  • intelligibility of the metered and patterned rhythmic cues was similar when the rate was 60% of habitual or habitual rate, but
  • when the metered and patterned rhythmic cues were presented at 80% of the habitual rate, intelligibility decreased.

 

  • What was the statistical test used to determine significance? ANOVA and Paired samples testing

 

  • Were effect sizes provided? No

 

  • Were confidence interval (CI) provided? No

 

 

  1. Summary of correlational results: NA, not provided.

 

 

  1. Summary of descriptive results: Qualitative research NA, this is only described when the data analysis was primarily Qualitative.

 

 

  1. Brief summary of clinically relevant results:

 

  • Both forms of rhythmic speech cueing (metered and patterned) resulted in improved word accuracy in Ps with PD. Neither form was found to be more effective than the other.

 

  • Rhythmic cueing was most effective with Ps who were classified as severely impaired speakers.

 

  • The optimum rate of speech for the rhythmic speech cueing appeared to be at the habitual speaking rate or 60% of habitual speaking rate.

 

ASSIGNED GRADE FOR QUALITY OF EXTERNAL EVIDENCE: B-

 

 

SUMMARY OF INTERVENTION

 

PURPOSE: To investigate the effectiveness of 2 forms of rhythmic speech cueing and 3 rates of speech for the rhythmic cueing on the word accuracy of speakers with PD

 

POPULATION: Parkinson’s disease; Adults

 

MODALITY TARGETED: Production

 

ELEMENTS OF PROSODY USED AS INTERVENTION: rhythm, rate

 

OTHER ASPECTS OF LANGUAGE/COMMUNICATION TARGETED: intelligibility (word accuracy)

 

DOSAGE: 1 treatment session

 

ADMINISTRATOR: unclear, probably music therapist

 

MAJOR COMPONENTS:

 

  • There were 2 forms of rhythmic speech cueing (metered, patterned) and 3 rates of presentation of the rhythmic speech cueing (habitual rate, 80% of the habitual rate, 60% of habitual rate.)

 

  • All Ps were administered all conditions (i.e., both conditions and all 3 rates) which were counterbalanced for order of presentation.

 

  • There were 2 sessions:

– #1 = Assessment and Training

– #2 = Experimental Conditions.

 

  • Session #1 consisted of

– motor speech assessment

– speech intelligibility assessment

– reading aloud 36 sentences without rhythmic cues (i.e., baseline assessment)

– training (Ps tapped, counted, and read aloud sentence to the beat of a metronome

 

  • Session #2 consisted of

– practice reading aloud sentences to rhythmic beat

– administration of the experimental conditions—The order of the 2 rhythmic conditions (metered, patterned) were counterbalanced among the Ps. Within each of the rhythmic conditions, Ps were presented with blocks of 3 rates (habitual, 80% of habitual, 60% of habitual.)

– The protocol for the experimental conditions was

  • Read aloud the targeted sentence
  • Listen to the sentence produced one syllable at a time
  • Read aloud the sentence paired with the targeted rhythmic condition and rate.

 

RHYTHMIC CUEING CONDITIONS:

 

– Metered Cueing = consistent rhythmic beat on each syllable

– Patterned Cueing = rhythmic beat of the sentences was similar to the rhythm one would expect in typical speech.

 

RATE CONDITIONS:

 

– Using syllables per minute as the measure of rate, the 3 speaking rates were:

  • habitual speaking rate as measured during the reading aloud of sentences during Session #1.
  • 80% of habitual speaking rate
  • 60% of habitual speaking rate