Gee (2010)

August 20, 2016

CRITIQUE OF UNSUPPORTED PROCEDURAL DESCRIPTIONS

(also known as Expert Opinion)

 

NOTES: A summary of the intervention presented in this article can be found by scrolling approximately ½ way down this page.

 

KEY
C = clinician

CAS = childhood apraxia of speech

NA = not applicable

P = patient or participant

pmh = Patricia Hargrove, blog developer

SLP = speech-language pathologist

 

 

Source: Gee, S. M. (2010). Pediatric speech-language pathology corner: Improving prosody in childhood apraxia of speech. ARTICLE Retrieved on August 16, 2016 from http://www.pediastaff.com/blog/speech-language-pathology-corner-improving-prosody-in-childhood-apraxia-of-speech-1389 ARTICLE:

 

Reviewer(s): pmh

 

Date: August 18, 2016

 

Overall Assigned Grade: No grade because there are no supporting data.

 

Level of Evidence: 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 brief, thoughtful discussion of role of prosody in the treatment of childhood apraxia of speech (CAS) provides a rationale for targeting prosody relatively early in the intervention process to reduce, or even prevent, the atypical prosody often observed in the speech of children with CAS. The author recommends focusing on coarticulation or concordance which involves the smooth transition from one speech sound to the next.

 

 

  1. Was there a review of the literature supporting components of the intervention? No. This was a very short article.

 

 

  1. Were the specific procedures/components of the intervention tied to the reviewed literature? Not Applicable

 

 

  1. Was the intervention based on clinically sound clinical procedures? Yes

 

 

  1. Did the author(s) provide a rationale for components of the intervention? Yes

 

 

  1. Description of outcome measures:

 

  • Are outcome measures suggested? Yes _ ____

 

  • Outcome #1: Production of speech with acceptable coarticulation (smooth transitions between adjacent speech sounds) or concordance

 

 

  1. Was generalization addressed? No

 

 

  1. Was maintenance addressed? No

 

 

SUMMARY OF INTERVENTION

 

PURPOSE: To produce speech that has a natural, fluid flow.

 

POPULATION: Childhood Apraxia of Speech; Children

 

MODALITY TARGETED: Production

 

ELEMENTS/FUNCTIONS OF PROSODY TARGETED: concordance/coarticulation, tempo (blending phonemes, pausing), stress (weak strong forms)

 

OTHER ASPECTS OF LANGUAGE/COMMUNICATION TARGETED: speech sounds (flapping or voicing of /t/ before unstressed syllables)

 

MAJOR COMPONENTS:

 

  • Initiate prosody intervention when the participant (P) can use CVC syllables to label objects. At this time, intervention should also target the production of 2 syllable words.

 

  • The clinician (C) should model and require P to produce “a” before all single syllable words. (Obviously, this also targets the production of articles, thus preventing the omission of articles in the speech of the P.)

 

  • As the P starts to use 2 word phrases, C should target Verb + Article + Object (e.g., hit a ball) instead of Verb + Object (e.g., hit ball.)

 

  • C models and encourages P to produce /t/ as /d/ when /t/ precedes an unstressed syllable beginning with a vowel in 2 syllable words.

 

  • C models and encourages P to produce the unstressed versions of “a” and “the.”

 

 

 


Darnell (2015)

August 15, 2016

CRITIQUE OF GROUP RESEARCH

NOTE: This review does not contain a treatment summary because the investigation was a survey about the use of music (in general) in speech-language intervention. Specific interventions were not addressed.

KEY
C = clinician

NA = not applicable

P = patient or participant

pmh = Patricia Hargrove, blog developer

SLP = speech-language pathologist

 

 

Source: Farnell, T. L. (2015). The inclusion of music therapy in speech-language interventions. Undergraduate honor thesis. University of Arkansas, Fayetteville, AK. Retrieved from http://scholarworks.uark.edu/cgi/viewcontent.cgi?article=1041&context=rhrcuht

 

 

Reviewer(s): pmh

 

Date: August 15, 2015

 

Overall Assigned Grade: There is no grade because this investigation was concerned with whether speech language pathologists (SLPs) use music therapy in speech-language interventions. It was a clinically related article and was not concerned with specific clinical interventions.

 

Level of Evidence: Not applicable (NA)

 

Take Away: This investigation is not concerned with the effectiveness of prosody interventions. Rather, it is a clinically related survey about the inclusion of music in the practice of speech-language pathology. The results indicate that SLPs use music to treat a variety of outcomes with both children and adults, although music is more likely to be used with children. Music is most likely to be employed for the following purposes calming, focus, vocalization, language, and vocabulary.

 

 

  1. What type of evidence was identified?

                                                                                                           

  • What was the type of evidence? SURVEY

                                                                                                          

  • What was the level of support associated with the type of evidence? NOT GRADED

 

                                                                                                           

  1. Group membership determination:

                                                                                                           

  • If there was more than one group, were participants (Ps) randomly assigned to groups? NA, there was only one group

 

  1. Was administration of intervention status concealed? NA, no intervention was administered.

                                                                                                                       

 

  1. Was the group adequately described? Yes

 

– How many Ps were involved in the study?

 

  • total # of Ps: 100 t
  • # of groups: 1
  • List names of groups and the # of participants in each group: practicing SLP (recruited via electronic media)

 

– DESCRIBED CHARACTERISTICS:

  • number of years of experiences as an SLP: 11 years or more (53%)
  • educational level of Participants (Ps):

– master’s degree = 95%

     – bachelor’s degree or doctorate = 5%

  • work setting:

– medical settings = 31%

     – schools, home, nonmedical = 73%

 

Were the groups similar before intervention began? NA, there was only one group

                                                         

– Were the communication problems adequately described? NA, Ps were typical speakers.

 

 

  1. Was membership in groups maintained throughout the study?

                                                                                                             

  • Did the group maintain at least 80% of their original members? Yes, this was a survey

                                                               

  • Were data from outliers removed from the study? No

 

 

  1. Were the groups controlled acceptably? NA, there was only one group.

 

 

  1. Were the survey questions appropriate and meaningful? Yes

                                                                                                             

– The survey questions included

  • DEMOGRAPHIC QUESTIONS:

     – Level of education of P

     – Years working as SLP

     – Work settings – 6 choices

     – Ages of clients –3 choices

  • QUESTION #1: How often is music used? –4 choices
  • QUESTION #2: Type of client P uses music with –3 choices (speech, language, voice)
  • QUESTION #3: For Ps working with adults, for what disorders does the P use music (6 choices)
  • QUESTION #4: For Ps working with children, for what disorders does the P use music (4 choices)
  • QUESTION #5: When using music to achieve specific goals, frequency of use with a specific client—4 choices
  • QUESTION #6: List general outcomes targeted when using music

                                         

 

  1. Were reliability measures provided? NA

 

 

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

 

SUMMARY OF IMPORTANT RESULTS

 

  • QUESTION #1: How often is music used?

– Often: 29%

– Sometimes: 49%

– Seldom: 18%

– Never: 4%

– Combined this question with the setting type demographic question:

  • The highest frequency of use of music was in schools and clinics.

– Combined this question with the client age demographic question:

  • Although music therapy was used with both children and adults, it was more likely to be used with children.

 

  • QUESTION #2: Type of client P uses music with –3 choices (speech, language, voice)—Did not find data

 

 

  • QUESTION #3: For Ps working with adults, for what disorders does the P use music (6 choices)

– Most likely to be with Ps diagnosed with aphasia, least likely was Ps diagnosed with hearing impairment.

  • QUESTION #4: For Ps working with children, for what disorders does the P use music (4 choices)

– Most likely to be with children diagnosed with developmental delay, least likely voice and fluency.

 

  • QUESTION #5: When using music to achieve specific goals, frequency of use with a specific client (daily, weekly, etc.)—did not find data.

 

  • QUESTION #6: List general outcomes targeted when using music—59 Ps responded to this question. The investigator qualitatively analyzed the data. Five categories of treatment outcomes were noted in the responses:

– Calming

– Focus

– Vocalization

– Language

– Vocabulary

 

 

  • DEMOGRAPHIC QUESTIONS:

     – Level of education of P—reported in item #4

     – Years of working as SLP — reported in item #4

     – Work settings – 6 choices — reported in item #4

     – Ages of clients –3 choices — reported in item #4

 

– What was the statistical test used to determine significance? NA, the investigator only presented descriptive statistics.

 

Were confidence interval (CI) provided? Yes ___         No __x___

 

 

  1. What is the clinical significanceNA, these data were not provided.

 

 

  1. Were maintenance data reported? No

 

 

  1. Were generalization data reported? No

 

 

  1. Describe the design of the investigation.

 

  • The first 100 responses to an electronically distributed questionnaire were selected for this investigation.
  • The questionnaire contained 10 questions concerned with the use of music therapy in speech-language intervention and some demographic information.

 

ASSIGNED OVERALL GRADE FOR QUALITY OF EXTERNAL EVIDENCE: no grade

 

 


Kargas et al. (2016)

August 9, 2016

ANALYSIS

Comparison Research

NOTES: The focus of the investigation is not on intervention. Accordingly, no summary of intervention is included in the review.

KEY:

 ADOS = Autism Diagnostic Observation Scale

ASD = autism spectrum disorders

eta =   partial eta squared

f = female

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: Kargas, N., López, B., Morris, P., & Reddy, V. (2016). Relations among detection of syllable stress, speech abnormalities, and communicative ability in adults with autism spectrum disorders. Journal of Speech, Language, and Hearing Research, 59, 206-215.

 

REVIEWER(S): pmh

 

DATE: August 4, 2016

 

ASSIGNED GRADE FOR OVERALL QUALITY: No grade assigned. This investigation is concerned with aspects of prosody in a clinical population. Nevertheless, it has application to the clinical practice.

 

TAKE AWAY: The investigators compared adults diagnosed with autism spectrum disorders to typical peers on a task tapping the perception of syllable stress (primary speech perception). The results revealed that adults with ASD have significantly lower scores on the Syllable Stress Perception Task compared to TD peers, although perception varied markedly within the ASD group. Also, within the ASD group, poor stress perception was associated with increased speech production (i.e., stress, intonation, rate) problems but not communication/language problems.

 

 

  1. What type of evidence was identified?
  • What was the type of design? Comparison Research — Prospective, Nonrandomized Group 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:

                                                                                                           

  • If there were groups, were participants randomly assigned to groups? No
  • 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? No

                                                                    

  • from administrators of experimental conditions? No

                                                                    

  • from analyzers/judges? Yes, the Ps responses were collected on the computer.

 

 

  1. Were the groups adequately described? Variable

 

– How many participants were involved in the study?

 

  • total # of Ps:  42
  • # of groups: 2
  • List names of groups and the number of Ps in each group:

     – Autism Spectrum Disorders (ASD) = 21

– Typically Developing (TD) = 21

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

                                                                                

– CONTROLLED CHARACTERISTICS                                                  

  • age: adults
  • gender: 18m; 3f in each group
  • diagnosis of Ps with ASD: Asperger’s syndrome using Autism Diagnostic Observation Scale (ADOS)
  • psychiatric or developmental diagnosis of the TD group: Self report of no diagnosis of either of these problems.
  • Hearing: within normal limits based on audiometric testing

 

== DESCRIBED CHARACTERISTICS

  • age:

     – ASD = mean 30.3 years

     – TD = mean 29.5 years

  • gender:
  • cognitive skills:

     – ASD

  • mean Full range IQ = 109.5
  • mean Verbal IQ = 109.8
  • mean Performance IQ 107.2

     – TD

  • mean Full range IQ = 115.9
  • mean Verbal IQ = 113.9
  • mean Performance IQ = 114.2

 

– Were the groups similar? Yes

 

– Were the communication problems adequately described? No

 

 

  1. What were the different conditions for this research?

                                                                                                             

— Subject (Classification) Groups? Yes

  • Diagnosis (ASD, TD)

                                                               

— Experimental Conditions? Yes

  • performance of the Syllable Stress Perception Task (described below in item #9)

 

— Criterion/Descriptive Conditions? Yes

  • performance on Language and Communication Measure of the ADOS

 

 

  1. Were the groups controlled acceptably? Yes

 

 

  1. Was the dependent measure appropriate and meaningful? Yes

 

  • OUTCOME #1: The accuracy of responses on the Syllable Stress Perception Task

 

  • The dependent measure was NOT subjective.

 

  • The dependent measure WAS objective? Ps entered their responses into the computer

 

 

  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:

 

  • Testing for each Ps was accomplished during 3 hour individual sessions.
  • Prior to the Experimental Phase of the testing, an IQ test and the ADOS were administered.
  • The Experimental Phase included:

– tests were administered in a quiet room.

– practice with the Experimental Task.

– the administration of the Experimental Task — Syllable Stress Perception Task in which the P pressed a button via the computer indicating whether the words were same or different

  • The Syllable Stress Perception Task involved

– Ps individually listening to word pairs in which the same 4 syllable word was presented 2 times in one of the 4 following sets:

  • first syllable stressed for both versions (same)
  • first syllable stressed for 1 version, second syllable stressed for the other version (different)
  • second syllable stressed for both versions (same)
  • second syllable stressed for 1 version, first syllable stressed for the other version (different)

 

  • Statistical analyses controlled for overall IQ, Verbal IQ, and Performance IQ.

 

 

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

 

  • OUTCOME #1: The accuracy of responses on the Syllable Stress Perception Task

– Ps with ASD performed significantly more poorly on the Syllable Stress Perception Task than the TD Ps. The response was stable irrespective of whether the stress was on the first or second syllable.

– Response bias for providing “Same” or “Different” response was similar for the Ps with ASD and the TD group.

– The investigators explored whether there were previously unrecognized subgroups within the 2 major groups (ASD, TD.) They determined that the ASD group had significantly more poor performers (2 standard deviations below the group mean) than the TD group (33% vs 10.5%)

 

  • What statistical tests were used to determine significance? t-test, ANOVA, Chi square

 

  • Were effect sizes provided? No, for the most part.

 

  • Were confidence interval (CI) provided? No

 

 

  1. Summary of correlational results:

 

  • OUTCOME #1: The accuracy of responses on the Syllable Stress Perception Task

– Correlation between accuracy and communication quality:

  • Significant correlation between syllable stress perception accuracy and Speech Abnormalities score on the ADOS (i.e., atypical production of rate, stress, intonation; higher scores signify more problems) — r = – 0.75
  • The correlation between syllable stress perception accuracy and language communication score on the ADOS was not significant

 

 

  1. Summary of descriptive results: Qualitative research NA

 

 

  1. Brief summary of clinically relevant results:
  • Adults with ASD have significantly lower scores on the Syllable Stress Perception Task compared to TD peers, although perception varied markedly within the ASD group.
  • Within the ASD group, poor stress perception was associated with and increased speech production (i.e., stress, intonation, rate) problems.

 

 

 

ASSIGNED GRADE FOR QUALITY OF EXTERNAL EVIDENCE: B