Cannito et al. (2012)

December 30, 2016

EBP THERAPY ANALYSIS

Treatment Groups 

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

f = female

LVST = Lee Silverman Voice Treatment

m = male

NA = not applicable

P = Patient or Participant

pmh = Patricia Hargrove, blog developer

RTM = regression to the mean

SLP = speech–language pathologist

 

 

SOURCE: Cannito, M. P., Suiter, D. M., Beverly, D., Chorna, L., Wolf, T., & Pfeiffer, R. M. (2012). Sentence intelligibility before and after treatment in speakers with idiopathic Parkinson’s disease. Journal of Voice, 26, 214-219.

 

 

REVIEWER(S): pmh

 

DATE: August 24, 2016

 

ASSIGNED GRADE FOR OVERALL QUALITY: B-  (The highest possible grade based on the experimental design of the investigation was B.)

 

TAKE AWAY: This single group pre-post test intervention experiment yielded results supporting the effectiveness of Lee Silverman Voice Treatment (LVST) in improving intelligibility of patients (Ps) with Parkinson’s disease. Overall, intelligibility significantly improved following LVST and analyses of effectiveness for individuals revealed that 6 of the 8 Ps improved significantly. The investigators described characteristics of the 2 remaining Ps to identify possible reasons for their failure to progress using LSVT.

 

 

  1. What type of evidence was identified?

                                                                                                           

  • What was the type of evidence? Prospective, Single Group with Pre- and Post-Testing

                                                                                                          

  • 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? Not Applicable (NA), there was only one group.

 

 

  1. Was administration of intervention status concealed?

                                                                                                           

  • from participants? No

                                                                    

  • from clinicians? No

                                                                    

  • from analyzers? Yes

                                                                    

 

  1. Were the groups adequately described? Yes

 

– How many Ps were involved in the study?

 

  • total # of Ps: 8
  • # of groups: 1
  • names of group and the # of participants in each group: Patients (Ps) with idiopathic Parkinson’s disease = 8 Ps

 

– CONTROLLED CHARACTERISTICS

  • medications: all Ps maintained their medication usage during the investigation
  • diagnosis of hypokinetic dysarthria: by a certified speech-language pathologist (SLP)
  • on-going speech therapy: None of Ps received additional speech therapy during the investigation
  • previous therapy: None of the Ps had previously received Lee Silverman Voice Treatment (LVST)

 

– DESCRIBED CHARACTERISTICS

  • age:   52 to 81 years (mean = 66.3 years)
  • gender: 5m; 3f
  • medication: Varied among 7 of the Ps; 1P did not take medication
  • severity of hypokinetic dysarthria: Severe (1), Marked (2), Moderate (3), Mild (2)
  • years post onset: 2 to 27 years
  • Bilateral Deep Brain Stimulation: 1P
  • Bilateral pallidotomy: 1P
  • Hearing aids: 3Ps
  • Ambulation:

ambulatory (5Ps)

     – used walkers (2Ps);

     – used wheelchair (1P)

 

–   Were the groups similar before intervention began? NA

                                                         

– Were the communication problems adequately described? Yes

  • disorder type: all Ps were diagnosed with hypokinetic dysarthria, 7 Ps exhibited intelligibility problems
  • functional level: severity of the dysarthria varied: Severe (1), Marked (2), Moderate (3), Mild (2)

 

  1. Was membership in groups maintained throughout the study?

                                                                                                             

  • Did the group maintain at least 80% of their original members? Yes

                                                               

  • Were data from outliers removed from the study? No

 

 

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

 

 

  1. Were the outcomes measure appropriate and meaningful? Yes

 

  • OUTCOME #1: Increased intensity (in dB) level of multiple productions of “ah.”
  • OUTCOME #2: Improved intelligibility (interpretation/transcription ) of read sentences

 

  • Outcome 2 was subjective.

 

  • Outcome 1 was objective.

                                         

 

  1. Were reliability measures provided?

                                                                                                            

  • Interobserver for analyzers? Yes

 

OUTCOME #2: Improved intelligibility (interpretation/transcription) of read sentences–

  • pretreatment interlistener reliability = 0.994
  • posttreatment interlistener reliability = 0.922

 

 

 

  • Intraobserver for analyzers?   Yes

 

– OUTCOME #2: Improved intelligibility (transcription) of read sentences–

  • intralistener reliability = 0.840
  • intraobserver reliability of the scoring of the transcriptions = 0.998

 

  • Treatment fidelity for clinicians? No, but the LVST was administered by an ASHA and LVST certified SLP.
  • If yes, describe

 

 

  1. What were the results?

 

PRE AND POST TREATMENT

 

  • OUTCOME #1: Increased intensity (in dB) level of multiple productions of “ah.”

– Overall, the post treatment intensity was significantly louder than the pre treatment intensity.

 

  • OUTCOME #2: Improved intelligibility (interpretation) of read sentences

– Overall post treatment intelligibility (85.82%) was significantly higher than pretreatment intelligibility (81.11%)

     – There was a significant difference among Ps. [NOTE: This did not remain significant following adjustment for regression to the mean (RTM).]

– The following interactions were significant:

  • treatment x P — suggests that Ps responded differently to treatment
  • days x P — some speakers responded differently on the days of data collection. This suggests either there was learning, RTM during the pre or post testing, or the measure is unstable for some Ps. (NOTE: There were 3 days of data collection for both pre and post testing and this did not remain significant following adjustment for RTM.)

     – RTM was detected among the pre and post scores.

     – Individual performances also were analyzed.

  • 6 Ps significantly increased intelligibility scores from pre to post treatment.
  • 1 P did not improve intelligibility significantly but increased intensity significantly. This P had been judged pretreatment to have adequate intelligibility with mild dysarthria.
  • 1 P decreased intelligibility from pre to post treatment.

 

  • What statistical tests were used to determine significance? t-tests (including nonparametric), ANOVA, Rocconi and Ethington RTM

 

  • Were confidence interval (CI) provided? No

 

 

  1. What is the clinical significance

 

  • Standardized Mean Difference (adjusted for RTM): d = 0.719 (large effect)

 

 

  1. Were maintenance data reported? No

 

  1. Were generalization data reported? No

 

 

  1. Describe briefly the experimental design of the investigation.
  • The investigators recruited 8 Ps with hypokinetic dysarthria associated with Parkinson’s disease.
  • An ASHA and LVST certified SLP administered LVST intervention of the Ps.
  • Each P participated in 4 individual sessions of LVST for 4 weeks.
  • Ps were tested on 3 consecutive days before (pretreatment) and after (post treatment):

– Read aloud test sentences (multiple listeners transcribed the sentences and then the sentences were scored for accuracy by different judges.)

– Sustained vocalizations of “ah” (measured in dB.)

  • The investigators presented clear descriptions of blinded listener and judge procedures and reliability measures.

 

ASSIGNED OVERALL GRADE FOR QUALITY OF EXTERNAL EVIDENCE: B-

 

 

SUMMARY OF INTERVENTION

 

PURPOSE: To investigate the effectiveness of LVST in improving the intelligibility of speech of Ps with Parkinson’s disease

 

POPULATION: Parkinson’s disease; Adults

 

MODALITY TARGETED: Production

 

ELEMENTS/FUNCTIONS OF PROSODY TARGETED: loudness

 

ELEMENTS OF PROSODY USED AS INTERVENTION: loudness

 

OTHER ASPECTS OF LANGUAGE/COMMUNICATION TARGETED: intelligibility

 

DOSAGE: 4 days a week for 4 weeks

 

ADMINISTRATOR: SLP certified by ASHA and LVST

 

MAJOR COMPONENTS:

 

LVST

 

  • Procedures are only briefly described:

– This intensive behavioral treatment was administered individually 4 times a week for 4 weeks.

– It is based in motor learning theory and encourages Ps to “think loud” while maintaining healthy vocal production strategies.

 

 

_______________________________________________________________

 

 

Advertisements

Simmons et al. (2016)

December 28, 2016

EBP THERAPY ANALYSIS

Treatment Groups

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

f = female

G = grade level

m = male

NA = not applicable

P = Patient or Participant

pmh = Patricia Hargrove, blog developer

Ss = students who were enrolled in speech-language therapy

SLPs = speech–language pathologists

 

 

SOURCE:  Simmons, E. S., Paul, R., & Shic, F. (2016.) A mobile application to treat prosodic deficits in autism spectrum disorder and other communication impairments. Journal of Autism and Developmental Disorders, 46, 320-327.

 

REVIEWER(S): pmh

 

DATE: December 21, 2016

 

ASSIGNED GRADE FOR OVERALL QUALITY: C (The highest possible overall quality grade for this investigation was C+, Prospective Single Group with Pre and Post Testing)

 

TAKE AWAY: This preliminary investigation explores whether a software program (SpeechPrompts) has potential for treating prosodic problems in children and adolescents. Basic issues (e.g., student engagement, use pattern, perceive improvement, ease of use) about the intervention were investigated and it was determined that speech-language pathologists (SLPs) found SpeechPrompts enjoyable and easy to use in a school setting and they perceived that it resulted in perceived improvements in the Ss’ ability to produce stress, loudness, and intonation, but not speaking rate. These improvements were reported despite a low dose of the intervention over an 8 week period.

 

  1. What type of evidence was identified?

                                                                                                           

  • What was the type of evidence? Prospective, Single Group with Pre- and Post-Testing

                                                                                                          

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

 

                                                                                                           

  1. Group membership determination:

                                                                                                           

  • If there was more than one group, were participants (Ps) randomly assigned to groups? Not Applicable (NA), there was only one group.

 

  1. Was administration of intervention status concealed?

                                                                                                           

  • from participants (Ps)? No

                                                                    

  • from clinicians? No

                                                                    

  • from analyzers? No

                                                                    

 

  1. Were the groups adequately described? Yes

 

–           How many Ps were involved in the study?

 

  • total # of Ps: 40 students (Ss); 10 speech language pathologists (SLPs) [The 2 major questions involved different sets of participants: students who were enrolled in speech-language therapy; SLPs]
  • # of groups: 3 groups:

∞ treatment group (consisting of participants with a range of diagnosis, although most had the diagnosis of ASD);

∞ a subset of the treatment group with the diagnosis of ASD who the investigators had permission to link their diagnosis with their performance on the investigation task

∞ SLPs

  • List names of groups and the # of participants in each group:

     ∞ SLPs (speech-language pathologists) = 10

     ∞ Ss (students receiving treatment) = 40

  • Autism Spectrum Disorder (ASD) Subset = 12 (for this group of participants, the investigators were able to link their data and their diagnoses)

 

– List the P characteristics that are controlled (i.e., inclusion/exclusion criteria) or described. Provide data for each characteristic.

 

SLPs

 

CONTROLLED:

  • Licensure: All SLPs were licensed by the State of Connecticut
  • Certification: All SLPs were certified by the American Speech-Language-Hearing Association
  • caseload: All SLPs had students on their caseload with prosodic deficits.

 

DESCRIBED

  • caseload: (NOTE: The total is more than 10 because some SLPs worked in more than 1 setting)

– Preschool = 3

     – Elementary School = 8

     – Middle School = 4

     – High School = 2

  • years in current position:

– 0 to 5 years: 2

     – 6 – 10 years: 4

     – 11-15 years: 2

     – 16-20 years: 0

     – 21 or more years : 2

  • experience with iPads:

– minimal: 2

     – some experience: 2

     – significant experience: 60

 

Ss

CONTROLLED

  • expressive language:

All Ss spoke in full sentences.

     – All Ss exhibited prosodic problems

  • enrollment in speech-language therapy

– All Ss were enrolled in speech-language therapy as part of special education

 

DESCRIBED:

  • age: 5 years to 19 years (mean = 9.63)
  • gender: 31m, 9f
  • educational level of students (Ss):

– Elementary (PreK to Grade 4, G4) = 22

     – Middle School (G5 to G8) = 13

     – High School (G9 to G12) = 5

  • diagnosis:

– Autism Spectrum Disorder = 67.5% (27 Ss)

     – Speech and language impairment = 17.5% (7 Ss)

     – Intellectual disability = 7.5% (3 Ss)

     – Multiple disabilities = 2.5% (1 S)

     – Traumatic brain injury = 2.5% (1 S)

     – Other health problems = 2.5% (1 S)

 

ASD Subset

(investigators had permission to link diagnosis and task performance)

CONTROLLED

  • expressive language:

All Ss spoke in full sentences.

     – All Ss exhibited prosodic problems

  • enrollment in speech-language therapy

– All Ss were enrolled in speech-language therapy as part of special education

  • diagnosis: All ASD Subset Ps were diagnosed with ASD and the investigators were able to link their data with them

 

DESCRIBED:

  • age: 6 to 12 years; mean = 8.25
  • gender: 11m; 1f

 

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

                                                         

– Were the communication problems adequately described? No

 

  • disorder type: (only prosodic disorders described; some of the Ss had problems in multiple domains)

– Rate/Rhythm = 27

– Stress = 29

– Volume = 28

 

 

  1. Was membership in groups maintained throughout the study?

                                                                                                             

  • Did the group maintain at least 80% of it original members? Yes, but 20% of the Ss were removed from data analysis because of absenteeism, SLP errors, or technical difficulties.

                                                               

  • Were data from outliers removed from the study? No

 

 

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

 

 

  1. Were the outcomes measure appropriate and meaningful? Yes

                                                                                                             

– OUTCOMES

 

PROSODIC PERFORMANCE OUTCOMES (3 point scale; 0 = typical prosody; 1 = mildly atypical prosody, 2 = clearly atypical prosody; p 323; lower mean score signifies improvement)

 

  • OUTCOME #1: SLP Ranking of the quality of speaking rate in a 5 minute speech sample
  • OUTCOME #2: SLP Ranking of the quality of lexical stress in a 5 minute speech sample
  • OUTCOME #3: SLP Ranking of the quality of sentence stress in a 5 minute speech sample
  • OUTCOME #4: SLP Ranking of the quality of intensity in a 5 minute speech sample
  • OUTCOME #5: SLP Ranking of global intonation in a 5 speech minute sample

 

SOFTWARE USE OUTCOMES

  • OUTCOME #6: Number of times the SLP used the software
  • OUTCOME #7: Length of treatment sessions

 

STUDENT ENGAGEMENT OUTCOMES (ranked on a 5 point scale 1 = strong agreement/engagement, 5 = strong disagreement/no engagement)

 

  • OUTCOME #8: SLP’s ranking of student’s enjoyment
  • OUTCOME #9: SLP’s ranking of student’s attention maintenance
  • OUTCOME #10: SLP’s ranking of student’s consistency of responses
  • OUTCOME #11: SLP’s ranking of the student’s lack maladaptive behavior during treatment

 

SLP OUTCOMES

  • OUTCOME #12: SLP ranking of whether the software was enjoyable
  • OUTCOME #13: SLP ranking of ease of use of the software
  • OUTCOME #14: SLP ranking of function of the software
  • OUTCOME #15: SLP ranking of positive changes

 

All outcome measures that were subjective.

 

– None of the outcome measures were objective.

                                         

 

  1. Were reliability measures provided?

                                                                                                            

– Interobserver for analyzers? Yes, for some of the Prosodic Performance Outcomes:

 

  • OUTCOMES #1 through #4 (SLP Ranking of the quality of speaking rate, lexical stress, sentence stress, and in intensity in a 5 minute sample)—Cohen’s Kappa coefficient = 0.68.

 

  • Intraobserver for analyzers? No

 

  • Treatment fidelity for clinicians? No. Although no data were provided, SLPs were involved in a 20 minutes training session in which they were instructed about the treatment program (SpeechPrompts.)

 

 

  1. What were the results of the inferential, correlational, and descriptive analyses ?

 

— Summary Of Important Results

  •  What level of significance was required to claim statistical significance? p = 0.05

 

PRE AND POST TREATMENT ONLY ANALYSES:

descriptive data, correlational data, inferential data

 

 

PROSODIC PERFORMANCE OUTCOMES (3 point scale; 0 = typical prosody; 1 = mildly atypical prosody, 2 = clearly atypical prosody; p 323; lower mean score signifies improvement)

 

  • OUTCOME #1: (SLP Ranking of the quality of speaking rate in a 5 minute sample)

     – All Ss: no significant difference between pre- and post- intervention rankings

     – ASD subgroup: no significant difference between pre- and post- intervention rankings

 

  • OUTCOME #2: (SLP Ranking of the quality of lexical stress in a 5-minute sample)

All Ss: significantly lower post intervention scores

     – ASD subgroup: no significant difference between pre- and post- intervention rankings

 

  • OUTCOME #3: (SLP Ranking of the quality of sentence stress in a 5-minute sample)

All Ss: significantly lower post intervention scores

ASD subgroup: significantly lower post intervention scores

 

  • OUTCOME #4: (SLP Ranking of the quality of intensity in a 5 minute sample)

     – All Ss: significantly lower post intervention scores

ASD subgroup: significantly lower post intervention scores

 

  • OUTCOME #5: (SLP Ranking of global intonation in a 5-minute sample)

     – All Ss: significantly lower post intervention scores; no significant correlation between global intonation and the number of treatment minutes

ASD subgroup: significantly lower post intervention scores

 

SOFTWARE USE OUTCOMES

 

  • OUTCOME #6: (Number of times the SLP used the software)

     – All Ss: range of use 1 to 12 sessions; mean = 4.7 sessions

     – ASD subgroup: range of use 2 to 10 session; mean = 5.83 sessions

 

  • OUTCOME #7: (Length of treatment sessions)

   – All Ss: range of length sessions 5 to 90 minutes; mean = 21.25 minutes; VoiceMatch was used 52.9% of the time, VoiceChart was used 47.1% of the time; no significant correlation between the number of minutes of treatment received by the S and the length of time his/her SLP had been employed at the facility

     – ASD subgroup: range of length of session 10 to 30 minutes; mean 25.99 minutes

 

STUDENT ENGAGEMENT OUTCOMES (ranked on a 5 point scale

1 = strong agreement/engagement, 5 = strong disagreement/no engagement)

 

  • OUTCOME #8: (SLP’s ranking of student’s enjoyment)

     – All Ss: ratings were low and stable for 1st and last sessions– 92.5% of SLPs ranked this as ≤3; mean 1.66

     – ASD subgroup: ratings were low and stable for 1st and last sessions

 

  • OUTCOME #9: (SLP’s ranking of student’s attention maintenance)

– All Ss: ratings were stable for 1st and last sessions; 87.5% of SLPs ranked this as ≤3; mean 1.74

     – ASD subgroup: ratings were low and stable for 1st and last sessions

 

  • OUTCOME #10: (SLP’s ranking of student’s consistency of responses maintenance)

     – All Ss: ratings were stable for 1st and last sessions; 87.5% of SLPs ranked this as ≤3; mean 1.78

     – ASD subgroup: ratings were low and stable for 1st and last sessions

  • OUTCOME #11: (SLP’s ranking of the student’s lack maladaptive behavior during treatment maintenance)

     – All Ss: ratings were stable for 1st and last sessions 85% of SLPs ranked this as ≤3; mean 1.79

     – ASD subgroup: ratings were low and stable for 1st session and decreased for the final session.

 

SLP OUTCOMES

 

  • OUTCOME #12: (SLP ranking of whether the software was enjoyable)–≤80% of SLPs reported the software was enjoyable

 

  • OUTCOME #13: (SLP ranking of ease of use of the software) —≤80% of SLPs reported the software was easy to use

 

  • OUTCOME #14: (SLP ranking of function of the software)–≤80% of SLPs reported the software was functional

 

  • OUTCOME #15: (SLP ranking of positive changes0–≤80% of SLPs reported they observed positive changes in the Ss.

 

– What was the statistical test used to determine significance? Place xxx after any statistical test that was used to determine significance. t-test

 

– Were confidence interval (CI) provided? No

 

 

  1. What is the clinical significance

 

–  The EBP measure provided by the investigators was Standardized Mean Difference.

 

– Results of EBP testing and the interpretation:

 

  • OUTCOME #2: (SLP Ranking of the quality of lexical stress in a 5 minute sample)

All Ss: lower post intervention scores; d = 0.48 (small effect)

 

  • OUTCOME #3: (SLP Ranking of the quality of sentence stress in a 5 minute sample)

All Ss: lower post intervention scores; d = 0.77 (moderate effect)

ASD subgroup: lower post intervention scores; d = 0.80 (large effect)

 

  • OUTCOME #4: (SLP Ranking of the quality of intensity in a 5 minute sample)

     – All Ss: lower post intervention scores; d = 0.77 (moderate effect)

ASD subgroup: lower post intervention scores; d = 0.90 (large effect)

 

  • OUTCOME #5: (SLP Ranking of global intonation in a 5 minute sample)

     – All Ss: lower post intervention scores; d = 0.71 (moderate effect)

ASD subgroup: lower post intervention scores; d = 0.81 (large effect)

 

 

  1. Were maintenance data reported? No

 

 

  1. Were generalization data reported? Not clear

 

 

  1. A brief description of the experimental of the investigation:

 

  • This was a preliminary investigation to determine the potential of the software (SpeechPrompts) for treating prosody impairment. The investigators analyzed data from 2 groups of participants: SLPs (N = 10) and students (S) who were enrolled in speech-language therapy and had been identified as having prosodic problems.

 

  • Most (27), but not all, of Ss (N = 40) had been diagnosed with ASD. Accordingly, the investigators identified and analyzed separately data from a subgroup of Ss of with the diagnosis of ASD.

 

  • The outcomes associated with the SLPs involved

– their ranking their own perceptions of S engagement, attention, improvement , and behavior.

– their ranking their own perceptions regarding the function, ease of use, enjoyment, and student improvement associated with SpeechPrompts

– measures of number of uses and length of time of use of SpeechPrompts collected by the software.

 

  • S outcomes were derived from SLP rankings of perceptions of the acceptability of certain aspects of Ss’ prosody.

 

  • The investigators briefly trained the SLPs to use SpeechPrompts and requested that they use it at least one time a week over an 8 week period. (NOTE: Outcome data indicated that SLPs the average use was between 4 and 6 times over the 8 weeks.)

 

  • For the most part, the data were analyzed descriptively although paired t-tests and standardized mean difference were calculated for one set of analyses (i.e., perceived S performance outcomes.)

 

ASSIGNED OVERALL GRADE FOR QUALITY OF EXTERNAL EVIDENCE: C

 

 

 

SUMMARY OF INTERVENTION

 

PURPOSE: To investigate whether the mobile application SpeechPrompts has potential for treating prosodic impairments in children and adolescents.

 

POPULATION: ASD, Speech and Language Impairment; Children, Adolescents

 

MODALITY TARGETED: production

 

ELEMENTS/FUNCTIONS OF PROSODY TARGETED: speaking rate, stress (lexical, sentence), intensity, intonation

 

DOSAGE: 1 time a week (this was requested but SLPs average use was 4-6 times in 8 weeks)

 

ADMINISTRATOR: SLP

 

MAJOR COMPONENTS:

 

  • The investigators used SpeechPrompts which was delivered via iPads.

 

  • SpeechPrompts provides visual representations of acoustic measures of prosody. Two features of SpeechPrompts were used in this investigation:

– VoiceMatch: provides visual representation of short segments of speech as a waveform for 2 speakers, here the Clinician (C) and the S.

– When using VoiceMatch, C modeled a sentence and then S attempted to replicate the rate and stress patterns of the C.

– VoiceChart: was used to provide feedback to the S regarding loudness level.

 

 


Grossman et al. (2010)

December 15, 2016

 

ANALYSIS

Comparison Research  

NOTES:

  • A summary of an intervention is not included in the review because this in not an investigation about intervention. 

KEY: 

ASD = autism spectrum disorders

eta =   partial eta squared

HFA = high-functioning autism

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., Bemis, R. H., Skwerer, D. P., & Tager-Flusberg, H. (2010.) Lexical and affective prosody in children with high-functioning autism. Journal of Speech, Language, and Hearing Research, 53, 778- 793.

 

REVIEWER(S): pmh

 

DATE: December 7, 2016

 

ASSIGNED GRADE FOR OVERALL QUALITY:  Not graded, this is an investigation of the nature of prosody within a clinical population; it is not an intervention study.

 

TAKE AWAY: This investigation of lexical and affective prosody in children and adolescents with high functioning autism (HFA) comprises 3 experiments: perception of affective prosody, perception of lexical prosody, and production of lexical prosody. The results indicate that children and adolescents with HFA are similar to TD peers with respect to their perception of affective prosody and lexical stress as well in their ability to mark correctly the stressed syllable in compound words (e.g., greenhouse) and noun phrases (green house.) However, the Ps with HFA differed from their TD peers with respect to how they marked the stressed syllable. Specially, the productions of Ps with HFA were of longer duration which was perceived be slower, more labored, containing longer pauses than TD peers.

 

 

  1. What type of evidence was identified?

                                                                                                           

  • What was the type of design? Comparison; 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? B+

 

                                                                                                           

  1. Group membership determination:

                                                                                                           

  • If there were groups, were participants randomly assigned to groups? Yes
  • 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? Unclear

                                                                    

 

  1. Were the groups adequately described? Yes

 

–    How many participants (Ps) were involved in the study?

 

NOTE: The same Ps were involved in all 3 experiments

  • total # of Ps: 31
  • # of groups: 2
  • List names of groups and the number of Ps in each group:

– High-Functioning Autism (HFA) = 16 (except Experiment #3, N = 11 for pitch and intensity analyses

– Typically Developing (TD) = 15 (except Experiment #3, N = 9 for pitch and intensity analyses

 

  • Did all groups maintain membership throughout the investigation? Yes, but data from some Ps were discarded from the pitch and intensity analysis for Experiment #3 due to excessive static on the recordings. This resulted in the following Ns for the 2 groups”

– TD = 9

– HFA = 11

                                                                                

–   CONTROLLED CHARACTERISTICS

                                                                                                                       

  • cognitive skills:

     – HFA = within normal range

     – TD = within normal range

 

  • receptive language:  (performance on the Peabody Picture Vocabulary Test)

     – HFA = within normal range

     – TD = within normal range

 

  • presence of identified genetic disorders: excluded from experiments

 

  • diagnosis of HFA =

     – met criteria in the Diagnostic and Statistical Manual of Mental Disorders; Autism Diagnostic Interview—Revised; Autism Diagnostic Observation Schedule

     – diagnosis noted that the P was in classified as “full range” autism

     – verbal IQ and receive vocabulary were within 2 standard deviations (SD) of the mean but the following challenges still resulted in diagnosis of ASD:

  • social skills
  • communication skills
  • pragmatic skills

     – excluded the following diagnoses:

  • Asperger syndrome
  • Autism, Pervasive Developmental Disorder, not otherwise specified

 

–   DESCRIBED CHARACTERISTICS (* = no significant differences between TD and HFA groups)

 

  • age*:

     HFA = mean – 12;4, range 7;6-17

     TD = mean 12;7, range 7;-18

 

  • gender: Not reported
  • cognitive skills:

HFA =

  • Full range IQ = 106.7 ( mean); 87-123 (range)
  • Verbal IQ* = 101.2 (mean); 83-127 (range)
  • Nonverbal IQ* = 109.6 (mean); 94-127 (range)

     TD =

  • Full range IQ = 108.9 (mean); 87-123 (range)
  • Verbal IQ* = 108.1 (mean); 81-127 (range)
  • Nonverbal IQ* = 106.7 (mean); range 85-116 (range)

 

  • receptive language*: (performance on the Peabody Picture Vocabulary Test)

     HFA = 107.0 (mean); 79-138 (range)

     TD =  111.3 (mean); 79-139 (range)

  • Hearing: Not reported

 

– Were the groups similar? Yes

                                                         

– Were the communication problems adequately described? Unclear.

 

  • disorder type: Ps in the HFA group were described as having social, pragmatic, and communication problems but they were not described. In addition, Ps with HFA were described as “did not at this time exhibit measureable language impairment” (p. 783’)

 

 

NOTE: This study investigated 3 experiments that used the same Ps described in item #4. Items #5 through #13 are presented separately for each of the experiments.

 

EXPERIMENT 1:

Investigation of the perception of affective prosody

 

 

  1. What were the different conditions for this research?

                                                                                                             

  • Subject (Classification) Groups? Yes

HFA

     – TD          

 

  • Experimental Conditions? Yes

 

CONTENT OF STIMULI

– Unfiltered Condition: 6 Sentences produced for each of 3 forms of affective prosody (happy, sad, neutral.) In each case, the content of the sentence and the prosody of the sentence matched the targeted content. For example, happy affective prosody was paired with the following sentence: “When Mike pets the puppy, it’s wagging its tail” (p.792)

– Filtered Condition: The 18 unfiltered sentences were passed through a low-pass filter deleting speech frequencies that resulted in the removal of semantic content but the retention of prosody.

 

EMOTION REPRESENTED ON STIMULI: (p. 781)

– Sad = lower pitch, slower rate, low tone ending

Happy = higher pitch, faster rate, complex tone ending

Neutral = midrange pitch, accent on the main topic, less complex final tone

 

  • Criterion/Descriptive Conditions? No

 

 

  1. Were the groups controlled acceptably? Yes

 

 

  1. Were dependent measures appropriate and meaningful? Yes

 

– OUTCOMES:

 

  • OUTCOME #1: Percentage of correct identifications of depicted affects in unfiltered and filtered sentence stimuli.

 

–   The outcome was subjective.

 

The outcome measures was not objective.

 

 

  1. Were reliability measures provided?

                                                                                                            

  • Interobserver for analyzers? No

 

  • Intraobserver for analyzers? No

 

  • Treatment or test administration fidelity for investigators?

 

 

  1. Description of design:
  • Following a training session that involved only unfiltered sentences, Ps listened to sentences and classified the emotions/affect as happy, sad, or neutral.
  • The validity of prerecorded sentence stimuli wasa ascertained by the independent rating of affect by 10 listeners who were not Ps in the investigation.
  • There were 18 sentences each for the unfiltered and filtered sentences. There were 3 versions of each of the sentence types which difference with respect to the order of sentence. The order of sentences was pseudorandomized and counterbalanced.
  • The verbal stimuli are included in an appendix.
  • Sentences were presented on acomputer via speakers. The filtered sentences were administered first; then the unfiltered sentences were administered.
  • Ps signified their choices by selecting the appropriated button.

 

 

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

 

– Results:

 

  • OUTCOME #1: Percentage of correct identifications of depicted affects in unfiltered and filtered sentence stimuli.
  • performance above chance for
  • filtered task: both TD and HFA
  • unfiltered task: both TD and HFA
  • performance was better on unfiltered than filtered for both TD and HFA
  • performance on neutral sentences was significantly poorer for neutral sentences for both TD and HFA
  • there was not an overall significant difference between TD and HFA groups

 

– The statistical tests used to determine significance included t-test; ANOVA: repeated measure 2 (Group—TD, HFA) x 2 (Task—filtered, unfiltered) x 3 (Emotion—happy, sad, neutral); repeated measure 2 (Group) x 3 (Emotion) for each task

 

– Were effect sizes provided? Yes

 

  • OUTCOME #1: Percentage of correct identifications of depicted affects in unfiltered and filtered sentence stimuli.
  • performance was better on unfiltered than filtered for both TD and HFA;
  • HFA – Cohen’s d = 1.04 (large effect)
  • TD – Cohen’s d = 0.76 (moderate effect)

 

– Were confidence interval (CI) provided? No

 

 

  1. Summary of correlational results: Not Applicable (NA)

 

 

  1. Summary of descriptive results: Qualitative research NA

 

 

  1. Brief summary of clinically relevant results:

 

  • TD and HFA Ps exhibited similar skills in interpreting affective prosody.
  • Both groups had significantly more difficulty on the filtered task than the unfiltered task. However, they still were able to label emotions above chance in the filtered condition. Therefore, both groups make use of semantic information to interpret affect (in addition to prosody.)
  • Both groups found the neutral affect sentences to be more difficult to interpret.

 

 

ASSIGNED GRADE FOR QUALITY OF EXTERNAL EVIDENCE: B

 

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

 

EXPERIMENT 2

Investigate the perception of lexical stress for differentiating noun phrases from compound nouns

 

  1. What were the different conditions for this research?

                                                                                                             

  • Subject (Classification) Groups? Yes

– HFA

     – TD

                                                               

  • Experimental Conditions? Yes

     – Noun Phrases (e.g. green house, wet suit, p. 792)

     – Compound Words (e.g., greenhouse, wetsuit, )

     – Foils (e.g., tree house, headphones, p. 792)

 

  • Criterion/Descriptive Conditions? No

 

 

  1. Were the groups controlled acceptably? Yes

 

 

  1. Were dependent measures appropriate and meaningful? Yes

 

–OUTCOMES:

  • OUTCOME #1: Percentage accuracy of responses to the experimental task

 

– The outcome measure was subjective.

 

 The outcome measure was not objective.

 

 

  1. Were reliability measures provided?

                                                                                                            

  • Interobserver for analyzers? No

 

  • Intraobserver for analyzers? No _

 

  • Treatment or test administration fidelity for investigators? No

 

  • Validity of the stimuli was supported by

AUDITORY STIMULI:

  • The investigators analyzed the experimental auditory stimuli using Praat to insure that the first syllable was stressed in the compound word (e.g., HOTdog) and the second syllable was stressed in the noun phrase (e.g., hot DOG.)
  • The acoustic criteria the investigators used to identify stressing were

         ¶ longer duration

         ¶ higher pitch

         ¶ greater intensity

  • For the foil items (i.e., stimuli produced with equal stress), acoustic analysis of the 3 above features did not reveal differences between the first and second syllable.
  • Ten judges listened to the auditory stimuli to determine which words could be properly identified as noun phrases or compound words.

 

VISUAL STIMULI:

  • The investigators insured that judges could properly link the auditory stimuli with pictures of the targeted words.

 

 

  1. Description of design:
  • The experimental stimuli included auditory and visual stimuli.

– Every experimental word (compound word or noun phrase) was paired with a picture presenting the target word and the opposite stress pattern. For example, for the target “wetsuit,” the investigator presented a picture of a “wet suit” and a picture of a suit that was wet.

–  Eleven foil words (i.e., compound words without corresponding noun phrases) were also presented auditorily and visually throughout the testing. For example, ne picture presented the target word (e.g., rainbow) and one picture presented the picture of a hair bow.

– The verbal stimuli are included in an appendix.

 

  • Prior to the experimental task, investigators administered a brief training task insuring that the Ps were able to press a button signifying their picture choice. Investigators provided corrective feedback to the Ps.

 

  • The Ps listened to prerecorded auditory stimuli of the compound words or noun phrases in isolation (i.e., not in a contextualizing sentence.)

 

 

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

 

– RESULTS:

 

  • OUTCOME #1: Percentage accuracy of responses to the experimental task
  • All Ps from both groups (TD, HFA) performed at the 80% accuracy level on foil stimuli.
  • All Ps from both groups (TD, HFA) performed at the 80% accuracy level for compound word and noun phrase stimuli.
  • Both groups were significantly more accurate on compound word/first syllable stress targets than noun phrase/second syllable stress target.
  • There was no significant differenceS between TD and HFA groups.

 

– The statistical tests used to determine significance included t-test; ANOVA: 2 (Groups: TD, HFA) x 2 (Stress: compound word/first syllable targets, noun phrase/ second syllable targets)

 

–   Were effect sizes provided? Yes

  • OUTCOME #1: Percentage accuracy of responses to the experimental task
  •  Both groups (TD, HFA) were significantly more accurate on compound word/first syllable stress targets than noun phrase/second syllable stress target.

∞ TD Cohen’s d = 0.80 (moderate effect)

∞ HFA Cohen’s d = 1.2 (large effect)

 

 

  1. Summary of correlational results: NA

 

 

  1. Summary of descriptive results: Qualitative research NA

 

 

  1. Brief summary of clinically relevant results:

 

  • HFA and TD groups performed similarly on the task requiring Ps to demonstrate comprehension of compound words (e.g., Yellowstone) compared to noun phrases (yellow stone.) Thus, Ps with HFA and their TD peers are equally competent on this task.

 

 

ASSIGNED GRADE FOR QUALITY OF EXTERNAL EVIDENCE:   B

 

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

 

EXPERIMENT 3

Investigate the production of lexical prosody

 

 

  1. What were the different conditions for this research?

                                                                                                             

  • Subject (Classification) Groups? Yes

HFA

     – TD

                                                               

  • Experimental Conditions? Yes

 

    – Lexical type (compound words/first syllable stress; noun phrases/second syllable stress)

 

  • Criterion/Descriptive Conditions? Yes

 

 

  1. Were the groups controlled acceptably? Yes

 

 

  1. Were dependent measures appropriate and meaningful? Yes

                                                                                                             

–  Outcome measures:

 

  • OUTCOME #1: Mean pitch of productions

 

  • OUTCOME #2: Mean intensity of productions

 

  • OUTCOME #3: Mean whole word duration

 

– The Outcome measures are not subjective.

 

All of the outcome measures are objective.

 

 

  1. Were reliability measures provided?

                                                                                                            

– Interobserver for analyzers? Yes

 

  • OUTCOME #3: Mean whole word duration—The investigators calculated the mean difference in overall duration length for the original analyzer and a second judge using 15% of the samples. The difference was 4 ms which met the investigators 5 ms or less criterion.

 

– Intraobserver for analyzers? No

 

– Treatment or test administration fidelity for investigators? No

 

 

  1. Description of design:

 

  • Experiment 3 was administered after a break following the administration of Experiments 1 and 2.
  • The investigators used the same picture stimuli as Experiment #2 with Experiment #2 always preceding Experiment #3.
  • In this investigation, there were 27 targets: 11 compound word/first syllable stress, 11 noun phrases/second syllable stress, 5 foils.
  • Scripts of the verbal stimuli are included in an appendix.
  • The investigators taught the procedures of Experiment 3 during a brief training session insuring that P clearly understood the procedures.
  • Investigators read a brief narrative designed to elicit the target word while a picture of that word was displayed.
  • Discarded data due to static on the recordings from the 2 groups resulted in reduced Ns for the intensity and pitch analyses to

– TD = 9

– HFA = 11

 

 

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

 

– RESULTS

 

  • OUTCOME #1: Mean pitch of productions

– No significant difference between groups (TD, HFA) on the production of

  • compound word/first syllable stressed targets
  • noun phrase/second syllable stressed targets

 

  • OUTCOME #2: Mean intensity of productions

– No significant difference between groups (TD, HFA) on the production of

  • compound word/first syllable stressed targets
  • noun phrase/second syllable stressed targets

 

  • OUTCOME #3: Mean whole word duration

     Compound words/first syllable stressed words were significantly shorter than noun phases/second syllable stressed word

– HFA group produced significantly longer utterances than the TD group

 

– What were the statistical tests used to determine significance? t-test; ANOVA: one way ANOVA; 2 (Group: HFA, TD) x 2 (Stress: compound word/first syllable stressed, noun phrase/second syllable stressed)

  • Other: (List the test and the associated outcomes)

 

– Were effect sizes provided? Yes.

 

  • OUTCOME #3: Mean whole word duration

     Compound words/first syllable stressed words were significantly shorter than noun phases/second syllable stressed word– eta = 0.53 (large effect)

  • for HFA the effect size was — Cohen’s d = 0.90 (large effect)
  • for TD the effect size was—Cohen’s d = 0.80 (large effect)

 

– HFA group produced significantly longer utterances than the TD group eta = 0.16 (large effect)

  • for compound words/first syllable stressed targets the effect size was –Cohen’s d = 0.82 (large effect)
  • for noun phrases/second syllable stressed targets the effect size was –Cohen’s d = 0.75 (moderate effect)

 

– Were confidence interval (CI) provided? No

 

 

  1. Summary of correlational results: NA

 

 

  1. Summary of descriptive results: Qualitative research NA

 

 

  1. Brief summary of clinically relevant results:

 

  • Ps with HFA were able to differentiate compound words/first syllable stress (e.g., highlight) from noun phrases/second syllable stress (e.g., high light) using duration.

 

  • However, their productions of both types of target words were significantly longer than their TD peers.

 

  • The investigators described their perceptions of Ps with HFA longer productions as being labored and slow with exaggerated pauses between syllables. The TD Ps productions, on the other hand, were perceived to be shorter, not labored, with smoother transitions between syllables.

 

 

ASSIGNED GRADE FOR QUALITY OF EXTERNAL EVIDENCE: __B-___

 


da Fontoura et al. (2014)

December 5, 2016

 

EBP THERAPY ANALYSIS for

Single Case Designs 

NOTES:

  • The summary of the intervention procedures can be viewed by scrolling about two-thirds of the way down on this page. 

Key:

AMIT = Adapted Melodic Intonation Therapy for Brazilian Portuguese speaker.

C = Clinician

CVA = Cerebrovascular Accident

EBP = evidence-based practice

MIT = Melodic Intonation Therapy

NA = not applicable

P = Patient or Participant

pmh = Patricia Hargrove, blog developer

SLP = speech–language pathologist

 

SOURCE: da Fontoura, D. R., de Carvalho Rodrigues, J., Brandão, L., Monção, A. M., & Fumagalli de Salles, J. (2014.) Efficacy of the Adapted Melodic Intonation Therapy: A case study of a Broca’s Aphasia patient. Distúrbios da Comunicação São Paulo, 26, 641-655.

 

REVIEWER(S): pmh

 

DATE: November 29, 2016

 

ASSIGNED OVERALL GRADE: D (Based on the design of the investigation, a case study, the highest possible grade is D+.)

 

TAKE AWAY: This single case study investigated the effect of an adapted form of Melodic Intonation Therapy (AMIT) on a patient (P) with Broca’s Aphasia who was a speaker of Brazilian Portuguese. The investigators monitored 73 outcomes before, after, and (in some cases) during intervention. Outcomes that improved were concerned with rate of speech, word finding, speech accuracy, literacy, memory, and imitation. The outcomes that did not improve tended to be concerned with skills not targeted by AMIT such as comprehension of words, directions, or Inferences.

                                                                                                           

                                                                                                           

  1. What was the focus of the research? Clinical Research

 

 

  1. What type of evidence was identified?
  • What type of single subject design was used? Case Studies- Description with Pre and Post Test Results with multiple outcomes

                                                                                                           

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

Level = D+    

                                                                                                           

 

  1. Was phase of treatment concealed?
  • from participants? No
  • from clinicians? No
  • from data analyzers? Unclear

 

 

  1. Was the participant adequately described? Yes

 

— How many Ps were involved in the study? 1

— DESCRIBED Characteristics:

  • age: 46 years old
  • language : Brazilian Portugese
  • gender: female
  • occupation: secretary (retired)
  • psychosocial status: no depression
  • years post onset: 5
  • etiology: Cerebrovascular Accident (CVA)
  • site of lesion: left middle cerebral artery (frontotemporal)
  • educational level of participant: nine years
  • literacy: read a few times a week and wrote telephone messages, previous to the CVA literacy habits were inconsistent.
  • previous therapy: since the stroke received physiotherapy 2 times a week; traditional speech and language therapy for 6 months after the CVA.

                                                 

– Were the communication problems adequately described? Yes

  • The disorder types were Nonfluent aphasia characterized by apraxia, anomia, phonological paraphasia, agrammatism; for the most part comprehension was good

 

                                                                                                                       

  1. Was membership in treatment maintained throughout the study? Yes, this was a single case study.

 

– If there was more than one participant, did at least 80% of the participants remain in the study? Not applicable (NA)

 

– Were any data removed from the study? No

 

 

  1. Did the design include appropriate controls?  No, this was a single case study.

                                                                      

  • Were baseline/preintervention data collected on all behaviors? Yes

 

  • Did probes/intervention data include untrained stimuli? Yes

 

  • Did probes/intervention data include trained stimuli? No

 

  • Was the data collection continuous? No

 

  • Were different treatment counterbalanced or randomized? NA

 

 

  1. Were the outcome measures appropriate and meaningful? Yes

 

  • OUTCOME #1: Improved speech rate in conversation (measured: Session 1, 2, 3; after Session 8; after Session 16; after Session 24; and Session 27)

 

  • OUTCOME #2: Performance on the Boston Diagnostic Aphasia Examination—Short Form, Brazilian Version subtest—Written Narrative (measured pre and post intervention)

 

  • OUTCOME #3: Performance on the Boston Diagnostic Aphasia Examination—Short Form, Brazilian Version subtest—Written Designation (measured pre and post intervention)

 

  • OUTCOME #4: Performance on the Boston Diagnostic Aphasia Examination—Short Form, Brazilian Version subtest—Basic Coding Skill (measured pre and post intervention)

 

  • OUTCOME #5: Performance on the Boston Diagnostic Aphasia Examination—Short Form, Brazilian Version subtest—Writing Mechanism (measured pre and post intervention)

 

  • OUTCOME #6: Performance on the Boston Diagnostic Aphasia Examination—Short Form, Brazilian Version subtest—Understanding of Reading: Paragraphs and …..(measured pre and post intervention)

 

  • OUTCOME #7: Performance on the Boston Diagnostic Aphasia Examination—Short Form, Brazilian Version subtest—Understanding of Oral Reading of Sentences (measured pre and post intervention)

 

  • OUTCOME #8: Performance on the Boston Diagnostic Aphasia Examination—Short Form, Brazilian Version subtest—Oral Reading of Sentences (measured pre and post intervention)

 

  • OUTCOME #9: Performance on the Boston Diagnostic Aphasia Examination—Short Form, Brazilian Version subtest—Oral Reading of Words (measured pre and post intervention)

 

  • OUTCOME #10: Performance on the Boston Diagnostic Aphasia Examination—Short Form, Brazilian Version subtest—Identification of Words (measured pre and post intervention)

 

  • OUTCOME #11: Performance on the Boston Diagnostic Aphasia Examination—Short Form, Brazilian Version subtest—Pairing Numbers (measured pre and post intervention)
  • OUTCOME #12: Performance on the Boston Diagnostic Aphasia Examination—Short Form, Brazilian Version subtest—Pairing Letters and Words (measured pre and post intervention)

 

  • OUTCOME #13: Performance on the Boston Diagnostic Aphasia Examination—Short Form, Brazilian Version subtest—Scanning for Specific Categories (measured pre and post intervention)

 

  • OUTCOME #14: Performance on the Boston Diagnostic Aphasia Examination—Short Form, Brazilian Version subtest—Naming (measured pre and post intervention)

 

  • OUTCOME #15: Performance on the Boston Diagnostic Aphasia Examination—Short Form, Brazilian Version subtest—Responsive Denomination (measured pre and post intervention)

 

  • OUTCOME #16: Performance on the Boston Diagnostic Aphasia Examination—Short Form, Brazilian Version subtest—Repetition of Sentences (measured pre and post intervention)

 

  • OUTCOME #17: Performance on the Boston Diagnostic Aphasia Examination—Short Form, Brazilian Version subtest—Repetition of Words (measured pre and post intervention)

 

  • OUTCOME #18: Performance on the Boston Diagnostic Aphasia Examination—Short Form, Brazilian Version subtest—Automatic Sequence (measured pre and post intervention)

 

  • OUTCOME #19: Performance on the Boston Diagnostic Aphasia Examination—Short Form, Brazilian Version subtest—Ideational Complex Material (measured pre and post intervention)

 

  • OUTCOME #20: Performance on the Boston Diagnostic Aphasia Examination—Short Form, Brazilian Version subtest—Understanding of Orders (measured pre and post intervention)

 

  • OUTCOME #21: Performance on the Boston Diagnostic Aphasia Examination—Short Form, Brazilian Version subtest—Understanding of Words (measured pre and post intervention)

 

  • OUTCOME #22: Performance on the Boston Diagnostic Aphasia Examination—Short Form, Brazilian Version subtest—Social Answers (measured pre and post intervention)

 

  • OUTCOME #23: Performance on NEUPSILIN-AF, an adaption of the Brief Neuropsychological Assessment Instrument (NEUPSILIN) section: Total Temporo-spatial Orientation, Oral Responses, (measurements from 1st and 2nd neuropsycholinguistic assessment)

 

  • OUTCOME #24: Performance on NEUPSILIN-AF, an adaption of the Brief Neuropsychological Assessment Instrument (NEUPSILIN) section: Total Temporo-spatial Orientation, Motor Response, (measurements from 1st and 2nd neuropsycholinguistic assessment)

 

  • OUTCOME #25: Performance on NEUPSILIN-AF, an adaption of the Brief Neuropsychological Assessment Instrument (NEUPSILIN) section: Temporal Orientation, Oral Response, (measurements from 1st and 2nd neuropsycholinguistic assessment)

 

  • OUTCOME #26: Performance on NEUPSILIN-AF, an adaption of the Brief Neuropsychological Assessment Instrument (NEUPSILIN) section: Temporal Orientation, Motor Response, (measurements from 1st and 2nd neuropsycholinguistic assessment)

 

  • OUTCOME #27: Performance on NEUPSILIN-AF, an adaption of the Brief Neuropsychological Assessment Instrument (NEUPSILIN) section: Total Attention (measurements from 1st and 2nd neuropsycholinguistic assessment)
  • OUTCOME #28: Performance on NEUPSILIN-AF, an adaption of the Brief Neuropsychological Assessment Instrument (NEUPSILIN) section: Reverse Counting (measurements from 1st and 2nd neuropsycholinguistic assessment)

 

  • OUTCOME #29: Performance on NEUPSILIN-AF, an adaption of the Brief Neuropsychological Assessment Instrument (NEUPSILIN) section: Digit Sequence Repetition (measurements from 1st and 2nd neuropsycholinguistic assessment)

 

  • OUTCOME #30: Performance on NEUPSILIN-AF, an adaption of the Brief Neuropsychological Assessment Instrument (NEUPSILIN) section: Total Perception(measurements from 1st and 2nd neuropsycholinguistic assessment)

 

  • OUTCOME #31: Performance on NEUPSILIN-AF, an adaption of the Brief Neuropsychological Assessment Instrument (NEUPSILIN) section: Total Memory, Oral Response (measurements from 1st and 2nd neuropsycholinguistic assessment)

 

  • OUTCOME #32: Performance on NEUPSILIN-AF, an adaption of the Brief Neuropsychological Assessment Instrument (NEUPSILIN) section: Total Memory, Motor Response (measurements from 1st and 2nd neuropsycholinguistic assessment)

 

  • OUTCOME #33: Performance on NEUPSILIN-AF, an adaption of the Brief Neuropsychological Assessment Instrument (NEUPSILIN) section: Total Working Memory (measurements from 1st and 2nd neuropsycholinguistic assessment)

 

  • OUTCOME #34: Performance on NEUPSILIN-AF, an adaption of the Brief Neuropsychological Assessment Instrument (NEUPSILIN) section: Inverse Digit Ordering (measurements from 1st and 2nd neuropsycholinguistic assessment)

 

  • OUTCOME #35: Performance on NEUPSILIN-AF, an adaption of the Brief Neuropsychological Assessment Instrument (NEUPSILIN) section: Word and Sentence Span (measurements from 1st and 2nd neuropsycholinguistic assessment)

 

  • OUTCOME #36: Performance on NEUPSILIN-AF, an adaption of the Brief Neuropsychological Assessment Instrument (NEUPSILIN) section: Total Episodic-Semantic Verbal Memory (measurements from 1st and 2nd neuropsycholinguistic assessment)

 

  • OUTCOME #37:  Performance on NEUPSILIN-AF, an adaption of the Brief Neuropsychological Assessment Instrument (NEUPSILIN) section: Immediate Evocation (measurements from 1st and 2nd neuropsycholinguistic assessment)

 

  • OUTCOME #38: Performance on NEUPSILIN-AF, an adaption of the Brief Neuropsychological Assessment Instrument (NEUPSILIN) section: Delayed Evocation (measurements from 1st and 2nd neuropsycholinguistic assessment)

 

  • OUTCOME #39: Performance on NEUPSILIN-AF, an adaption of the Brief Neuropsychological Assessment Instrument (NEUPSILIN) section: Recognition (measurements from 1st and 2nd neuropsycholinguistic assessment)

 

  • OUTCOME #40: Performance on NEUPSILIN-AF, an adaption of the Brief Neuropsychological Assessment Instrument (NEUPSILIN) section: Long Term Semantic Memory, Oral Responses (measurements from 1st and 2nd neuropsycholinguistic assessment)

 

  • OUTCOME #41: Performance on NEUPSILIN-AF, an adaption of the Brief Neuropsychological Assessment Instrument (NEUPSILIN) section: Long Term Semantic Memory, Motor Responses (measurements from 1st and 2nd neuropsycholinguistic assessment)

 

  • OUTCOME #42: Performance on NEUPSILIN-AF, an adaption of the Brief Neuropsychological Assessment Instrument (NEUPSILIN) section: Short Term Visual Memory (measurements from 1st and 2nd neuropsycholinguistic assessment)

 

  • OUTCOME #43: Performance on NEUPSILIN-AF, an adaption of the Brief Neuropsychologica l Assessment Instrument (NEUPSILIN) section:   Prospective Memory (measurements from 1st and 2nd neuropsycholinguistic assessment)

 

  • OUTCOME #44: Performance on NEUPSILIN-AF, an adaption of the Brief Neuropsychological Assessment Instrument (NEUPSILIN) section: Arithmetic Skills (measurements from 1st and 2nd neuropsycholinguistic assessment)

 

  • OUTCOME #45: Performance on NEUPSILIN-AF, an adaption of the Brief Neuropsychological Assessment Instrument (NEUPSILIN) section: Total Language, Oral Response (measurements from 1st and 2nd neuropsycholinguistic assessment)
  • OUTCOME #46:  Performance on NEUPSILIN-AF, an adaption of the Brief Neuropsychological Assessment Instrument (NEUPSILIN) section: Total Language, Motor Response (measurements from 1st and 2nd neuropsycholinguistic assessment)

 

  • OUTCOME #47: Performance on NEUPSILIN-AF, an adaption of the Brief Neuropsychological Assessment Instrument (NEUPSILIN) section: Total Oral Language, Oral Response (measurements from 1st and 2nd neuropsycholinguistic assessment)

 

  • OUTCOME #48: Performance on NEUPSILIN-AF, an adaption of the Brief Neuropsychological Assessment Instrument (NEUPSILIN) section: Total Oral Language, Motor Response (measurements from 1st and 2nd neuropsycholinguistic assessment)

 

 

  • OUTCOME #49: Performance on NEUPSILIN-AF, an adaption of the Brief Neuropsychological Assessment Instrument (NEUPSILIN) section: Automatic Language (measurements from 1st and 2nd neuropsycholinguistic assessment)

 

  • OUTCOME #50: Performance on NEUPSILIN-AF, an adaption of the Brief Neuropsychological Assessment Instrument (NEUPSILIN) section: Naming Technique (measurements from 1st and 2nd neuropsycholinguistic assessment)

 

  • OUTCOME #51: Performance on NEUPSILIN-AF, an adaption of the Brief Neuropsychological Assessment Instrument (NEUPSILIN) section: Repetition (measurements from 1st and 2nd neuropsycholinguistic assessment)

 

  • OUTCOME #52: Performance on NEUPSILIN-AF, an adaption of the Brief Neuropsychological Assessment Instrument (NEUPSILIN) section: Oral Understanding (measurements from 1st and 2nd neuropsycholinguistic assessment)

 

  • OUTCOME #53: Performance on NEUPSILIN-AF, an adaption of the Brief Neuropsychological Assessment Instrument (NEUPSILIN) section: Processing of Inferences, Oral Response (measurements from 1st and 2nd neuropsycholinguistic assessment)

 

  • OUTCOME #54: Performance on NEUPSILIN-AF, an adaption of the Brief Neuropsychological Assessment Instrument (NEUPSILIN) section: Processing of Inferences, Motor Response (measurements from 1st and 2nd neuropsycholinguistic assessment)

 

  • OUTCOME #55: Performance on NEUPSILIN-AF, an adaption of the Brief Neuropsychological Assessment Instrument (NEUPSILIN) section: Total Written Language (measurements from 1st and 2nd neuropsycholinguistic assessment)

 

  • OUTCOME #56: Performance on NEUPSILIN-AF, an adaption of the Brief Neuropsychological Assessment Instrument (NEUPSILIN) section: Reading Aloud (measurements from 1st and 2nd neuropsycholinguistic assessment)

 

  • OUTCOME #57: Performance on NEUPSILIN-AF, an adaption of the Brief Neuropsychological Assessment Instrument (NEUPSILIN) section: Written Understanding (measurements from 1st and 2nd neuropsycholinguistic assessment)

 

  • OUTCOME #58: Performance on NEUPSILIN-AF, an adaption of the Brief Neuropsychological Assessment Instrument (NEUPSILIN) section: Spontaneous Writing (measurements from 1st and 2nd neuropsycholinguistic assessment)
  • OUTCOME #59: Performance on NEUPSILIN-AF, an adaption of the Brief Neuropsychological Assessment Instrument (NEUPSILIN) section: Copied Writing (measurements from 1st and 2nd neuropsycholinguistic assessment)

 

  • OUTCOME #60: Performance on NEUPSILIN-AF, an adaption of the Brief Neuropsychological Assessment Instrument (NEUPSILIN) section: Dictated Writing (measurements from 1st and 2nd neuropsycholinguistic assessment)

 

  • OUTCOME #61:   Performance on NEUPSILIN-AF, an adaption of the Brief Neuropsychological Assessment Instrument (NEUPSILIN) section: Total Praxis (measurements from 1st and 2nd neuropsycholinguistic assessment)

 

  • OUTCOME #62

Performance on NEUPSILIN-AF, an adaption of the Brief Neuropsychological Assessment Instrument (NEUPSILIN) section: Resolution of Problems, Oral Response (measurements from 1st and 2nd neuropsycholinguistic assessment)

 

  • OUTCOME #63: Performance on NEUPSILIN-AF, an adaption of the Brief Neuropsychological Assessment Instrument (NEUPSILIN) section: Resolution of Problems, Motor Response (measurements from 1st and 2nd neuropsycholinguistic assessment)

 

  • OUTCOME #64: Performance on NEUPSILIN-AF, an adaption of the Brief Neuropsychological Assessment Instrument (NEUPSILIN) section: Executive Function—Spelling Fluency, number of words (measurements from 1st and 2nd neuropsycholinguistic assessment)

 

  • OUTCOME #65: Performance on NEUPSILIN-AF, an adaption of the Brief Neuropsychological Assessment Instrument (NEUPSILIN) section: Executive Function—Semantic Fluency, number of words (measurements from 1st and 2nd neuropsycholinguistic assessment)

 

  • OUTCOME #66: Improved performance on the Functional Assessment of Communication Skills (ASHA-Facs) subtest: Daily Planning (pre and post intervention assessment)
  • OUTCOME #67: Improved performance on ASHA-Facs subtest: Reading, Writing and Numerical Concepts (pre and post intervention assessment

 

  • OUTCOME #68: Improved performance on ASHA-Facs subtest: Communication of Basic Needs (pre and post intervention assessment)

 

  • OUTCOME #69: Improved performance on ASHA-Facs subtest: Social Communication (pre and post intervention assessment)

 

  • OUTCOME #70: Improved performance on ASHA-Facs subtest: Total ASHA-Facs(pre and post intervention assessment)

 

  • OUTCOME #71: Reduced word-finding as represented on a speech analysis

 

  • OUTCOME #72: Reduced evidence of speech apraxia as represented on a speech analysis

 

  • OUTCOME #73: Improved syntax as represented on a speech analysis

 

All of the outcomes were subjective.

 

None of the outcomes were objective.

 

None outcome measures were associated with reliability data

 

 

  1. Results: The reviewer rated the effectiveness of each outcome using the descriptive data provided by the investigator as strong, moderate, limited, ineffective, or contraindicated. In some cases, an outcome was rated as ineffective even when the score at Assessment #1 was lower than the score at Assessment #2 because the reviewer judged the difference in the scores to be minimal.

 

  • OUTCOME #1: Improved speech rate in conversation–improved over the course of the intervention –strong

 

  • OUTCOME #2: Performance on the Boston Diagnostic Aphasia Examination—Short Form, Brazilian Version subtest—Written Narrative– unchanged—ineffective

 

  • OUTCOME #3: Performance on the Boston Diagnostic Aphasia Examination—Short Form, Brazilian Version subtest—Written Designation– 2nd assessment better than the first assessment—strong support

 

  • OUTCOME #4: Performance on the Boston Diagnostic Aphasia Examination—Short Form, Brazilian Version subtest—Basic Coding Skill unchanged—ineffective

 

  • OUTCOME #5: Performance on the Boston Diagnostic Aphasia Examination—Short Form, Brazilian Version subtest—Writing Mechanism unchanged but was at maximum at assessment 1—cannot interpret

 

  • OUTCOME #6: Performance on the Boston Diagnostic Aphasia Examination—Short Form, Brazilian Version subtest—Understanding of Reading: Paragraphs and ….. unchanged—ineffective

 

  • OUTCOME #7: Performance on the Boston Diagnostic Aphasia Examination—Short Form, Brazilian Version subtest—Understanding of Oral Reading of Sentences (measured pre and post intervention) unchanged but was at maximum at assessment 1—cannot interpret
  • OUTCOME #8: Performance on the Boston Diagnostic Aphasia Examination—Short Form, Brazilian Version subtest—Oral Reading of Sentences 2nd assessment better than assessment 1—strong support

 

  • OUTCOME #9: Performance on the Boston Diagnostic Aphasia Examination—Short Form, Brazilian Version subtest—Oral Reading of Words unchanged but was at maximum at assessment 1—cannot interpret

 

  • OUTCOME #10: Performance on the Boston Diagnostic Aphasia Examination—Short Form, Brazilian Version subtest—Identification of Words assessment 2 was better than assessment 1—moderately effective

 

  • OUTCOME #11: Performance on the Boston Diagnostic Aphasia Examination—Short Form, Brazilian Version subtest—Pairing Numbers unchanged but was at maximum at assessment 1—cannot interpret

 

  • OUTCOME #12: Performance on the Boston Diagnostic Aphasia Examination—Short Form, Brazilian Version subtest—Pairing Letters and Words unchanged but was at maximum at assessment 1—cannot interpret

 

  • OUTCOME #13: Performance on the Boston Diagnostic Aphasia Examination—Short Form, Brazilian Version subtest—Scanning for Specific Categories assessment 2 was better than assessment 1—moderately effective

 

  • OUTCOME #14: Performance on the Boston Diagnostic Aphasia Examination—Short Form, Brazilian Version subtest—Naming unchanged—ineffective

 

  • OUTCOME #15: Performance on the Boston Diagnostic Aphasia Examination—Short Form, Brazilian Version subtest—Responsive Denomination unchanged—ineffective

 

  • OUTCOME #16: Performance on the Boston Diagnostic Aphasia Examination—Short Form, Brazilian Version subtest—Repetition of Sentences) not reported on Chart 2

 

  • OUTCOME #17: Performance on the Boston Diagnostic Aphasia Examination—Short Form, Brazilian Version subtest—Repetition of Words assessment 2 was better than assessment 1—limited effectiveness

 

  • OUTCOME #18: Performance on the Boston Diagnostic Aphasia Examination—Short Form, Brazilian Version subtest—Automatic Sequence assessment 2 was better than assessment 1—limited effectiveness

 

  • OUTCOME #19: Performance on the Boston Diagnostic Aphasia Examination—Short Form, Brazilian Version subtest—Ideational Complex Material–assessment 2 was better than assessment 1—limited effectiveness

 

  • OUTCOME #20: Performance on the Boston Diagnostic Aphasia Examination—Short Form, Brazilian Version subtest—Understanding of Orders assessment 1 was better than assessment 2—contraindicated

 

  • OUTCOME #21: Performance on the Boston Diagnostic Aphasia Examination—Short Form, Brazilian Version subtest—Understanding of Words unchanged –ineffective

 

  • OUTCOME #22: Performance on the Boston Diagnostic Aphasia Examination—Short Form, Brazilian Version subtest—Social Answers– unchanged but was at maximum at assessment 1-cannot interpret

 

  • OUTCOME #23: Performance on NEUPSILIN-AF, an adaption of the Brief Neuropsychological Assessment Instrument (NEUPSILIN) section: Total Temporo-spatial Orientation, Oral Responses– unchanged—ineffective

 

  • OUTCOME #24: Performance on NEUPSILIN-AF, an adaption of the Brief Neuropsychological Assessment Instrument (NEUPSILIN) section: Total Temporo-spatial Orientation, Motor Response–unchanged—ineffective

 

  • OUTCOME #25: Performance on NEUPSILIN-AF, an adaption of the Brief Neuropsychological Assessment Instrument (NEUPSILIN) section: Temporal Orientation, Oral Response —unchanged—ineffective

 

  • OUTCOME #26: Performance on NEUPSILIN-AF, an adaption of the Brief Neuropsychological Assessment Instrument (NEUPSILIN) section: Temporal Orientation, Motor Response- unchanged—ineffective

 

  • OUTCOME #27: Performance on NEUPSILIN-AF, an adaption of the Brief Neuropsychological Assessment Instrument (NEUPSILIN) section: Total Attention– assessment 1 score was lower than assessment 2—moderate effectiveness

 

  • OUTCOME #28: Performance on NEUPSILIN-AF, an adaption of the Brief Neuropsychological Assessment Instrument (NEUPSILIN) section: Reverse Counting– assessment 1 score was lower than assessment 2—moderate effectiveness

 

  • OUTCOME #29: Performance on NEUPSILIN-AF, an adaption of the Brief Neuropsychological Assessment Instrument (NEUPSILIN) section: Digit Sequence Repetition– unchanged—ineffective

 

  • OUTCOME #30: Performance on NEUPSILIN-AF, an adaption of the Brief Neuropsychological Assessment Instrument (NEUPSILIN) section: Total Perception —unchanged—ineffective

 

  • OUTCOME #31: Performance on NEUPSILIN-AF, an adaption of the Brief Neuropsychological Assessment Instrument (NEUPSILIN) section: Total Memory, Oral Response–assessment 1 score was lower than assessment 2—moderate effectiveness

 

  • OUTCOME #32: Performance on NEUPSILIN-AF, an adaption of the Brief Neuropsychological Assessment Instrument (NEUPSILIN) section: Total Memory, Motor Response–assessment 1 score was lower than assessment 2—moderate effectiveness

 

  • OUTCOME #33: Performance on NEUPSILIN-AF, an adaption of the Brief Neuropsychological Assessment Instrument (NEUPSILIN) section: Total Working Memory — assessment 1 was lower than assessment 2—limited effectiveness

 

  • OUTCOME #34: Performance on NEUPSILIN-AF, an adaption of the Brief Neuropsychological Assessment Instrument (NEUPSILIN) section: Inverse Digit Ordering– unchanged—ineffective

 

  • OUTCOME #35: Performance on NEUPSILIN-AF, an adaption of the Brief Neuropsychological Assessment Instrument (NEUPSILIN) section: Word and Sentence Span– assessment 1 was lower than assessment 2—limited

 

  • OUTCOME #36: Performance on NEUPSILIN-AF, an adaption of the Brief Neuropsychological Assessment Instrument (NEUPSILIN) section: Total Episodic-Semantic Verbal Memory– assessment 1 was lower than assessment 2—ineffective

 

  • OUTCOME #37:  Performance on NEUPSILIN-AF, an adaption of the Brief Neuropsychological Assessment Instrument (NEUPSILIN) section: Immediate Evocation unchanged—ineffective

 

  • OUTCOME #38: Performance on NEUPSILIN-AF, an adaption of the Brief Neuropsychological Assessment Instrument (NEUPSILIN) section: Delayed Evocation – unchanged—ineffective

 

  • OUTCOME #39: Performance on NEUPSILIN-AF, an adaption of the Brief Neuropsychological Assessment Instrument (NEUPSILIN) section: Recognition–assessment 1 was lower than assessment 2- ineffective

 

  • OUTCOME #40: Performance on NEUPSILIN-AF, an adaption of the Brief Neuropsychological Assessment Instrument (NEUPSILIN) section: Long Term Semantic Memory, Oral Responses– unchanged–ineffective

 

  • OUTCOME #41: Performance on NEUPSILIN-AF, an adaption of the Brief Neuropsychological Assessment Instrument (NEUPSILIN) section: Long Term Semantic Memory, Motor Responses– unchanged—ineffective

 

  • OUTCOME #42: Performance on NEUPSILIN-AF, an adaption of the Brief Neuropsychological Assessment Instrument (NEUPSILIN) section: Short Term Visual Memory (measurements from 1st and 2nd neuropsycholinguistic assessment) unchanged—ineffective

 

  • OUTCOME #43: Performance on NEUPSILIN-AF, an adaption of the Brief Neuropsychological Assessment Instrument (NEUPSILIN) section: Prospective Memory– assessment 1 was lower than assessment 2—limited

 

  • OUTCOME #44: Performance on NEUPSILIN-AF, an adaption of the Brief Neuropsychological Assessment Instrument (NEUPSILIN) section: Arithmetic Skills–unchanged—ineffective

 

  • OUTCOME #45: Performance on NEUPSILIN-AF, an adaption of the Brief Neuropsychological Assessment Instrument (NEUPSILIN) section: Total Language, Oral Response– assessment 1 was lower than assessment 2—limited

 

  • OUTCOME #46:  Performance on NEUPSILIN-AF, an adaption of the Brief Neuropsychological Assessment Instrument (NEUPSILIN) section: Total Language, Motor Response – assessment 1 was lower than assessment 2—limited

 

  • OUTCOME #47: Performance on NEUPSILIN-AF, an adaption of the Brief Neuropsychological Assessment Instrument (NEUPSILIN) section: Total Oral Language, Oral Response — unchanged–ineffective

 

  • OUTCOME #48: Performance on NEUPSILIN-AF, an adaption of the Brief Neuropsychological Assessment Instrument (NEUPSILIN) section: Total Oral Language, Motor Response — unchanged—ineffective

 

  • OUTCOME #49: Performance on NEUPSILIN-AF, an adaption of the Brief Neuropsychological Assessment Instrument (NEUPSILIN) section: Automatic Language– unchanged—ineffective

 

  • OUTCOME #50: Performance on NEUPSILIN-AF, an adaption of the Brief Neuropsychological Assessment Instrument (NEUPSILIN) section: Naming Technique–assessment 1 was lower than assessment 2- ineffective

 

  • OUTCOME #51: Performance on NEUPSILIN-AF, an adaption of the Brief Neuropsychological Assessment Instrument (NEUPSILIN) section: Repetition assessment 1 was lower than assessment 2—limited

 

  • OUTCOME #52: Performance on NEUPSILIN-AF, an adaption of the Brief Neuropsychological Assessment Instrument (NEUPSILIN) section: Oral Understanding– unchanged—ineffective

 

  • OUTCOME #53: Performance on NEUPSILIN-AF, an adaption of the Brief Neuropsychological Assessment Instrument (NEUPSILIN) section: Processing of Inferences, Oral Response– unchanged—ineffective

 

  • OUTCOME #54: Performance on NEUPSILIN-AF, an adaption of the Brief Neuropsychological Assessment Instrument (NEUPSILIN) section: Processing of Inferences, Motor Response — unchanged—ineffective

 

  • OUTCOME #55: Performance on NEUPSILIN-AF, an adaption of the Brief Neuropsychological Assessment Instrument (NEUPSILIN) section: Total Written Language- assessment #1 was lower than assessment 2—moderate effectiveness

 

  • OUTCOME #56: Performance on NEUPSILIN-AF, an adaption of the Brief Neuropsychological Assessment Instrument (NEUPSILIN) section: Reading Aloud– assessment 1 was lower than assessment 2- strong support

 

  • OUTCOME #57: Performance on NEUPSILIN-AF, an adaption of the Brief Neuropsychological Assessment Instrument (NEUPSILIN) section: Written Understanding– unchanged—ineffective

 

  • OUTCOME #58: Performance on NEUPSILIN-AF, an adaption of the Brief Neuropsychological Assessment Instrument (NEUPSILIN) section: Spontaneous Writing– assessment 1 was lower than assessment 2—limited support

 

  • OUTCOME #59: Performance on NEUPSILIN-AF, an adaption of the Brief Neuropsychological Assessment Instrument (NEUPSILIN) section: Copied Writing– unchanged—ineffective

 

  • OUTCOME #60: Performance on NEUPSILIN-AF, an adaption of the Brief Neuropsychological Assessment Instrument (NEUPSILIN) section: Dictated Writing– assessment 1 was lower than assessment 2—ineffective

 

  • OUTCOME #61: Performance on NEUPSILIN-AF, an adaption of the Brief Neuropsychological Assessment Instrument (NEUPSILIN) section: Total Praxis– assessment 1 was higher than assessment 2—contraindicated

 

  • OUTCOME #62: Performance on NEUPSILIN-AF, an adaption of the Brief Neuropsychological Assessment Instrument (NEUPSILIN) section: Resolution of Problems, Oral Response– unchanged—ineffective

 

  • OUTCOME #63: Performance on NEUPSILIN-AF, an adaption of the Brief Neuropsychological Assessment Instrument (NEUPSILIN) section: Resolution of Problems, Motor Response– unchanged–ineffective

 

  • OUTCOME #64: Performance on NEUPSILIN-AF, an adaption of the Brief Neuropsychological Assessment Instrument (NEUPSILIN) section: Executive Function—Spelling Fluency, number of words– assessment 1 was higher than assessment 2—contraindicated

 

  • OUTCOME #65: Performance on NEUPSILIN-AF, an adaption of the Brief Neuropsychological Assessment Instrument (NEUPSILIN) section: Executive Function—Semantic Fluency, number of words- assessment 1 was higher than assessment 2—contraindicated

 

  • OUTCOME #66: Improved performance on the Functional Assessment of Communication Skills (ASHA-Facs) subtest: Daily Planning00 small improvement but 2nd assessment was the maximum score—limited support

 

  • OUTCOME #67: Improved performance on ASHA-Facs subtest: Reading, Writing and Numerical Concepts–small improvement but 2nd assessment was the maximum score—limited support

 

  • OUTCOME #68: Improved performance on ASHA-Facs subtest: Communication of Basic Needs– unchanged, both scores were maximum scores—cannot interpret

 

  • OUTCOME #69: Improved performance on ASHA-Facs subtest: Social Communication– assessment 2 shows moderate improvement—moderately effective
  • OUTCOME #70: Improved performance on ASHA-Facs subtest: Total ASHA-Facs– assessment 2 shows limited to moderate improvement—moderately effective

 

  • OUTCOME #71: Reduced word-finding as represented on a speech analysis investigators reported improvement but did not quantify the improvement –limited support
  • OUTCOME #72: Reduced evidence of speech apraxia as represented on a speech analysis investigators reported improvement but did not quantify the improvement –limited support

 

  • OUTCOME #73: Improved syntax as represented on a speech analysis investigators reported improvement but did not quantify the improvement –limited support

 

 

  1. Description of baseline:

 

– Were baseline/preintervention data provided? Yes

 

  • OUTCOME #1: baseline was collected in the first 3 session
  • OUTCOMES #2 – 70: preintervention data collected in single session

 

 

– Was baseline low (or high, as appropriate) and stable?

 

  • OUTCOME #1: low and stable
  • OUTCOMES #2 -70:  NA

 

– Was the percentage of nonoverlapping data (PND) provided?

 

 

  1. What is the clinical significance? NA, the investigators did not provide data quantifying the magnitude of response to intervention.

 

 

  1. Was information about treatment fidelity adequate? No

 

 

  1. Were maintenance data reported? No

 

 

  1. Were generalization data reported? Yes
  • All of the results in Item #8 can be considered to be generalizations because they were not directly targeted in intervention procedures.

 

 

  1. Brief description of the design:

 

This single case study investigates the effect of an adapted form of Melodic Intonation Therapy (AMIT) with a speaker of Brazilian Portuguese. The investigators administered a battery of tests before, during (for some outcomes) and after the intervention. The investigated explored the performance of the P on 73 outcomes using descriptive analyses.

 

ASSIGNED OVERALL GRADE OF THE QUALITY OF SUPPORT FOR THE INTERVENTION: D

 

 

SUMMARY OF INTERVENTION

 

PURPOSE: To investigate the effectiveness of an adapted version of MIT for a speaker of Brazilian Portuguese (AMIT)

 

POPULATION: Broca’s Aphasia; Adult

 

MODALITY TARGETED: Production

 

PROSODIC TARGET/OUTCOMES:  rate of speech

 

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

 

OTHER ASPECTS OF LANGUAGE/COMMUNICATION TARGETED: number of words per minute; Performance on the following tests: Boston Diagnostic Aphasia Examination-Short For, Neuropsychological Assessment Instrument for patients with expressive aphasia; syntax; word finding (anomia); articulation (speech dyspraxia); literacy; comprehension

 

DOSAGE: 2 sessions per week, 45 minutes in length, for 3 months (24 sessions)

 

ADMINISTRATOR: SLP

 

MAJOR COMPONENTS:

 

– For the most part, the procedures of traditional MIT are followed. The changes in AMIT include

 

  • The stimuli were lyrics from songs that were popular in Brazil rather than the traditional common and functional phrases.

 

  • P participated in the selection of the songs with special attention to P’s preferences.

 

  • In the beginning of the intervention, the tempo (timing) of the music was slow and paired with written words and illustrations.

 

  • Gradually, P moved from singing single words to singing phrases. Ultimately, P produced the targeted phrases with typical prosody.