da Fontoura et al. (2014)

 

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.
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