Chenausky & Schlag (2018)

April 29, 2018

EBP THERAPY ANALYSIS

Treatment Groups 

Note: Scroll about 80% of the way down the page to read the summary of the procedure.

 Key:

AMMT =  Auditory-motor mapping training

approximately correct =  P produced consonant bisyllable target with 2 of 3

features (manner, place, voicing)  of an adult form of the consonant AND the

vowel portion of the bisyllable target was of the same class (i.e., same height

and degree of backness)

ASD =  Autism Spectrum Disorder

C = Clinician

EBP = evidence-based practice

f = female

m = male

MV =  Minimally Verbal

NA = not applicable

P = Patient or Participant

pmh =  Patricia  Hargrove, blog developer

SLP = speech–language pathologist

SRT =  Speech Repetition Therapy

 

 

SOURCE: Chenausky, K. V., & Schlaug, G. (2018). From intuition to intervention: Developing an intonation-based treatment for autism.  Annals of the New York Academy of Sciences, 1-13. doi: 10.1111/nyas. 13609 (Early Online Version before inclusion in an issue)

 

 

REVIEWER(S):  pmh

 

DATE:   April 24, 2018

 

ASSIGNED GRADE FOR OVERALL QUALITY: 

– Proof of Concept Study =  C-

– Replication Study =  C-

– Comparison Study =  B-

 

TAKE AWAY: Although the article provides information that could be used as a summary of stages of program assessment, the focus of this review is limited to the evidence for the effective of a music-based intervention: Auditory-motor mapping training (AMMT.) Three studies were reported in this investigation:  Proof of Concept, Replication, and Comparison. Some participants’ data were used in more than one investigation. Each of the studies is reviewed separately and indicate that AMMT has potential for success.

 

 

  1. What type of evidence was identified?

                                                                                                           

  • What was the type of evidence?

     – Prospective, Nonrandomized Group Design with Controls?   Comparison Study

– Prospective, Single Group with Pre- and Post-Testing  Proof of Concept Study, Replication Study

 

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

     – Proof of Concept Level = C+

     – Replication Level = C+

     – Comparison Level = B+

 

PROOF OF CONCEPT STUDY

                                                                                                           

  1. Group membership determination:

                                                                                                           

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

 

  • If there were groups and Ps were not randomly assigned to groups, were members of groups carefully matched?NA

 

 

  1. Was administration of intervention status concealed?

                                                                                                           

  • from participants?No
  • from clinicians? No
  • from analyzers? Yes

                                                                    

 

  1. Was the group adequately described? No

 

–  How many  Ps were involved in the study?

  • total # of Ps:   6
  • # of groups:  1

 

–  CONTROLLED CHARACTERISTICS

  • expressive vocabulary:less than 20 words
  • imitation skills: able to imitate at least 2 sounds
  • diagnosis:Minimally Verbal (MV) Autism Spectrum Disorder (ASD)
  • other diagnoses:excluded sensorineural disorders (e.g., deafness, Down syndrome)

 

–  DESCRIBED CHARACTERISTICS

  • age:5 years 9 months to  8 years 9 months (mean = 6 years 7 months)
  • gender: 1f; 5m

 

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

                                                         

–  Were the communication problems adequately described?  No

  • disorder type:  MV ASD
  • functional level:  baseline phonetic inventory =  7.9 (+/- 5.3)

 

 

  1. Was membership in the group 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. Was the group controlled acceptably?  No, this was a single group study.

 

 

  1. Was the outcome measure appropriate and meaningful? Yes

 

  • OUTCOME #1:Percentage of “syllables approximately correct” (p. 4)  from a list of 30 bisyllable words/phrases

 

NOTE:  approximately correct =  P produced consonant bisyllable target with 2 of 3 features (manner, place, voicing)  of an adult form of the consonant AND the vowel portion of the bisyllable target was of the same class (i.e., same height and degree of backness)

 

  • The outcome measures was subjective.

 

*  The outcome measure was NOTobjective.

                                         

 

  1. Were reliability measures provided?

                                                                                                             

  • Interobserver for analyzers?Yes

    –  OUTCOME #1:  Percentage of “syllables approximately correct” (p. 4)  from a list  of 30 bisyllable words/phrases

–  for the measure “approximately correct”

            ∞ percent of interobserver agreement was 68%

            ∞ difference in from change agreement–  Cohen’s K = 0.55 (p <

                0.0005)

            ∞ investigators claimed these measures were “favorable” (p. 5) and

                 “at least ‘moderate’ or ‘good’)

 

  • Intraobserver for analyzers?No 

 

  • Treatment fidelity for clinicians? No , but the investigators developed a manual describing treatment procedures.

 

 

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

 

– Summary Of Important Results

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

 

 

PRE AND POST TREATMENT ONLY ANALYSES

 

 

  • OUTCOME #1:Percentage of “syllables approximately correct” (p. 4)  from a list of 30 bisyllable words/phrases:  Ps scores were significantly better following treatment compared to pretreatment data

 

  • What was the statistical test used to determine significance?

–  t-test

     –  binominal test of significant

 

  • Were confidence interval (CI) provided?Yes

     –  95% CI:  xxx, investigators reported that the Ps pretreatment scores were beyond the 95% CI for the post intervention scores.

 

 

  1. What is the clinical significanceNo EBP data provided but investigators claim clinical significance by describing the increase of percentage of approximately correct bisyllables.

 

 

  1. Were maintenance data reported?No

 

 

  1. Were generalization data reported?No, but the outcome measure included trained and untrained stimuli but the trained/untrained data were not presented separately.

 

 

  1. Describe briefly the experimental design of the investigation.

 

  • Six Ps were selected to determine if AMMT regularly resulted in improvements in the outcome.

 

  • The 6 Ps each participated in 40 treatment sessions and served as his/her control.

 

  • The investigators performed multiple baseline assessment of the outcome and used the best performance of each P as his/her baseline.

 

  • Following the 10thsession and every 5 sessions after the 10th, the investigators performed an assessment or probe session. Probe sessions were similar to the treatment session except they included both trained and untrained (generalization) stimuli.

 

  • Each Ps’ clinician (C) administered the probes but the ratings of correct/incorrect were performed by a blinded rater.

 

 

GRADE= C-

 

 

REPLICATION STUDY

 

 

  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. Was the group adequately described? No

 

– How many  Ps were involved in the study?

  • total # of Ps: 17
  • # of groups:1

 

–  CONTROLLED CHARACTERISTICS

  • expressive vocabulary:less than 20 words
  • imitation skills: able to imitate at least 2 sounds
  • diagnosis:Minimally Verbal (MV) Autism Spectrum Disorder (ASD)
  • other diagnoses:excluded sensorineural disorders (e.g., deafness, Down syndrome)

 

–  DESCRIBED CHARACTERISTICS

  • age:3 years; 5 months to 9 years; 8 months (mean =6 years; 6 months)
  • gender:2f; 15m

 

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

                                                         

–  Were the communication problems adequately described?  No

  • disorder type: MV ASD
  • functional level: baseline phonetic inventory:  mean = 7.2 (+/- 4.3)

 

 

  1. Was membership in the group 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 a single group.

 

 

  1. Was the outcome measure appropriate and meaningful? Yes

 

  • OUTCOME #1:Percentage of “syllables approximately correct” (p. 4)  from a list of 30 bisyllable words/phrases

 

  • The outcome measures was subjective.
  • The outcome measure was NOTobjective.

                                         

 

  1. Were reliability measures provided?

                                                                                                             

  • Interobserver for analyzers?No, but see the results for interobserver reliability for the Proof of Concept study.

 

  • Intraobserver for analyzers?No 

 

  • Treatment fidelity for clinicians?Yes

–  All of the reviewed sessions included the major AMMT components (intoned speech) and drums.

 

 

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

 

–  Summary Of Important Results

 

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

 

PRE AND POST TREATMENT ONLY ANALYSES

 

OUTCOME #1:  Percentage of “syllables approximately correct” (p. 4)  from a list  of 30 bisyllable words/phrases imitated

  • There post treatment scores were significantly better than thepretreatment score.
  • The investigators compared the results of the Replication Group and the Proof of Concept Group at 25 sessions and determined

∞  that there was no significant difference between the groups,

∞  that their combined outcomes were significantly better after treatment, and

∞  that the trajectories of their improvement were similar

∞  overall the number of correct syllables in the combined groups was about 15 at baseline and 27 following 25 sessions.

 

 

—  What was the statistical test used to determine significance?

  • t-test
  • ANOVA

 

–  Were confidence interval (CI) provided?  No

 

 

  1. What is the clinical significance(List outcome number with data with the appropriate Evidence Based Practice, EBP, measure.) No 

 

 

  1. Were maintenance data reported?No

 

 

  1. Were generalization data reported?No, treated bisyllables were included in the assessment data but they were not described separately.

 

 

  1. Describe briefly the experimental design of the investigation.
  • Seventeen Ps were selected to determine to replicate the finding of the Proof of Concept study with a larger group.

 

  • The 17 Ps each participated in 25 treatment sessions and served as his/her control. The 25 sessions dosage is markedly reduced from the Proof of Concept study but was used because of the burden of 40 sessions for families. The decision also was made to use 25 sessions because almost 90% of the change in the Proof of Concept study had been achieved by session 25.

 

  • The investigators performed multiple initial preintervention assessments of the outcome and used the best performance of each P as his/her baseline.

 

  • Following the 10thsession and every 5 sessions after the 10th, the investigators performed an assessment or probe session. Probe sessions were similar to the treatment sessions except they included both trained and untrained (generalization) stimuli. Each Ps’ clinician (C) administered the probes but the ratings of correct/incorrect were performed by a blinded rater.

 

  • The investigators combinedthe data from the Ps in the Proof of Concept and the Replication studies because the performance of the 2 groups was similar.

 

GRADE C-

 

 

COMPARISON STUDY

 

  1. Group membership determination:

                                                                                                           

  • If there was more than one group, were participants (Ps) randomly assigned to groups? No 

 

  • If there were groups andthe Ps were not randomly assigned to groups, were members of groups carefully matched?  Yes
  • -Seven Ps from the original Ps in the Replication study were matched to 7 Ps who were to be assigned to the control group, Speech Repetition Therapy (SRT.)

     –  The Ps were matched on the basis of

∞  chronological age

∞  mental age

∞  baseline phonemic (phonetic) repetition ability

                                                                    

 

  1. Was administration of intervention status concealed?

                                                                                                           

  • from participants? No
  • from clinicians? No
  • from analyzers? Yes

                                                                    

 

  1. Were the groups adequately described? No

 

–  How many  Ps were involved in the study?

  • total # of Ps: probably
  • # of groups:2
  • List names of groups and the # of participants in each group:

     –  AMMT = 7  (a subgroup of Ps from the AMMT treated Replication study)

–  SRT = 7

 

–  CONTROLLED CHARACTERISTICS

  • expressive vocabulary:less than 20 words
  • imitation skills: able to imitate at least 2 sounds
  • diagnosis:Minimally Verbal (MV) Autism Spectrum Disorder (ASD)
  • other diagnoses:excluded sensorineural disorders (e.g., deafness, Down syndrome)

 

–  DESCRIBED CHARACTERISTICS

  • age:

     –  AMMT = 3 years; 5 months to 8 years; 11 months (mean =  6 years, 1 month)

     –  SRT =  3 years; 9  months to 8 years; 5 months (means = 5 years; 8 months)

  • gender:

     –  AMMT = 7m

     –  SRT = 2f; 5m

 

–   Were the groups similar before intervention began? Yes

                                                         

–  Were the communication problems adequately described?  No 

  • disorder type: (List) MV  ASD
  • functional level: baseline phonetic inventory

– AMMT =  7.1 (+/- 3.4)

– SRT =  8.9 (+/- 5.4)

 

 

  1. Was membership in groups maintained throughout the study?

                                                                                                             

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

                                                               

  • Were data from outliers removed from the study? No 

 

 

  1. Were the groups controlled acceptably? Yes

                                                                                                             

  • Was there a no intervention group?No   
  • Was there a foil intervention group? No
  • Was there a comparison group?Yes
  • Was the time involved in the foil/comparison and the target groups constant? Yes

 

 

  1. Was the outcome measure appropriate and meaningful? Yes

                                                                                                             

  • OUTCOME #1:Percentage of “syllables approximately correct” (p. 4)  from a list of 30 bisyllable words/phrases

 

  • The outcome measure was subjective.
  • The outcome measure was NOT objective.

                                         

 

  1. Were reliability measures provided?

                                                                                                             

  • Interobserver for analyzers?No, but see the results for interobserver reliability for the Proof of Concept study.

 

  • Intraobserver for analyzers?No 

 

  • Treatment fidelity for clinicians?Yes

     – Every AMMT reviewed trial reviewed contained the 2 major components of AMMT:  intoned speech and drumming.

     – None of the SRT  trials reviewed contained the 2 major components of AMMT: intoned speech and drumming.

 

 

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

 

  • Summary Of Important Results

 

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

 

TREATMENT AND FOIL/COMPARISON/NO TREATMENT GROUP ANALYSES

 

  • OUTCOME #1:  Percentage of “syllables approximately correct” (p. 4)  from a list  of 30 bisyllable words/phrases

–  Overall, both the AMMT and the SRT groups improved significantly from baseline to the end of treatment.

     –  The 2 groups (AMMT, SRT) scores were not significantly different from one another over the 4 testing periods.

 

  • What was the statistical test used to determine significance? ANOVA

 

  • Were confidence interval (CI) provided? No

 

 

  1. What is the clinical significanceNA

 

 

  1. Were maintenance data reported? Yes  __x__  No ______
  • Improvements following treatment of 25 weeks were maintained 4 and 8 weeks post treatment.(That is, there no significant difference between outcomes immediately after treatment and 4 and 8 weeks post treatment.

 

  • There were no significantly different outcome scores for the 2 groups .

 

 

  1. Were generalization data reported?Yes

 

  • Trained stimuli were significantlymore likely to be correct than untrained stimuli.

 

  • There were no significantly different outcome scores for the 2 groups .

 

 

  1. Describe briefly the experimental design of the investigation.

 

  • The investigators matched 7 of the Ps from the Replication study to a group of Ps who received SRT.

 

  • The 14 Ps each participated in 25 treatment sessions and served as his/her control.

 

  • The investigators compared the outcomes of the AMMT and SRT groups following 25 sessions and analyzed the data.

 

  • For the maintenance analysis, the investigators then selected 10 AMMT Ps for the Replication study and the 7 SRT Ps from this Comparison study and compared their performance 4 and 8 weeks following the termination of treatment.

 

ASSIGNED OVERALL GRADE FOR QUALITY OF EXTERNAL EVIDENCE:  B-

 

 

 

SUMMARY OF INTERVENTION

 

PURPOSE: To determine if a music-based intervention (AMMT), based on Melodic Intonation Therapy, warrants additional research

 

POPULATION:  ASD

 

MODALITY TARGETED:  production

 

 

ELEMENTS OF PROSODY USED AS INTERVENTION:  music (rhythm, intonation, pitch), rate.

 

OTHER ASPECTS OF LANGUAGE/COMMUNICATION TARGETED: Articulation

 

DOSAGE:  45 minute individual sessions for 40 (Proof of Concept study) or 25 sessions (Replication study or Comparison study)

 

ADMINISTRATOR:  probably SLP

 

 

MAJOR COMPONENTS:

 

  • Two treatments were described in the article:AMMT and SRT

 

 

AUDITORY-MOTOR MAPPING TRAINING (AMMT)

 

  • AMMT is derived from Melodic Intonation Therapy.

 

  • The main objective of AMMT is to increase speech sound accuracy and intelligibility.

 

  • AMMT involves scaffolding, massed practice, spaced practice, and several behavioral management techniques.

 

  • Clinicians (Cs) model intoned bisyllables at 1 syllable per second using 2 pitch levels that corresponded to naturalspeech. The C accompanied the production of the intoned bisyllables with tapping of an electronic drum using the same pitches as the intoned modeled bisyllables. Again, the rate is one tap per second.

 

  • There are 5 hierarchical steps in AMMT:

–  Listening:  The C produces a model of the bisyllable target word at the end of a sentence. Example: “It is fun to blow bubbles” (p. 6.)  The target was intoned using the 2 pitches and the intoning was accompanied the tapping of an electronic drum.

 

–  Unison: C and P produce the bisyllable target word together. Example:  C says: “Let’s say it together:  bubbles” (p. 6.) The target was intoned using the 2 pitches and the intoning was accompanied the tapping of an electronic drum.

 

–  Unison Fade: C says the first syllable of the bisyllable target word, cuing P to produce the whole target. Example:  C says: Again:  bu….”   (p. 6.) The target was intoned using the 2 pitches and the intoning was accompanied the tapping of an electronic drum.

 

–  Imitation: C models the target word and directs P to imitate. The target was intoned using the 2 pitches and the intoning was accompanied the tapping of an electronic drum. Example:

∞  C says: “My turn: bubbles.” (p. 6)

∞  C says: “You turn …..”  (p. 6)

 

–  Cloze: C elicits the independent production of the bisyllable target from P. Example: “Last time It’s fun to blow …..” (p. 6.).

 

  • Each session involved 15 bisyllable target words in which each was practiced 5 times before moving to the next target.

 

 

SPEECH REPETITION THERAPY  (SRT)

 

  • SRT used the same procedures at AMMT without the intoning and drumming.

 

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Ankari & Davis (2018)

April 3, 2018

EBP THERAPY ANALYSIS for

Single Case Designs

NOTES: 

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

Key:

ASD =  Autism Spectrum Disorder

C = Clinician

EBP = evidence-based practice

F0 =  fundamental frequency

NA = not applicable

P = Patient or Participant

pmh = Patricia Hargrove, blog developer

PVSP =  Perceived performance on the Prosody-Voice Screening Profile

SLP = speech–language pathologist

WNL = within normal limits

 

SOURCE:  Akbari, C. C., & Davis. A. H. (2018).  Treating expressive affective prosody in Autism Spectrum Disorder: A case study.  Communication Disorders Quarterly. Article first published online: February 27, 2018 DOI; 10.1177/1525740118755669  cdq.sagepub.com

 

REVIEWER(S):  pmh

 

DATE: March 22, 2018

 

ASSIGNED OVERALL GRADE:  D-  The highest possible grade for this investigator is D+. This grade is based on the design of the investigation, a single case study. This grade does not represent a judgment regarding the quality of the investigation nor the quality of the intervention. It solely represents the level of the support for the intervention in this investigation.

 

TAKE AWAY:  This single case study revealed that an adaptation of an intervention used with adults with aphasia to improve expressive affective prosody was used effectively with an adolescent with Autism Spectrum Disorder. The outcomes were acoustic and perceptual measures of features used to expressive affective prosody.

                                                                                                           

 

  1. What was the focus of the research? Clinical

 

 

  1. What type of evidence was identified?
  • What type of single subject design was used?  Case Study– Description with Pre and Post Test Results
  • 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?No

 

 

  1. Was the participant (P) adequately described? Yes

 

–  How many Ps were involved in the study?  1

 

–  DESCRIBED CHARACTERISTICS

  • age:14 years
  • gender:male                               
  • cognitive skills:within normal limits (WNL)
  • language scores:WNL
  • oral peripheral status: WNL
  • diagnosis:Autism Spectrum Disorder (ASD)
  • hearing: WNL

 

–  Were the communication problems adequately described?  Yes

  • The disorder type(s):ASD
  • Other aspects of communication that were described:

–  Problems in the following aspects of prosody

         ∞  phrasing

         ∞  rate

         ∞  stress

    –   Voice quality was WNL.

 

                                                                                                                       

  1. Was membership in treatment maintained throughout the study?Yes

                

  • 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, it was a single case study.

                                                                      

  • Were preintervention data collected on all behaviors?Yes
  • Did pre and post intervention data include untrained stimuli? Yes
  • Did pre and post 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, but I did not see an outcome targeting the accuracy of listeners’ interpretation of the expressive affect.

 

OUTCOMES

 

  • OUTCOME #1: Perceived performance on the Prosody-Voice Screening Profile (PVSP): Phrasing
  • OUTCOME #2:Perceived performance on the PVSP: Rate
  • OUTCOME #3: Perceived performance on the PVSP: Stress
  • OUTCOME #4: Perceived performance on the PVSP: Loudness
  • OUTCOME #5:Perceived performance on the PVSP: Pitch
  • OUTCOME #6: Perceived performance on the PVSP: Quality
  • OUTCOME #7: Production of duration of full sentences representing happiness
  • OUTCOME #8:Production of duration of full sentences representing anger
  • OUTCOME #9: Production of duration of full sentences representing sadness
  • OUTCOME #10: Production of fundamental frequency (F0) in sentences representing happiness
  • OUTCOME #11:Production of F0 in sentences representing anger
  • OUTCOME #12: Production of F0 in sentences representing sadness
  • OUTCOME #13: Production of duration of unstressed syllables in sentences representing happiness
  • OUTCOME #14:Production of duration of unstressed syllables in sentences representing anger
  • OUTCOME #15: Production of duration of unstressed syllables in sentences representing sadness
  • OUTCOME #16: Production of duration of stressed syllables in sentences representing happiness
  • OUTCOME #147:Production of duration of stressed syllables in sentences representing anger
  • OUTCOME #18: Production of duration of stressed syllables in sentences representing sadness
  • OUTCOME #19: Production of intensity of unstressed syllables in sentences representing happiness
  • OUTCOME #21:Production of intensity of unstressed syllables in sentences representing anger
  • OUTCOME #22: Production of intensity of unstressed syllables in sentences representing sadness
  • OUTCOME #23: Production of intensity of stressed syllables in sentences representing happiness
  • OUTCOME #24:Production of intensity of stressed syllables in sentences representing anger
  • OUTCOME #25: Production of intensity of stressed syllables in sentences representing sadness

 

SUBJECTIVE OUTCOMES

  • OUTCOME #1: Perceived performance on the Prosody-Voice Screening Profile (PVSP): Phrasing
  • OUTCOME #2:Perceived performance on the PVSP: Rate
  • OUTCOME #3: Perceived performance on the PVSP: Stress
  • OUTCOME #4: Perceived performance on the PVSP: Loudness
  • OUTCOME #5:Perceived performance on the PVSP: Pitch
  • OUTCOME #6: Perceived performance on the PVSP: Quality

 

OBJECTIVE OUTCOMES

  • OUTCOME #7: Production of duration of full sentences representing happiness
  • OUTCOME #8:Production of duration of full sentences representing anger
  • OUTCOME #9: Production of duration of full sentences representing sadness
  • OUTCOME #10: Production of fundamental frequency (F0) in sentences representing happiness
  • OUTCOME #11:Production of F0 in sentences representing anger
  • OUTCOME #12: Production of F0 in sentences representing sadness
  • OUTCOME #13: Production of duration of unstressed syllables in sentences representing happiness
  • OUTCOME #14:Production of duration of unstressed syllables in sentences representing anger
  • OUTCOME #15: Production of duration of unstressed syllables in sentences representing sadness
  • OUTCOME #16: Production of duration of stressed syllables in sentences representing happiness
  • OUTCOME #147:Production of duration of stressed syllables in sentences representing anger
  • OUTCOME #18: Production of duration of stressed syllables in sentences representing sadness
  • OUTCOME #19: Production of intensity of unstressed syllables in sentences representing happiness
  • OUTCOME #21:Production of intensity of unstressed syllables in sentences representing anger
  • OUTCOME #22: Production of intensity of unstressed syllables in sentences representing sadness
  • OUTCOME #23: Production of intensity of stressed syllables in sentences representing happiness

 

 

–  Reliability data

 

  • Intra rater reliability of acoustic measurement:Authors claim little variation in the following measures:

–  F0

–  stressed syllable duration

– unstressed syllable duration

– stressed syllable intensity

– unstressed syllable intensity

 

 

  1. Results:

 

–  Did the target behavior(s) improve when treated?  Yes, for the most part

 

  • OUTCOME #1: Perceived performance on the Prosody-Voice Screening Profile (PVSP): Phrasing — WNL for both pre and post testing

 

  • OUTCOME #2: Perceived performance on the PVSP: Rate —WNL for both pre and post testing

 

  • OUTCOME #3: Perceived performance on the PVSP: Stress– pretest =  approximately 44% correct; post test = approximately 84% correct

 

  • OUTCOME #4: Perceived performance on the PVSP: Loudness-WNL for both pre and post testing

 

  • OUTCOME #5: Perceived performance on the PVSP: Pitch — WNL for both pre and post testing

 

  • OUTCOME #6: Perceived performance on the PVSP: Quality  — WNL for both pre and post testing

 

  • OUTCOME #7: Production of duration of full sentences representing happiness —Significantly longer following post testing

 

  • OUTCOME #8: Production of duration of full sentences representing anger  —Significantly longer following post testing

 

  • OUTCOME #9: Production of duration of full sentences representing sadness  Significantly longer following post testing

 

  • OUTCOME #10:Production of fundamental frequency (F0) in sentences representing happiness  —No significant differences between pre and post testing

 

  • OUTCOME #11: Production of F0 in sentences representing anger  —No significant differences between pre and post testing

 

  • OUTCOME #12: Production of F0 in sentences representing sadness —No significant differences between pre and post testing 

 

  • OUTCOME #13: Production of duration of unstressed syllables in sentences representing happiness —No significant differences between pre and post testing

 

  • OUTCOME #14: Production of duration of unstressed syllables in sentences representing anger  —No significant differences between pre and post testing

 

  • OUTCOME #15: Production of duration of unstressed syllables in sentences representing sadness  —Significantly longer following post testing

 

  • OUTCOME #16: Production of duration of stressed syllables in sentences representing happiness anger  —No significant differences between pre and post testing

 

  • OUTCOME #147: Production of duration of stressed syllables in sentences representing anger  —Significantly shorter following post testing

 

  • OUTCOME #18: Production of duration of stressed syllables in sentences representing sadness —Significantly longer following post testing

 

  • OUTCOME #19: Production of intensity of unstressed syllables in sentences representing happiness  —No significant differences between pre and post testing

 

  • OUTCOME #21: Production of intensity of unstressed syllables in sentences representing anger– Significantly reduced following post testing

 

  • OUTCOME #22: Production of intensity of unstressed syllables in sentences representing sadness — Significantly reduced following post testing

 

  • OUTCOME #23:Production of intensity of stressed syllables in sentences representing happiness —No significant differences between pre and post testing

 

  • OUTCOME #24: Production of intensity of stressed syllables in sentences representing anger —Significantly reduced following post testing

 

  • OUTCOME #25: Production of intensity of stressed syllables in sentences representing sadness — Significantly reduced following post testing

 

 

  1. Description of baseline:
  • Were baseline data provided? No,but there was pretesting for all measures

numbering as needed)

 

 

  1. What is the clinical significanceNo data provided.

 

  1. Was information about treatment fidelity adequate? No

 

 

  1. Were maintenance data reported?No

 

 

  1. Were generalization data reported?Yes. The sentences used in the pre- and post-testing differed from the sentences usedin the intervention

 

 

  1. Brief description of the design:
  • This was a single case study.
  • The second investigator served as the clinician (C) and as the pre and post intervention assessor.
  • Pre and post testing comprised

– 24 spontaneous utterances

–  12 sentences (4 sentences representing each of 3 emotions) read aloud

  • The C used 24 sentences during Intervention that differed from the pre-and post-testing sentences.
  • All testing and intervention sentences were provided in the appendixes.

 

 

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

 

SUMMARY OF INTERVENTION

 

PURPOSE: To explore the effectiveness of an intervention designed for adults with aphasia in improving the expressive affective prosody of an adolescent with ASD

 

POPULATION:  ASD; Children (Adolescence)

 

MODALITY TARGETED:  Expressive

 

ELEMENTS/FUNCTIONS OF PROSODY TARGETED (do not list the specific dependent variables here):intensity, duration, F0, loudness, pitch, stress, rate,

 

OTHER ASPECTS OF LANGUAGE/COMMUNICATION TARGETED (Dependent variable):  voice quality

 

DOSAGE:  individual sessions, 1 hour per week, for 10 weeks

 

ADMINISTRATOR:  the second author

 

MAJOR COMPONENTS:

 

  • The intervention was an adaptation of a six step program designed to improve the expressive affective prosody of Ps with aphasia.

 

  • The investigators included all the treatment (practice) and testing (assessment targets) in the appendices.

 

  • The steps of the intervention are outlined in Appendix B. Treatment involves providing maximum cueing and fading to minimal or no cueing.

 

  • To move from one step to the next, P needed to produce 3 consecutive correct response.

 

  • A summary of the 6 steps of the intervention:

 

  1. C reads aloud a practice sentence with one of the 3 targeted prosodic affects and identified the targeted affect to the P. C and P produce the sentence in unison.
  2. C models the practice sentence with the targeted prosodic affect and facial expression then directs P to imitate her.
  3. C models the practice sentence with the targeted prosodic affect but ot with facial expression then directs P to imitate her prosody.
  4. C produces the practice sentence with a neutral affect and directs P to reproduce with but to include the targeted affective prosody.
  5. C asks a question designed to elicit the targeted emotion and P answers with the practice sentence and the targeted prosodic affect.
  6. C engages in role-playing in which P produces the practice sentence with the targeted affective prosody.

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