Ankari & Davis (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.

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

Advertisements

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google+ photo

You are commenting using your Google+ account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

%d bloggers like this: