Hallam (2018)

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

m = male

NA = not applicable

P = Patient or Participant

pmh =  Patricia  Hargrove, blog developer

RFR =  Rhythm for Reading program

SES = socioeconomic status

SLP = speech–language pathologist

 

SOURCE:  Hallam, S. (2018). Can a rhythmic intervention support reading development in poor readers?  Psychology of Music, 1-14. DOI:  10.1177/0305735618771491

REVIEWER(S):  pmh

 

DATE: July 13, 2018

 

ASSIGNED GRADE FOR OVERALL QUALITY:  B+ The highest possible grade, based on the design of the investigation, is  A. The Grade for Overall Quality reflects the quality of the evidence supporting the intervention. It is not an evaluation of the quality of the intervention nor is it an evaluation of the paper itself.

 

TAKE AWAY: Rhythm for Reading (RFR), a music-based intervention, resulted in improved reading accuracy and comprehension (but not reading rate) in poor readers in London schools who were 11-12 years of age.

 

  1. What type of evidence was identified?

                                                                                                           

  • What was the type of evidence?Prospective, Randomized Group Design with Controls

                                                                                                           

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

 

                                                                                                           

  1. Group membership determination:

                                                                                                           

  • If there was more than one group, were participants (Ps) randomly assigned to groups? Yes, but  the investigators claimed that the Ps also were distributed equally on several variable.

 

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

                                                                    

 

  1. Was administration of intervention status concealed?

                                                                                                           

  • from participants? No

                                                                    

  • from clinicians? No

                                                                    

  • from analyzers? Unclear

                                                                    

 

  1. Were the groups adequately described? Yes

 

– How many  Ps were involved in the study?

  • total # of Ps: 421
  • # of groups:2
  • List names of groups and the # of participants in each group:
  • Treatment group = 209
  • Control group (no treatment) = 212

 

CONTROLLED CHARACTERISTICS

  • age:only included Ps who had just achieved or not achieved national reading criteria
  • Treatment group =  11 to 12 years old
  • Control group =  11 to 12 years old

 

  • gender:
  • Treatment group =  147 (m); 62 (f)
  • Control group =  141 (m); 71 (f)

 

  • Reading accuracy:
  •   Treatment group =  91.98
  • Control group =  91.34

 

  • Reading comprehension:
  • Treatment group =  85.57
  • Control group =  86.03

 

  • Reading rate:
  • Treatment group =  89.65
  • Control group =  98.58

 

  • Educational Level:
  • Treatment group =  year 7; first year of secondary school (British school system)
  • Control group =  year 7; first year of secondary school (British school system)

 

DESCRIBED CHARACTERISTICS

 

  • eligible for Free Lunch:
  • Treatment group =  70
  • Control group = 75

 

–   Were the groups similar before intervention began? Yes

                                                         

–  Were the communication problems adequately described?  Yes

  • disorder type: Literacy skills were labeled as ‘poor.’

 

 

  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?Yes
  • Was there a foil intervention group? No
  • Was there a comparison group?No
  • Was the time involved in the foil/comparison and the target groups constant? NA, the control group was a No Intervention group.

 

 

  1. Were the outcomes measure appropriate and meaningful? Yes

 

–  OUTCOMES

  • OUTCOME #1:Changes in reading accuracy as measured by NARA II
  • OUTCOME #2:Changes in reading comprehension as measured by NARA II
  • OUTCOME #3:Changes in reading rate as measured by NARA II

 

–  The outcome measures that are subjective were

  • OUTCOME #1:Changes in reading accuracy as measured by NARA II
  • OUTCOME #2:Changes in reading comprehension as measured by NARA II

 

–  The outcome measure that is objective is

  • OUTCOME #3:Changes in reading rate as measured by NARA II

                                         

 

  1. Were reliability measures provided?
  • Interobserver for analyzers?No
  • Intraobserver for analyzers?No 
  • Treatment fidelity for clinicians? No

 

 

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

 

SUMMARY OF IMPORTANT RESULTS

TREATMENT AND NO TREATMENT GROUP ANALYSES

 

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

 

  • OUTCOME #1:Changes in reading accuracy as measured by NARA II—

Treatment group produced significantly more change than the control group

 

  • OUTCOME #2:Changes in reading comprehension as measured by NARA II–

–  Treatment group produced significantly more change than the control group

     – For the subgroup of Ps who received free lunches, Ps who received intervention performed significantly better than the control group

 

  • OUTCOME #3:Changes in reading rate as measured by NARA II—

–  The changes produced by the Treatment and Control groups were not significantly different.

 

–   What was the statistical test used to determine significance?

  • ANOVA xxx
  • MANOVA: xxx

 

–  Were confidence interval (CI) provided?  No

 

 

  1. What is the clinical significance

 

–   EBP measure provided: ETA

–  Results of EBP testing and the interpretation:

  • OUTCOME #1:

∞  Changes in reading accuracy for intervention group  versus control group as measured by NARA II—  Eta was 0.012  (small treatment effect)

 

  • OUTCOME #2:

–  Changes in reading comprehension for intervention group versus control group as measured by NARA II– Eta was 0.028  (small treatment effect)

–  Changes in reading comprehension for the subgroup of Ps who received free lunches fo intervention group versus control group as measured by NARA II– Eta was 0.014  (small treatment effect)

 

 

  1. Were maintenance data reported?No

 

  1. Were generalization data reported?No

 

 

  1. Describe briefly the experimental design of the investigation.
  • The Ps were low socioeconomic status (SES), inner city children who had been classified as having poor reading skills.
  • Ps were randomly assigned to treatment or no treatment groups. However, the assignments were not fully random because the investigators controlled for several P characteristics.
  • All Ps were assessed at the beginning and end of the treatment phase for the Treatment group. The investigators assessed the reading skills of the Ps using a published test of reading. Outcome measures were derived from the assessments.
  • The investigators compared the change for the Outcome measures to assess the effectiveness of the treatment.
  • The Ps in the Treatment group received the intervention in their home schools. The investigators reported that there was variability with respect to implementation.

 

 

ASSIGNED OVERALL GRADE FOR QUALITY OF EXTERNAL EVIDENCE:  B+

 

 

SUMMARY OF INTERVENTION

 

PURPOSE:Does musical rhythmic intervention improve reading skills?

 

POPULATION: Poor readers

 

MODALITY TARGETED:  production, comprehension

 

 

ELEMENTS OF PROSODY USED AS INTERVENTION:  music (rhythm, pitch, pausing)

 

OTHER ASPECTS OF LANGUAGE/COMMUNICATION TARGETED:literacy

 

DOSAGE:  group, 10 minutes a week, for 10 weeks

 

MAJOR COMPONENTS:

 

  • The intervention was the Rhythm for Reading program (RFR.)

 

  • RFR was developed for economically disadvantaged children with educational challenges.

 

  • RFR is an intensive, group intervention designed to improve selected aspects of cognitive attention

–  stability,

– strength, and

– resilience.

 

  • The focus of RFR was to improve auditory processing and attention.

 

  • RFR used a variety of musical styles including

– classical western music,

– funk,

– rock,

– pop,

– syncopation, and

– metrical complexity.

 

  • Intervention activities included reading simple musical notation and the following in time with the beat of music by

– clapping,

– chanting, and

– stamping feet

 

  • Simple musical notation consisted of

–  2 levels of beat,

– restricted pitch levels, and

– restricted intervals between pitches.

 

_______________________________________________________________

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