Quadflieg et al. (2007)

August 30, 2018

ANALYSIS— Comparison Research

KEY:

eta =   partial eta squared

GSP =  Generalized Social Phobia

HC  = “healthy” controls

NA = Not Applicable

P = participant or patient

pmh = Patricia Hargrove, blog developer

SLP = speech-language pathologist

SP =  social phobia

SOURCE:  Quadflieg, S., Wendt, B., Mohr, A., Miltner, W. H. T., & Straube, T. (2007.) Recognition and evaluation of emotional prosody in individuals with generalized social phobia: A pilot study. Behaviour Research and Therapy, 45, 3096-3103.

REVIEWER(S): pmh

DATE:  August 28, 2018

ASSIGNED GRADE FOR OVERALL QUALITY:   B (The highest possible grade for this investigation, based on its design, is B. The grade does not represent a judgment of the quality of the research. Rather it describes the quality of the evidence in making clinical decisions.

TAKE AWAY:The results of this comparison investigation revealed that participants (Ps) with social media phobia differed from “healthy controls” (HC) in their recognition of some aspects of affective prosody although the 2 groups did not differ with respect to valence and arousal. The findings suggest that Ps with a diagnosis of social media phobia are more accurate than HC peers in identifying sad and fearful affective prosody and less sensitive in identify happy affective prosody.

  1. What type of evidence was identified?                                                                                                       
  • What was the type of design? Comparison Research

 

  • What was the focus of the research? Clinically Related

                                                                                                           

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

                                                                                                            

  1. Group membership determination:

                                                                                                           

  • If there were groups, were participants randomly assigned to groups? Not Applicable (NA) ______; the groups could not be randomly assigned because they were clinical (social phobia) and typical (HC) groups.

 

  • If there were groups and Ps were not randomly assigned to groups, were members of groups carefully matched?Yes, the groups were matched for age, gender, and education.

                                                                    

  1. Were experimental conditions concealed?                                                                                                      
  • from participants? No

                                                                    

  • from administrators of experimental conditions?  No

                                                                    

  • from analyzers/judges?  No

 

  1. Were the groups adequately described? Yes

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

  • total # of Ps: 30
  • # of groups: 2
  • Names of groups and the number of Ps in each group:

     –  Social Phobia (SP) group  — n = 15

–  Healthy Controls (HC) who were reportedly free of psychiatric symptoms –

n = 15

  • Did all groups maintain membership throughout the investigation? Yes

 

  CONTROLLED CHARACTERISTICS                                        

  • age:

     –  SP  = 23.27 (mean age)

–  HC  = 23.93 (mean age)

  • gender:both groups 7 males, 8 females
  • pay?:all Ps were paid for their participation
  • handedness:all Ps were right handed
  • educational level of Ps:all Ps were college/university students
  • educational level of parents:
  • Social-Emotional Status:the following conditions excluded Ps from the

investigation:

–  panic disorders

–  agoraphobia

–  obsessive compulsive disorder

–  alcohol/substance abuse

–  psychosis

–  dememtia

–  seizures

–  head trauma with loss of consciousness

–  psychotropic drugs in the previous 6 months

–  depression

  • Health:All Ps were free from severe medical conditions that could not be

controlled.

 

–  DESCRIBED CHARACTERISTICS

  • Diagnosis:

–  SP = moderate to severe Generalized Social Phobia (GSP)

 

–   Were the groups similar?  Yes

                                                         

–  Were the communication problems adequately described?  NA. The condition under investigation is not a communication disorder.

  

  1. What were the different conditions for this research?

                                                                                                             

  • Subject (Classification) Groups? Yes

–  SP

–  HC

  • Experimental Conditions? Yes

–  Ps listenedd to audio recording of 384 nonsense words. There were 6 emotional categories. Each emotional category was assigned 32 different nonsense words that were spoken 2 times; one by a male and once by a female actor. The 6 emotional categories were

∞  happy,

∞  sad,

∞  disgusted,

∞  angry,

∞  fearful, and

∞  neutral

  Criterion/Descriptive Conditions?  No 

 

  1. Were the groups controlled acceptably?   Yes

 

  1. Were dependent measures appropriate and meaningful? Yes

    CORRECT RESPONSES:

  • OUTCOME #1: Percentage of correct identifications of the emotion happy
  • OUTCOME #2:Percentage of correct identifications of the emotion sad
  • OUTCOME #3:Percentage of correct identifications of the emotion disgusted
  • OUTCOME #4:Percentage of correct identifications of the emotion angry
  • OUTCOME #5:Percentage of correct identifications of the emotion fearful
  • OUTCOME #6:Number of correct identifications of the neutral emotion
  • OUTCOME #7:Total Percentage of correct identifications of emotion

 

VALENCE

  • OUTCOME #8:Mean rating of pleasantness of happy nonsense words
  • OUTCOME #9:Mean rating of pleasantness of sad nonsense words
  • OUTCOME #10:Mean rating of pleasantness of disgusted nonsense words
  • OUTCOME #11: Mean rating of pleasantness of angry nonsense words
  • OUTCOME #12:Mean rating of pleasantness of fearful nonsense words
  • OUTCOME #13:Mean rating of pleasantness of neutral nonsense words

 

AROUSAL

  • OUTCOME #14:Mean rating of arousal of happy nonsense words
  • OUTCOME #15:Mean rating of arousal of sad nonsense words
  • OUTCOME #16:Mean rating of arousal of disgusted nonsense words
  • OUTCOME #17:Mean rating of arousal of angry nonsense words
  • OUTCOME #18:Mean rating of arousal of fearful nonsense words
  • OUTCOME #19:Mean rating of arousal of neutral nonsense words

All the dependent /outcome measures were subjective.

None of the outcome measures were objective. 

  1. Were reliability measures provided?
  •   Interobserver for analyzers?  No 
  •  Intraobserver for analyzers?   No  
  •  Treatment or test administration fidelity for investigators?   No 

 

  1. Description ofdesign:
  • Two groups of college/university students served as participants:

–  The SP group (n = 15) had been diagnosed with GSP.

–  The HC group (n = 15) were free from GSP and other social/psychiatric

diagnoses.

  • The SP and HC groups were matched for age, gender, and educational level.
  • The stimuli for the investigation were derived from a previously published corpus of emotional prosody stimuli.
  • Ps listened to audio recording of 384 nonsense words. There were 6 emotional categories. Each emotional category was assigned 32 different nonsense words that were spoken 2 times; one by a male and once by a female actor. The 6 emotional categories were

∞  happy,

∞  sad,

∞  disgusted,

∞  angry,

∞  fearful, and

∞  neutral

  • There was a single order of presentation ofstimuli but that order had been  randomized.
  • After listening to the stimuli, Ps indicated the emotion that the stimuli represented on score sheet.
  • Some of the stimuli were associated with 2 other tasks:

–  Ranking the valence of the stimuli on a 7 point scale from very unpleasant to very pleasant.

–  Ranking the arousal of the stimuli on a 7 point scale from not arousing to very arousing.

  • Stimuli were separated by 8 second pauses with the exception of the tasks that included the ranking of valence and arousal. In those cases, Ps were permitted to ask for additional time to respond.
  • Prior to experimental testing, the investigators provided training sessions consisting of 12 stimuli (2 for each emotional category.)The training stimuli differed from the experimental stimuli.

 

  1. What were the results of the statistical (inferential) testing?
  •  Comparisons that are significant  (e.g.,  p ≤ 0.05): F

 

CORRECT RESPONSES:

  • OUTCOME #1: Percentage of correct identifications of the emotion happy

–  SP group identified significantly fewer happy stimuli than HC.

–  Both groups were more likely to identify happy stimuli as neutral with the SP being more like than the HC to identify happy as neutral.

 

  • OUTCOME #2:Percentage of correct identifications of the emotion sad

–  SP group identified significantly more sad utterances than HC.

–  Both groups tended to  to misidentify sad stimuli as happy or neutral.

 

  • OUTCOME #5:Percentage of correct identifications of the emotion fearful

–  SP group identified significantly more fearful utterances than HC.

–  Both groups were most likely to identify fearful stimuli as happy or sad but SP Ps were less likely to identify fearful utterances as happy.

 

VALENCE

  • Although there were significant differences associated with emotional category, the 2 groups (SP and HC) did not differ,

 

AROUSAL

  • Although there were significant differences associated with emotional category, the 2 groups (SP and HC) did not differ,

 

 

–  What was the statistical test used to determine significance? Place xxx after any inferential statistical test used in the investigation? t-test, ANOVA

–   Were effect sizes provided?   No

 –  Were confidence interval (CI) provided?  No 

 

  1. Summary of correlational results:   There were some correlational analyses but they were not applicable to the clinical question.

 

  1. Summary of descriptive results: Qualitative research   NA. This was quantitative research.

   13.  Brief summary of clinically relevant results:

  • College students with GSP tend to be less accurate in identifying of emotions and more likely to misidentify emotions as negative or neutral.

 

ASSIGNED GRADE FOR QUALITY OF EXTERNAL EVIDENCE:  B

 

 

 

 

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Stoeckel (2016)

August 14, 2018

CRITIQUE OF UNSUPPORTED PROCEDURAL DESCRIPTIONS

(also known as Expert Opinion)

NOTE:  Scroll ½ way down this post to access the summaries for the 5 activities.

KEY

C =  clinician

CAS = Childhood Apraxia of Speech

NA = not applicable

P =  patient or participant

pmh =  Patricia Hargrove, blog developer

SLP = speech-language pathologist

Source:  Stoeckel, R. (2016.)  5 fun ways to mix prosody into CAS therapy.  Retrieved from http://www.medbridgeeducation.com/blog/2016/10/5-fun-ways-to-mix-prosody-into-cas-therapy/ 

Reviewer(s):  pmh

Date:  August 14, 2018

Overall Assigned Grade (because there are no supporting data, the highest grade will be F)

Level of Evidence:  F = Expert Opinion, no supporting evidence for the effectiveness of the intervention although the author may provide secondary evidence supporting components of the intervention. The Level of Evidence grade should not be construed as a judgment of the quality of the recommended activities. It is only concerned with the nature of the evidence supporting the author’s recommendation.

 

Take Away:  This blog post briefly describes activities that speech language pathologists (SLPs) can use to integrate prosody into interventions for children with Childhood Apraxia of Speech (CAS.) 

  1. Was there a review of the literature supporting components of the intervention?No, the author did not provide a review of the literature supporting the recommended activities but did provide a brief review of a rationale for integrating prosody activities into intervention for children with CAS.

 

  1. Were the specific procedures/components of the intervention tied to the reviewed literature? No, the author did not provide a review of the literature supporting the recommended activities but did provide a brief review of a rationale for integrating prosody into intervention for children with CAS.

 

  1. Was the intervention based on clinically sound clinical procedures? Yes

 

  1. Did the author(s) provide a rationale for components of the intervention? No

 

  1. Description of outcome measures:

 

  • Are outcome measures suggested? No

 

  1. Was generalization addressed? No

 

  1. Was maintenance addressed? No

 

SUMMARY OF INTERVENTION

NOTE:  The author recommended 5 activities for integrating prosody into treatment of children with CAS. The 5 activities are

–  Songs and Fingerplays

–  Toys that Provide Auditory Feedback

–  Action Figures, Dolls, and Stuffed Animals

–  Board Games

–  Books

Songs and Fingerplays

POPULATION:  Childhood Apraxia of Speech; Children

MODALITY TARGETED: production 

ELEMENTS/FUNCTIONS OF PROSODY TARGETED:  stress, music

ELEMENTS OF PROSODY USED AS INTERVENTION:  duration, loudness, pitch

OTHER ASPECTS OF LANGUAGE/COMMUNICATION TARGETED: production of word or phrase

MAJOR COMPONENTS:

  • The clinician (C) can focus on either one aspect of prosody or multiple aspects of prosody depending on the age of the child.
  • For example, C may encourage the participant (P) to use duration alone to mark stress or to use pitch, loudness, and duration.
  • This activity can also be used to focus on target words/phrases to be produced in the songs.

 

 Toys that Provide Auditory Feedback

POPULATION:  Childhood Apraxia of Speech; Children 

MODALITY TARGETED: production 

ELEMENTS/FUNCTIONS OF PROSODY TARGETED:  loudness, music

ELEMENTS OF PROSODY USED AS INTERVENTION:  rhythm

OTHER ASPECTS OF LANGUAGE/COMMUNICATION TARGETED: production of syllables

MAJOR COMPONENTS:

  • Toys with embedded microphones can facilitate the production of different aspects of prosody.
  • The use of drums can encourage the production of loudness or of targeted syllables.

 

Action Figures, Dolls, and Stuffed Animals

POPULATION:  Childhood Apraxia of Speech; Children

MODALITY TARGETED: production 

ELEMENTS/FUNCTIONS OF PROSODY TARGETED: pitch, loudness

OTHER ASPECTS OF LANGUAGE/COMMUNICATION TARGETED: voice quality; words/phrases

MAJOR COMPONENTS:

  • Role playing with action figures, dolls, and stuffed (plush) animals can focus on prosody by encouraging P to use different speaking styles for different characters and to signal different meanings.
  • C encourages target words/phrases production as part of the play.

 

Board Games

POPULATION:  Childhood Apraxia of Speech; Children 

MODALITY TARGETED: production

ELEMENTS/FUNCTIONS OF PROSODY TARGETED:  rate, contrastive stress

OTHER ASPECTS OF LANGUAGE/COMMUNICATION TARGETED: voice quality 

MAJOR COMPONENTS:

  • Before taking a turn P imitates sentences/phrases modeled by C with

– different voice qualities or

– different rates

  • C asks P questions to elicit contrastive such as

– Is it YOUR turn or MY turn?  (p. 2)

– Does your character have BLUE eyes? (p. 2.)

Books

POPULATION:  Childhood Apraxia of Speech; Children 

MODALITY TARGETED: production 

ELEMENTS/FUNCTIONS OF PROSODY TARGETED:  affective prosody

OTHER ASPECTS OF LANGUAGE/COMMUNICATION TARGETED: literacy 

MAJOR COMPONENTS:

EMERGING READERS:

  • When reading with the P, C has him/her complete a sentence that signals

– an emotion,

– emphasis,

–  a character voice (p. 2.)

 

READER:

  • C identifies passages that could benefit with modifications of prosody to enhance interest.
  • C provides reading material a little below P’s reading level when P is practicing prosodic modifications during reading aloud activities.

 

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