Fairbanks (1960, Ch 11, Pitch Level)

August 27, 2019

 

 CRITIQUE OF UNSUPPORTED PROCEDURAL DESCRIPTIONS

(also known as Expert Opinion)

NOTE:  Scroll down about two-thirds of the page to read the summary of the intervention.

KEY

C =  clinician

NA = not applicable

P =  patient or participant

Pitch inflection   = pitch modulation within an utterance

Pitch variability =  pitch range

pmh =  Patricia Hargrove, blog developer

SLP = speech-language pathologist

WPM =  words per minute

 

Source:   Fairbanks, G. (1960. Ch. 11, Pitch Level)  Voice and articulation drillbook.  New York: Harper & Row.  (pp. 122-129)

 

Reviewer(s):  pmh

 

Date: Aug 27, 2019

 

Overall Assigned Grade (because there are no supporting data, the highest grade will be F)  The Assigned Overall Grade reflects the quality of the evidence supporting the intervention and does not represent a judgment regarding the quality of the intervention.

 

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.

 

Take Away: This chapter of Fairbanks (1960) is concerned with the production of Pitch. Fairbanks notes that pitch level, pitch variability (pitch range), and inflection (pitch modulation within an utterance) and stress comprise pitch; this review, however, is only concerned with Pitch Level. Several strategies for treating pitch level are presented in this part of Chapter 11.

 

 

  1. Was there a review of the literature supporting components of the intervention?No

 

  1. Were the specific procedures/components of the intervention tied to the reviewed literature?No

 

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

 

  1. Did the author(s) provide a rationale for components of the intervention? Variable

 

  1. Description of outcome measures:
  • Are outcome measures suggested? Yes
  • Outcome: To produce speech using an appropriate pitch level

 

  1. Was generalization addressed? No

 

  1. Was maintenance addressed? No

 

SUMMARY OF INTERVENTION

 

 

PURPOSE: To produce speech using an appropriate pitch level

 

POPULATION:  Adults

 

MODALITY TARGETED: production

 

ELEMENTS/FUNCTIONS OF PROSODY TARGETED: pitch level, pitch variability

 

ADMINISTRATOR:  The book is written so that a lay person could use it as a self-help book. Historically, I know of many speech-language pathologists who have used the techniques and the materials in their therapy sessions.

 

MAJOR COMPONENTS:

 

  • Fairbanks (1960, Ch 11, Pitch Level) defines several terms (e.g., pitch level, group pitch level, natural level, habitual level, highest pitch, expected pitch levels for young men and women) used in this section of the chapter. Fairbanks also provides directions for identifying natural pitch level and habitual level. This part of Chapter 11 also provides the script for the extended version of the iconic “Rainbow Passage.”

 

  • TheClinician (C) and the Participant/Patient (P) compares P’s habitual and natural pitch levels. If they differ, the focus of treatment should be the natural pitch.

–  P hums using the natural pitch then chants lines from “The Rainbow Passage” gradually adding pitch inflections.

–  P and C monitor vocalizations for improved variability, loudness, and voice quality thus identifying the ‘best’ pitch level.

 

  • P and C verify the best (or natural) pitch level by

–  singing sustained vowels multiple (10 -12) times and

–  P varies the duration and the loudness of the vowels.

 

  • P practices producing the best pitch level on cue.

 

  • P chants words from a word list (Fairbanks, 1960, Chapter 11, p. 128, #8) using the best pitch level.

 

  • P chants sentence from a sentence list (Fairbanks, 1960, Chapter 11, p. 128, #9) using the best pitch level.

 

  • P speaks words from the word list (Fairbanks, 1960, Chapter 11, p. 128, #8) using the best pitch level adding a downward pitch inflection.

 

  • P chants sentence from the sentence list (Fairbanks, 1960, Chapter 11, p. 128, #9) with the dominant pitch level being the ‘best’ pitch. P also included natural variability in the production of the sentences.

 

  • P chant part of “The Rainbow Passage.”

–  P chants the passage until reaching the portion of the script marked by vertical lines (||) found on p. 127, paragraph 2, line 4.)

– At this point, P continues to chant but increases variability until reaching the second set of vertical lines found on p. 127, paragraph 2, line 17.)

–  P continues to chant but reduces variability to mainly produce the ‘best’ level.

–  P and C monitor the P’s performance.

 

  • P reads aloud the “Amplified Passage” (Fairbanks, 1960, Chapter 10, p. 114) using a rate of 160 – 170 words per minute (WPM) and the ‘best’ pitch level.

 

  • Fairbanks (1960, Chapter 11, #14) provides a set of 3 sentences for P to read aloud multiple times. Each time P reads the sentences, a different emotion should be expressed using pitch level and rate changes.

–  anger and fear should be produced with a high pitch level

– contempt, grief, and indifference should be produced with a low pitch level

–  HINT:  The two sets of emotions should be separated by at least 2 octaves.


Dalhberg et al. (2018)

August 20, 2019

ANALYSIS GUIDELINES

Comparison Research

NOTE:  This research focuses on a clinical disorder, not on an intervention. Accordingly, no summary of intervention is included in the review.

KEY:

ADD =  attention deficit disorder

ADHD =  attention deficit/hyperactivity disorder

ASD = autism spectrum disorder(s)

c2v/second =  consonant-to-vowel transitions per second

eta =  partial eta squared

fo = fundamental frequency

Hz =  Hertz

MLU = mean length of utterance

NA = Not Applicable

NAP =  Narrative Assessment Profile

P = participant or patient

pmh = Patricia Hargrove, blog developer

SLP = speech-language pathologist

WLN = within normal limits

 

SOURCE:  Dahlberg, S., Sandberg, A. D., Strömbergsson, S., Wenhov, L., Råstam, M, & Nettelbladt, U. (2018). Prosodic traits in speech produced by children with autism spectrum disorders—Perceptual and acoustic measurements. Autism & Developmental Language Impairments, 3, 1- 10.

 

REVIEWER(S): pmh

 

DATE:  August 12, 2019

 

ASSIGNED GRADE FOR OVERALL QUALITY:  B-  (Based on the design of the investigation, the highest possible grade is B+.)

 

TAKE AWAY: This investigation explored the productive prosody of 11 Swedish children diagnosed with high functioning autism spectrum disorder (ASD group) and 11 Swedish children judged to the typically developing (TDC group). Perceptual and acoustic analyses of one-minute speech samples extracted from each child’s narratives revealed only one significantly different measure:  the ASD group produced significantly longer utterances than their TDC peers despite the fact that the TDC group had significantly more advanced receptive language scores.

 

  1. What type of evidence was identified?

–  What was the type of design? Comparison Research; Prospective Nonrandomized Group Design with Controls

–  What was the focus of the research?  Clinically Related  xxx

–  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? No
  • If there were groups and Ps were not randomly assigned to groups, were members of groups carefully matched? Yes

                                                                    

 

  1. Were conditions concealed?
  • from participants? No
  • from administrators of procedures? No
  • from analyzers/judges?Yes

                                                                    

 

  1. Were the groups adequately described? Yes

   How many participants were involved in the study?

  • total # of Ps:22
  • # of groups:2
  • List names of groups and the number of Ps in each group:

     –  Autism Spectrum Disorders (ASD)  = 11

–  Typically Developing Children (TDC) = 11

  • Did all groups maintain membership throughout the investigation? Yes

 

–  CONTROLLED CHARACTERISTICS                                                  

  • cognitive skills:all participants were within normal limits (WLN)
  • diagnosis:

     – ASD group = diagnosis of ASD

     – TDC group = no diagnosis of ASD; no history of assessment or treatment with a speech-language pathologist (SLP) or a psychologist

 

DESCRIBED CHARACTERISTICS  (* = a significant difference between groups)

  • age:

     – ASD group =   11.1. years  (9.2 to 12.9)

     – TDC group =   11.1 years  (10.5. to 12.1)

  • gender:

     – ASD group =  10 males; 1 female

     – TDC group =  6 males; 1 female

  • receptive vocabulary*:

     – ASD group =  4.8 scaled score

     – TDC group =  9.6 scaled score

  • receptive linguistic age*:

     – ASD group =  10.4 years

     – TDC group =  14.7 years

  • Narrative Assessment Profile (NAP; maximum score 18; production):

     – ASD group =  14.9

     – TDC group =   16.1

  • additional diagnoses:

     – ASD group = in addition to ASD, there were the following diagnoses

         –  4 Ps = attention deficit/hyperactivity disorder (ADHD)

          –  1 P = attention deficit disorder (ADD)

     – TDC group =  no diagnoses

 

– Were the groups similar?  Yes on most variables, but there were significant differences in receptive language age and receptive vocabulary.

                                                         

–  Were the communication problems adequately described?  Unclear

  • disorder type: High Functioning ASD

 

 

  1. What were the different conditions for this research?
  • Subject (Classification) Groups? Yes

     – ASD

     – TDC       

  • Experimental Conditions? No 
  • Criterion/Descriptive Conditions?No 

 

 

  1. Were the groups controlled acceptably? Yes

 

 

  1. Were dependent measures appropriate and meaningful? Yes

 

ACOUSTIC MEASURES

  • OUTCOME #1:fundamental frequency (f0) average in Hertz (Hz)
  • OUTCOME #2:f0range in semitones
  • OUTCOME #3:f0 variation in semitones
  • OUTCOME #4:speech rate as represented by syllables per second which operationally was defined as consonant-to-vowel transitions per second (c2v/second)
  • OUTCOME #5:utterance length orwords per utterance

 

PERCEPTUAL MEASURES

  • OUTCOME #6:Rating of Pitch from 1 to 4 with 4 indicating the highest deviancy from typical development.
  • OUTCOME #7:Rating of Intonation from 1 to 4 with 4 indicating the highest deviancy from typical development.
  • OUTCOME #8:Rating of Speech Rate from 1 to 4 with 4 indicating the highest deviancy from typical development.
  • OUTCOME #9:Rating of Length of Utterance from 1 to 4 with 4 indicating the highest deviancy from typical development.
  • OUTCOME #10:Rating of Intensity from 1 to 4 with 4 indicating the highest deviancy from typical development.
  • OUTCOME #11:Rating of Timbre from 1 to 4 with 4 indicating the highest deviancy from typical development.
  • OUTCOME #12:Rating of Fluency from 1 to 4 with 4 indicating the highest deviancy from typical development.
  • OUTCOME #13:Rating of Nasality with indications of deviancy or no deviancy
  • OUTCOME #14:Rating of overall impression of Prosody as adequate, atypical, or very atypical.
  • OUTCOME #15:Categorization of P as having a diagnosis or ASD or not from the speech samples.

 

POST HOC ANALYSES MEASURES

  • OUTCOME #16: Comparison on all measures of the 3 Ps from the ASD group who had been correctly identified by listeners as having ASD versus the remaining 8 Ps in the ASD group

 

–  The perceptual measures were subjective.

–  The acoustic measures were objective.

 

 

  1. Were reliability measures provided?
  • Interobserver for analyzers? No.  However, the raters, 3 SLPs with a specialization in voice, discussed their ratings of each P and came to a consensus.
  • Intraobserver for analyzers? No
  • Treatment or test administration fidelity for investigators?NA

 

 

  1. Description ofdesign:
  • Eleven Swedish children diagnosed with ASD and 11 matched typically developing Swedish peers were recorded telling a narrative about the beach.

 

  • The investigators removed 1 minute samples from each narrative and subjected them to acoustic and perceptual analyses.

 

  • Raters for the perceptual measures listened to the speech samples which were presented in a random order with respect to group and gender.

 

  • Because none of the TDC group and only 3 Ps from the ASD group were judged to be ASD speakers, the investigators sought to identify if the 3 identified Ps were different from their ASD peers. (I have labeled this the Post Hoc Analysis.)

 

 

  1. What were the results of the statistical (inferential) testing?
  • There was only significant difference among all the acoustic and perceptual measures:

–  OUTCOME #5: utterance length orwords per utterance

 

  • The Post Hoc analysis identified the differences between the 3 Ps from the ASD group who had been judged to be ASD speakers from their 1 minute samples and the rest of the ASD group. The analysis yielded the following significant differences:

–  The 3 Ps identified as ASD

∞ performed significantly more poorly on the NAP from the descriptive characteristics.

∞ produced significantly more atypical fluency in the 1- minute samples

∞ produced significantly more atypical speaking rates in the 1- minute samples

 

  • What was the statistical test used to determine significance?ANOVA and Mann-Whitney U

 

  • Were effect sizes provided?Yes, for one Outcome

     –  OUTCOME #5:  Utterance length or words per utterance  (Cohen’s d was 0.99 which is considered to be a large effect.

 

  • Were confidence interval (CI) provided?No

 

 

  1. Summary of correlational results:   Not Applicable (NA)

 

 

  1. Summary of descriptive results: Qualitative research  NA

 

 

  1. Brief summary of clinically relevant results:
  • SLP judges were not able to differentiate ASD and TDC speakers listening to 1 minute narrative speech samples.

 

  • Only one measure, words per utterance, differentiated the ASD group from the TDC group. (The ASD group was labeled as high functioning.)

 

  • The Ps who were correctly identified as having ASD had

– significantly poorer narrative skills

–  significantly more atypical fluency

– significantly more atypical speaking rate

 

ASSIGNED GRADE FOR QUALITY OF EXTERNAL EVIDENCE:  B-


Fairbanks, G. (1960; Ch 10; Rhythm)

August 6, 2019

 

 CRITIQUE OF UNSUPPORTED PROCEDURAL DESCRIPTIONS

(also known as Expert Opinion)

NOTE:  Scroll down about two-thirds of the page to read the summary of the intervention.

KEY
C =  clinician

NA = not applicable

P =  patient or participant

pmh =  Patricia Hargrove, blog developer

SLP = speech-language pathologist

WPM =  words per minute

Source:   Fairbanks, G. (1960. Ch. 10, Rhythm)  Voice and articulation drillbook.  New York: Harper & Row.  (pp. 118-121)

 

Reviewer(s):  pmh

 

Date: July 31, 2019

 

Overall Assigned Grade (because there are no supporting data, the highest grade will be F)  The Assigned Overall Grade reflects the quality of the evidence supporting the intervention and does not represent a judgment regarding the quality of the intervention.

 

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.

 

Take Away: This chapter of Fairbanks (1960) is concerned with the production of Timing. Although Fairbanks notes that rate, rhythm, phrasing, and during comprise Timing, he only focuses on Rate and Rhythm in Chapter 10. This review is concerned with Rhythm Intervention. Fairbanks, however, reminds readers that prosodic features overlap with one another.

 

 

  1. Was there a review of the literature supporting components of the intervention?No

 

  1. Were the specific procedures/components of the intervention tied to the reviewed literature?No

 

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

 

  1. Did the author(s) provide a rationale for components of the intervention? Variable

 

  1. Description of outcome measures:
  • Are outcome measures suggested? Yes
  • Outcome: To produce successive stressed-unstressed patterns in connected speech

 

  1. Was generalization addressed? No

 

  1. Was maintenance addressed? No

 

SUMMARY OF INTERVENTION

 

 

PURPOSE: To improve production of speech rhythm and timing (Tempo)

 

POPULATION:  Adults

 

MODALITY TARGETED: production

 

ELEMENTS/FUNCTIONS OF PROSODY TARGETED (do not list the specific outcomes here):  rhythm, timing (Tempo)

 

ADMINISTRATOR:  The book is written so that a lay person could use it as a self-help book. Historically, I know of many speech-language pathologists who have used the techniques and the materials in their therapy sessions.

 

MAJOR COMPONENTS:

 

  • Fairbanks (1960) defines rhythm as a recurring pattern of vocal changes. Although one reason for the changes is linked to respiration, the speech features that contribute are

–  articulatory pauses

–  vowel-consonant pairings

–  stressing and unstressing

–  modifications of

∞  rate

∞  pitch

∞  intensity

 

  • The author defined terms such as jerky and patterned/monotones and he noted that many features are associated with rhythm. In Chapter 10, however, Fairbanks focuses on the recurrence of stresses as a marker of rhythm.

 

  • Fairbanks (1960, Ch 8, pp. 118-119) provided four poems which C should use to direct P to read silently and then to read aloud. Following the reading of each poem, C and P discuss its stressed-unstressed patterns.

 

  • Fairbanks provides a passage (Fairbanks, 1960, pp. 119-120) describing the rhythm in the four poems. C directs P to read the passage aloud and then C and P discuss the content.

 

  • P reads the 4 poems from pages 118-119 again but this time with exaggerated rhythm. P and, perhaps C discuss how the exaggerated rhythm, noting the mismatches with the stressed-unstressed patterns.

 

  • C reformulates the poems as prose (i.e., prose poem) by maintaining the words but modifying punctuation and capitalization. C instructs P to read the prose poems with little poetic rhythm. C and P discuss P’s performance.

 

  • P rereads the prose poems with a moderate (i.e., not exaggerated) rhythm. C and P discuss P’s performance.

 

  • P reviews the poems and identifies three poems with a similar rhythm.

 

  • P sings the song “America” (My country tis of thee.) C rewrites the first stanza of “America” as prose. C then reads aloud the first stanza with maximum rhythm. C and P discuss P’s performance.

 

  • C selects a popular song and writes it on paper. P then reads the words of the song aloud with normal rhythm, then with maximum rhythm, and finally with little or no rhythm.

 

  • Fairbanks (1960, Ch. 10, p. 121) provided a list of short phrases aloud.

–  C reads the phrases aloud attempting to produce stressed-unstressed patterns with similar duration but with clear contrasts between the stressed and unstressed syllables.

–  Fairbanks recommends speakers stress about one-third of the syllables.

 

  • P rereads the paragraph describing the rhythm in the four poems (Fairbanks, 1960, pp. 119-120). P identifies the rhythmic patterns within the paragraph.

 

  • P opens a book at random and identify rhythm of the sentences. P then tries to identify rhythmic periods (3 or more successive repetitions of a stressed-unstressed pattern.)