Morgan & Ferguson (2017)

December 24, 2019

ANALYSIS GUIDELINES

Comparison/Nonintervention Research

NOTE:  The focus of the investigation is not an intervention. Accordingly, no summary of intervention is included in the review.

KEY:

eta =   partial eta squared

HI =  hearing impairment

MLU = mean length of utterance

NA = Not Applicable

P = participant or patient

pmh = Patricia Hargrove, blog developer

SLP = speech-language pathologist

WNL =  within normal limits

YNH = Young Adults with Normal Hearing

YNH1 = Ps from Experiment 1 who were young adults with normal hearing

YNH2 = Ps from Experiment 2 who were young adults with normal hearing

 

SOURCE:  Morgan, S. D., & Ferguson, S. H. (2017). Judgments of emotion in clear and conversational speech by young adults with normal hearing and older adults with hearing impairment. Journal of Speech, Language, and Hearing Research, 60, 2271-2280.

 

REVIEWER(S): pmh

 

DATE:December 17, 2019

 

ASSIGNED GRADE FOR OVERALL QUALITY:  Not graded, this is not an intervention study.  There are 2 experiments in this investigation. The review is concerned only with Experiment 2.

 

TAKE AWAY: Young adults with normal hearing (YNH) and older adults with hearing impairment (OHI) are likely to perceive Clear Speech as signaling angry or disgusted emotions, although YNH listeners were even more likely to perceive sentences negatively than OHI listeners. Nevertheless, those counseling friends and family of those with hearing impairment (HI) should monitor the prosody of their communications, especially when speakers are attempting to use Clear Speech.

 

 

  1. What type of evidence was identified?
  • What was the type of design? Comparison Research; Prospective, Nonrandomized Group Design with
  • What was the focus of the research? Clinically Related

                                                                                                           

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

                                                                                                           

  1. Group membership determination:
  • If there were groups, were participants randomly assigned to groups? No, the categories of YNH and OHI cannot be randomly assigned.
  • If there were groups and Ps were not randomly assigned to groups, were members of groups carefully matched? No _______

                                                                    

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

 

  1. Were the groups adequately described? Yes

–   How many participants were involved in the study?

  • total # of Ps: 48  (but only 30 Ps were in Experiment 2—Ps from Experiment 1 were included in some of the statistical analysis)
  • # of groups: 2 groups, although the Young Adults with Normal Hearing comprised 2 subgroups:  YNH1 = participants (Ps) from Experiment 1 and YNH2 = Ps from Experiment 2
  • List names of groups and the number of Ps in each group:

     –  YNH total =  28

∞  YHN1 = 19 initially reduced to 18 due to late disclosure

∞  YNH 2 = 13 initially reduced to 10 due to software problems and late disclosures

–  OHI =  20

  • Did all groups maintain membership throughout the investigation? No, as noted 3 YNH2 Ps were removed from the study.

 

CONTROLLED CHARACTERISTICS                                                   

  • age:

     –  YNH =  likely over 18 years, less than 35 years

     –  OHI =  greater than 65 years

 

  • cognitive skills:

     –  YNH =  within normal limits (WNL

     –  OHI = 

  • native language:

     –  YNH =  all native speakers of American English

     –  OHI =  all native speakers of American English

  • Socio-economic status:

     –  YNH

     –  OHI

  • educational level of clients:

     –  YNH

     –  OHI =  students in a University Psychology Participant Pool

  • speech or language disorders:

     –  YNH = no history

     –  OHI = no history

  • speech or language therapy:

     –  YNH = no history

     –  OHI = no history

  • Word recognition skills:

     –  OHI =  greater than 80% 

  • Hearing:

     –  YNH =   WNL by self report

     –  OHI =   in at least one ear a mild to moderately severe sloping sensorineural hearing loss

 

–  DESCRIBED CHARACTERISTICS

  • age:

     –  YNH1  = 18 to 33 years

     –  YNH2  = 18 to 30 years

     –  OHI =  65 – 78 years

  • Word recognition skills:

     –  YNH  =  average was 93%

 

–  Were the groups similar?  No

                                                         

–  Were the communication problems adequately described?

Yes ___      No  _x__      Unclear ____   NA ____x___

 

  • disorder type: Hearing Impaired  

 

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

–  YNH listeners

–  OHI listeners

 

  • Conditions?Yes

–  Sentences (14)

–  Speaking Style (Conversation, Clear Speech)

–  Talkers (8; 4 male 4 female; 4 Good Clear Speech Talkers, 4 Poor Clear Speech Talkers)

 

*  Criterion/Descriptive Conditions?  No 

 

  1. Were the groups controlled acceptably?  Yes

 

  1. Was the dependent measure appropriate and meaningful? Yes
  • OUTCOME #1: Listener judgment of perceived emotion
  • The dependent measure was subjective.
  • The dependent measure was NOT objective.

 

 

  1. Were reliability measures provided?
  • Interobserver for analyzers?
  • Intraobserver for analyzers?
  • Treatment or test administration fidelity for investigators?No, however,  the protocol was administered on a computer.

 

  1. Description ofdesign:
  • Clear Speech is a speaking style often directed to listeners with HI; in fact, communicative partners are often counseled to use Clear Speech when talking with individuals with HI. The purpose of this investigation is to determine if this modification speaking style unintentionally conveys negative emotions.

 

  • The Ps were OHI and YNH. The OHI Ps were investigated to explore emotions perceived when listening to Clear Speech. The YNH Ps were included as norms.

 

  • All Ps listened to recordings of 224 sentences (multiple recordings of 14 different semantically neutral sentences) which were recorded by 8 speakers (4 male, 4 female; 2 good speakers of Clear Speech and 2 poor speakers of Clear Speech.) The prerecorded sentences were selected from the Ferguson Clear Speech Database. Half of the sentences were in Conversational Style and half were in Clear Speech Style. The intent of the talkers was to produce a neutral affect.

 

  • Prior to being administered the experimental stimuli, the investigators were familiarized with the procedures.

 

  • Ps listened to each sentence and categorized the emotion represented in the sentence as

–  anger,

–  fear,

–  disgust,

–  sadness,

–  happiness, or

–  neutral.

 

  1. What were the results of the statistical testing?
  • OUTCOME #1: Listener judgment of perceived emotion

     –  Overall, when listening to Clear Speech, listeners were more likely to judge the emotions as “anger” or “disgust” and less likely to select “fear”, “happiness”, “sadness”, and “neutral than when listening to Conversational Speech.

–  OHI listeners chose the following emotions less often than YHI listeners:

∞ anger

∞  fear

∞  sadness

∞  happiness

–  OHI listeners chose the neutral emotion more often than YHI listeners.

–  OHI listeners chose angry less frequently than YNH listeners for both Conversational Speech and Clear Speech.

–  Overall talkers’ skill in using Clear Speech influenced judgments about emotions with Good Talkers of Clear Speech more likely to be judged as “angry” or “fearful” than Poor Talkers of Clear Speech.

–  YNH listeners were more likely than OHI listeners to judge Good Talkers of Clear Speech as angry or fearful but YNI and OHI listeners were similar in their judgment of angry or fearful for Poor Talkers of Clear Speech.

(add additional outcomes as appropriate)

 

  • What was the statistical test used to determine significance? Linear mixed-effects modeling:

 

  • Were effect sizes provided?No____

 

  • Were confidence interval (CI) provided?No

 

  1. Summary of correlational results:  NA

 

  1. Summary of descriptive results: Qualitative research  NA

 

  1. Brief summary of clinically relevant results:
  • Those counseling friends and family of people with HI should remind the speakers to monitor the prosody of their communications, especially when they are attempting to use Clear Speech

 

ASSIGNED GRADE FOR QUALITY OF EXTERNAL EVIDENCE: Not graded


Hidalgo et al. (2019)

December 6, 2019

 

EBP THERAPY ANALYSIS

Treatment Group

Note: Scroll about 90% of the way down the page to read the summary of the procedure(s).

Key:

C = Clinician

CI = cochlear implant

EBP = evidence-based practice

ERP = event related potentials

HA =  hearing aid

HL = hearing loss

MMN =  mismatch negativity

NA =  not applicable

NH = normal hearing

P = patient or participant

pmh =  Patricia  Hargrove, blog developer

SLP = speech–language pathologist

WNL =  within normal limits

 

SOURCE: Hidalgo, C., Pesnot-Lerousseau, J., Marquis, P., Roman, S., & Schön, D. (2019). Rhythmic training improves temporal anticipation and adaptation abilities in children with hearing loss during verbal interaction. Journal of Speech, Hearing, and Language Research, 62, 3234-3247.

 

REVIEWER(S):   pmh

 

DATE:December 4, 2019

 

ASSIGNED GRADE FOR OVERALL QUALITY:  Not graded. Although this investigation has clinical implications (i.e., it is Clinically Related), it is not classified as Clinical Research.

 

TAKE AWAY: This investigation consists of two experiments:  the exploration of (1) the ability of children with normal hearing (NH) to adapt to temporal changes during a speech interaction task and  (2) the ability of children with hearing loss (HL) to benefit from a brief (30 minute) exposure to rhythmic training. Only the second experiment is reviewed (analyzed and summarized) here. The findings indicate that a single rhythmic treatment  session improves the ability of adapt to and anticipate verbal  turn taking in children with HL.

 

  1. What type of evidence was identified?
  • What was the type of evidence?Prospective Single Group with Alternating Treatments
  • What was the level of support associated with the type of evidence? Level = C+

                                                                                                           

  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 data analyzers?Unclear

 

  1. Were the Ps adequately described? Yes

–  How many  Ps were involved in the study?

  • total # of Ps: 16 (in the intervention experiment, Experiment 2)
  • # of groups:1

 

–  CONTROLLED CHARACTERISTICS

  • age:6 to 10 years old
  • hearing status: medium to severe hearing loss (HL)
  • aid status: bilateral/unilateral user of hearing aids (HA) or cochlear implants (CI)
  • onset of HL: per- or peri-lingual
  • gender:9m; 7f
  • native language:French
  • cognitive skills:within normal limits (WNL)
  • language skills:WNL
  • visual skills:WNL
  • education of Ps:mainstream primary school (14/16); not enrolled in mainstream primary school but estimated to have good language skills (2/16)

 

–  DESCRIBED CHARACTERISTICS

  • duration of use of hearing device:40 to 104 months
  • age CI switched on or began wearing HA:6 to 103 months
  • type of device:Hearing Aid (HA) = 4; CI = 9; CI + HA = 1
  • HL without HA(s) or CI(s):moderate to cophosis (‘total deafness’)
  • onset of HL:unknown = 2; congenital =  10; perilingual = 1; progressive =

 

 Were the communication problems adequately described?  The hearing status was clearly described; speech was not described.

  • disorder type: hearing impaIrment
  • functional level: TABLE 1 provided hearing threshold at 250, 500, 1000, 2000 Hz for all Ps.

 

  1. Was membership in groups maintained throughout the study?
  • Did the group maintain at least 80% of their original members? Yes, but 2 Ps (12.5%) were removed due to the quality of their EEG data
  • Were data from outliers removed from the study?No

 

  1. Were the groups controlled acceptably?  NA, there was only one group.

 

  1. Were the outcomes measure appropriate and meaningful? Yes
  • OUTCOME #1:Speech rate (word duration in milleseconds)
  • OUTCOME #2:Stress consistency and accuracy
  • OUTCOME #3:Presence of mismatch negativity (MMN) in event-related

 

–  None of the outcome measures were subjective.

–  Allof the outcome measures were objective.           

 

  1. Were reliability measures provided?

  Interobserver for analyzers?  No 

–  Intraobserver for analyzers?   No

–  Treatment fidelity for clinicians?

 

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

 

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

 

  • OUTCOME #1:Speech rate (word duration in milliseconds)

–  Participants’ (Ps’) word durations were shorter in the fast interactive condition than in the slow interactive condition following both instrumental rhythmic condition and auditory training conditions.

  • OUTCOME #2:Stress consistency and accuracy

–  Ps produced stress more consistently and accurately when the interacter regularly produced stress compared to when the interacter irregularly produced stress.

–  Ps performance on irregular trials improved following rhythm but not auditory training,  suggesting improved flexibility as the result of the rhythm treatment.

  • OUTCOME #3:Presence of mismatch negativity (MMN) in event-related potentials (ERP)

     –  The electrophysiological response to regular and irregular turns was different which the investigators considered to be an MMN-like effect detecting temporal deviance. (The most common turn type we the regular turn.)

     –  The MMN effects occurred following both interventions.

 

– What was the statistical test used to determine significance?

  • t-test: xxxx
  • ANOVA
  • Spearman’s Rank Order Correlation

 

–  Were confidence interval (CI) provided?  No

 

  1. What is the clinical significanceNA

 

  1. Were maintenance data reported? No

 

  1. Were generalization data reported?

 

  1. Describe briefly the experimental design of the investigation.
  • The investigation comprised 2 experiments. Only the second experiment is reviewed here.

 

  • The investigators recruited 16 children (Ps), ages 6 to 10, with HL to participate. The Ps used either hearing aids (HA) or cochlear implants (CI).
  • Two of the Ps were removed from the investigation because of technical problems with the EEG data.
  • There were 3 sets of conditions and the Ps went through the task 2 times.

–  Rate of speech (fast, slow) of interacter (audiorecording) that was serving as a model for the Ps.

–  Regularity of the presentation (regular or irregular) of the stimuli by the interacter.

–  Training strategy:  Rhythmic Trainin(30 minutes) or Auditory Training (30 minutes) with order counterbalanced.

  • The assessment task involved the visual presentation of an object and the interacter (an audiorecorded signal) modeling the name of the object and then the P producting the name of the picture. Ps were assessed immediately following each treatment.
  • The P’s speech was audiorecorded for future analysis and the Ps wore a 21 electrode cap to permitthe collection of EEG data.
  • There were 2 treatment sessions (rhythm and auditory training) that were administered to each P; the order administration of treatment strategies was counterbalanced. The 2 treatment sessions were separated by one week.

 

 

ASSIGNED OVERALL GRADE FOR QUALITY OF EXTERNAL EVIDENCE:   Not graded;  this is not an intervention study despite its clinical implications.

 

SUMMARY OF INTERVENTION

 

PURPOSE:  to investigate the effectiveness of rhythm training on temporal adaptation in verbal interactions

 

POPULATION: hearing impairment; children

 

MODALITY TARGETED:  production

 

ELEMENTS/FUNCTIONS OF PROSODY TARGETED:  rate, stress

 

ELEMENTS OF PROSODY USED AS INTERVENTION:  rhythm

 

DOSAGE: a single 30-minute lesson of each treatment strategy

 

ADMINISTRATOR:  investigator

 

MAJOR COMPONENTS:

 

  • There were 2 treatment strategies:rhythm and auditory training

 

RHYTHM

 

  • The clinician (C) administered a series of exercises including

–  Follow the Beat:  walking to the beat of metronome.

–  Structure the Beat into a Meter:  listening to and tapping a beat with one’s feed and tapping other beats with hands in unison with C.

–  Learn a New Rhythm:  listening to music, identifying a beat, moving one’s body to the beat, tapping the beat with claves (word sticks with a hollow sound).

–  Follow Metric Changes:  listening to music, changing body movements with the metrical changes.

–  Body Tapping:  tapping rhythm in without an external model.

–  Beatboxing:  producing a rhythm with the mouth solo and in unison with C.

 

AUDITORY TRAINING

 

  • C administered a series of exercises including

–  Timber Recognition Across Categories: sorting sounds into different categories (e.g. animal sounds, musical instruments, environmental sounds).

–  Timbre Recognition Within Categories:  sorting sounds within the same category (e.g., for the animal sounds category:  dogs, cats, cows, etc. or even angry dogs, happy dogs, sad dogs, etc.).

–  Sound Sequence Recognition Within Categories: using sounds within a category, P identified sequences of sounds of increasing length

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