CRITIQUE OF UNSUPPORTED PROCEDURAL DESCRIPTIONS
(also known as Expert Opinion)
NOTE: To view the summary of the intervention, scroll about one quarter of the way down this post.
C = clinician
NA = not applicable
P = patient or participant
pmh = Patricia Hargrove, blog developer
SLP = speech-language pathologist
V: = sustained vowel
Source: Fairbanks, G. (1960, Ch. 12, Intensity Level) Voice and articulation drillbook. New York: Harper & Row. (pp. 137-141)
Date: May7, 2020
Overall Assigned Grade (because there are no supporting data, there is not a grade)
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 Intensity or Loudness. Fairbanks notes that loudness level and loudness variability (loudness range) comprise intensity. This post, however, is only concerned with intensity level.
- Was there a review of the literature supporting components of the intervention? No
- Were the specific procedures/components of the intervention tied to the reviewed literature? Not Applicable (NA)
- Was the intervention based on clinically sound clinical procedures? Yes
- Did the author provide a rationale for components of the intervention? Variable
- Description of outcome measures:
– Are outcome measures suggested? Yes
- Outcome #1: Modifying loudness level in connected speech
- Outcome #2: Producing speech with loudness appropriate to the context
- Was generalization addressed? No
- Was maintenance addressed? No
SUMMARY OF INTERVENTION
PURPOSE: To produce speech using appropriate level
MODALITY TARGETED: production
ELEMENTS/FUNCTIONS OF PROSODY TARGETED: loudness/intensity level
ASPECTS OF PROSODY USED TO TREAT THE TARGET: singing,
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.
- Fairbanks (1960, Ch 12, Intensity) defines several terms used in this section of the chapter as well as ideas for low technology strategies for measuring intensity.
- There are several parts to the first step:
– The patient (P) sustains /a/ using his/her best pitch level at a moderate intensity level.
– Inhaling before each sustained vowel, P produces a series of sustained vowels.
– Being careful to maintain the same (i.e., best) pitch, P gradually increases the intensity until voice quality begins to suffer.
– Using a briefly sustained vowel, P sings up the scale one octave. With each note, P focuses on maximum loudness and an acceptable voice quality. (As pitch rises, intensity should naturally rise.)
– Once P sings up the octave, he/she should immediately sing down the scale to the original pitch. One of the following should occur: (1) the original pitch is produced with more loudness or (2) or if the loudness gain is moderate, loudness should be easier to produce and the voice quality should be better,
– This activity can be used as a warm-up activity.
- P repeats the warm-up activity; then P reads along an assigned paragraph (p. 138, #2) beginning with the pitch, loudness, and quality of the warm-up.
- P repeats the warm-up activity and re-reads aloud the paragraph from p. 139, #2. This time, however, P reads the first sentence with maximum loudness and gradually reduces loudness in subsequent sentences until the loudness is at conversational level.
- Using any vowel,
– P sustains the vowel for 3 to 4 seconds with best pitch, moderate loudness, and acceptable quality.
– P then pauses, inhales, and repeats the sustained vowel.
– This pattern is repeated 4 times (i.e., V:-pause-V:-pause- V:-pause- V:-pause.)
– Once P can produce this pattern reliability, P increases loudness and repeats ., V:-pause-V:-pause- V:-pause- V:-pause .
– The increases in loudness are repeated to maximum loudness while avoiding strain and reduced vocal quality.
– Once the maximum is reached, P begins reducing loudness until minimal loudness is reached. P is cautioned to avoid breathiness.
– This procedure is repeated with
∞ at least 4 vowels
∞ 4 voiced continuant consonants
- At the best pitch, P sustains /u/ at a moderately difficult loudness level. P performs this a few times,
– P then produces /u/ as long as possible on one exhalation. (Target should be 20 to 25 seconds.)
– P repeats the activity with each of the following vowel: /a, æ, i/
– P and C should discuss the differences associated with changes in vowels, , pitches, loudness levels, and breathiness.
- P speaks the as many of the letters of the alphabet on one exhalation.
– P then speaks a 2 to 4 letters per second, with the most common pitch being the best pitch and including downward inflections.
- P repeats the previous activity speaking as many numbers as possible.
- P repeats the previous activity using letters but with an upward inflection and then repeats the activity using numbers with an upward inflection.
- P repeats the previous activities but starts at a pitch level higher than the best pitch level AND uses a downward inflection.
- Using the word list starting on the 3rd line of #10 on p. 139, P produces each word abruptly moving to peak intensity.
- Using the word list starting on the 5th line of #10 on p. 139, P produces each word with breathiness, gradually moving to peak intensity.
- Using the word list starting on the 3rd line of #10 on p. 139, P produces each word with breathiness, gradually moving to peak intensity.
- The words on the 3rd and 5th lines of #10 on p. 139 are paired (e.g., eat versus heat; ill versus hill.). Using paired words from the lists, P produces both word in a word pair (e. g., owl versus howl) with an abrupt beginning.
- Using words from the 3 sets provided in #11 p. 140, P produces the words in each set using average effort throughout.The C and P listen for reduced intensity as P progresses through the list.
- P reads aloud the first set of words from #11 on p. 140 at a moderately difficult loudness level using the best pitch.
– P reads aloud the 2nd and 3rd sets of words, maintaining the loudness level,
– The re-reads the 2nd and 3rd sets, using a lower pitch.
- C provides P with a set of 2 sets of words (see p. 140 #13). C directs P to read aloud the lists first with average and equal effort and then with equal intensity.
- C provides a factual passage that is several pages long.C stands about 30 to 40 feet away from P and using good rate and pitch directs P to
– start reading the passage aloud at a soft level but then to increase loudness until P signals the loudness level is appropriate. (This should occur in 4 or 5 lines.)
– P continues at that level for 4 or 5 lines.
– P continues reading aloud but at a high level of loudness and then gradually reduces the loudness level.
– P repeats the activity going from soft to loud and loud to soft.
– Following a break (or another activity), P reads aloud the passage but watches C’s hand motions to indicate the loudness level that should be attempted.
- P redoes the activity above but using spontaneous speaking rather than read aloud passage.
- P practices using loudness that is appropriate to different contexts while also using good rate, pitch, quality, and articulation.