most recent update:  August 17,   2017

newest entry:   Murray  et al.   (2015)


This section contains brief notes summarizing each of the reviewed sources.  A link to the review follows the annotation. Click on the address for direct access to the review.   Thank you to Judy Kuster for recommending the addition of this section and to Richard Schiming recommending providing links.

Abrams, S. (n.d.).  The effects of fluency instruction incorporating Readers Theatre on oral reading fluency in an eighth-grade classroom. Retrieved from  This investigation involved an intervention using decoding strategies, reading aloud grade level materials, and Readers Theatre. The results indicated improvement in reading rate but not prosodic reading fluency. The short treatment dosage, difference between intervention and assessment tasks, the assessment task itself, and use of grade-level rather than reading level passages (see Allington, 2006) may have contributed to the lack of improvement in prosodic reading fluency.


Akbarpour, S., & Roohani, A. (2015.) The comparative impact of song and nonsong vocabulary instruction. International Journal of Language Learning and Applied Linguistics World, 10 (1), 1-12. NOTE: although the copy of the article I received clearly listed the issue number to be #2; I found the article on the Journal’s webpage to be issue #1. I am using issue #1 in this citation. Went you go to the webpage, select “September 2015 full version” and click on the following pdf: finalversion1011   JOURNAL ADDRESS:   School-aged Iranian English language learners improved vocabulary comprehension over 12 weeks of intervention. Neither Song nor Nonsong instructional methods resulted in better outcomes, although both methods improved post intervention. This suggests that Song is a reasonable but not a superior intervention procedure.

Allington, R. L. (2006). Fluency: Still waiting after all these years.  In S. J. Samuels & A. E. Farstrup (Eds.), What research has to say about fluency instruction (pp. 94-105). Washington, DC: International Reading Association   ARTICLE:  This expert opinion presents evidence from the literature that dysfluent reading may be associated with teacher behaviors. Although the focus of the teaching strategies was dysfluent reading, these strategies could be helpful with prosodic problems.

Ballard, K. J., Robin, D. A., McCabe, P., & McDonald, J. (2010). A treatment for dysprosody in childhood apraxia of speech. Journal of Speech, Language, and Hearing Research, 53, 1227-1245. This presentation of three single subject experimental design studies provides moderately strong information about the effectiveness of a program designed to improved the stress production of children diagnosed with childhood apraxia of speech.

Ballard, K. J., Varley, R, & Kendall, D. (2010b). Promising approaches to treatment of apraxia of speech: Preliminary evidence and directions for the future. Perspectives on Neurophysiology and Neurogenic Speech and Language Disorders, 20, 87-93.   doi:10.1044/nnsld20.3.87   The authors critiqued three emerging approaches to treating apraxia of speech. This review was concerned only with the approach that used prosody: Rapid Syllable Transition Treatment (ReST). The authors contended that ReST has potential for success with adults with apraxia of speech. The measure that showed improvement was a durational differential of stressed and unstressed syllables in trained and untrained words.


Ballard, K. J., Wambaugh, J.L., Duffy, J. R., Layfield, C., Maas, E., Mauszycki, S., S., & McNeil, M. R. (2015). Treatment for acquired apraxia of speech: A systematic review of intervention research between 2004 and 2012. American Journal of Speech-Language Pathology, 24, 316-337. This Systematic Review (SR) included a broad range of research designs investigating the effectiveness of intervention for acquired apraxia of speech (AOS.) Most of the sources involved nonprosodic outcomes and/or treatment procedures with only 8 sources focusing on prosodic outcomes and/or prosodic treatment procedures. Accordingly, only those 8 sources are summarized and analyzed in this review. The findings indicated that treating prosody directly and using prosody to treat articulatory and/or naming outcomes can result in improvements.


Baumann, N. A., & Palasik, S. (2017). The effects of music therapy on stuttering. Honors Research Projects- The University of Akron.   This case study explored the effectiveness of music in stuttering therapy. There were several outcomes. Generally in monologues, there was limited improvement in the overall measures of stuttering and variable change in the type of disfluences. For reading aloud, there was limited improvement in the rate of disfluencies and variable changes in the type of disfluency. Measures of Mindfulness also were variable with one measure not showing improvement, two measures yielding overall limited improvement, one measure showing moderate improvement, and one measure showing moderate improvement in one of 5 categories.


Bearthard, B., & Krout, R. E. (2008). A music therapy clinical case study of a girl with childhood apraxia of speech. The Arts in Psychotherapy, 35, 107-126.    This case study describes music therapy designed for a child with Childhood Apraxia of Speech. Descriptions of the therapy and its results suggest improvement in some aspects of communication, literacy, and music.


Behrman, A. (2014). Segmental and prosodic approaches to accent management. American Journal of Speech-Language Pathology, 23, 546-561.    This investigation employed segmental and prosodic treatment approaches to increase the use of American English (AE) among nonnative speakers of AE. The investigations revealed that (1) prosody improved when the treatment target was prosody, (2) segmentals improved when segmentals were the treatment focus and (3) ratings of accentedness and ease of understanding (comprehensibility) improved following the treatment that included both prosody and segmental targets.


Bellon-Harn, M., Harn, W. E., & Watson, G. D.  (2007).  Targeting prosody in an eight-year-old child with high-functioning autism during an interactive approach to therapy.  Child Language Teaching and Therapy, 23, 157-179. This case study is a promising approach that combines explicit and interactive components to resolve lengthening and pausing problems of a child diagnosed with High Functioning Autism.

Ballard, K. J., Varley, R, & Kendall, D. (2010b). Promising approaches to treatment of apraxia of speech: Preliminary evidence and directions for the future. Perspectives on Neurophysiology and Neurogenic Speech and Language Disorders, 20, 87-93.    doi:10.1044/nnsld20.3.87  The authors critiqued three emerging approaches to treating apraxia of speech. This review was concerned only with the approach that used prosody:  Rapid Syllable Transition Treatment (ReST).The authors contended that ReST has potential for success with adults with apraxia of speech. The measure that showed improvement was a durational differential of stressed and unstressed syllables in trained and untrained words.

Bellon-Harn, M.  (2011). Targeting prosody:  A case study of an adolescent.  Communication Disorders Quarterly, 2 (2), 109-117.  The results of this case study indicate that the intervention, which involves explicit targets and meta awareness procedures, has promise for adolescents with prosodic problems.

Bertirotti, A. (2004.) Theoretical aims on music for prosody in speech therapy setting. Retrieved from This expository paper presents a case for why music should be incorporated into speech-language therapy. The author discusses links between music and language including evolutionary and functional perspectives, neurological representations, and the therapeutic uses of music outside of speech-language therapy. One of the major arguments for the use of music in speech-language therapy is tied to prosody, especially rhythm and pitch. The author provides some treatment recommendations.

Blanchet, P. G., & Snyder, G. J.  (2010).  Speech rate treatments for individuals with dysarthria:  A tutorial.  Perceptual and Motor Skills, 110, 965-982. This narrative review of the literature provides moderate support for using rigid rate control approaches for clients with severe dysarthria and more naturalistic approaches for clients with less severe dysarthria.

Blake, M. L., Frymark, T., & Venedictov, R. (2013). An evidence-based systematic review on communication treatment for individuals with right hemisphere brain damage. American Journal of Speech-Language Pathology, 22, 146-160. This systematic review focused on 4 outcomes for treating individuals with right hemisphere brain damage. Only one of the outcomes was concerned with prosody and only that outcome is reviewed here. This is a well-executed systematic review but a major limitation is the limited number of qualifying sources. Nevertheless, two approaches to teaching the production of sentence with prosody that are appropriate for designated affective states were identified.

Bonakdarpour, B., Eftekjarzadeh, A., & Asgayeru, H. (2003). Melodic intonation therapy in Persian aphasic patients.  Aphasiology, 17 (1), 75-95.  Good evidence supporting the use of MIT with Persian speakers with aphasia. The investigators also provided generalization and intervention hints.

Bornhofen, C., & McDonald, S. (2008). Comparing strategies for treating emotional perception deficits in traumatic brain injury. Journal of Head Trauma Rehabilitation, 103-115.      This investigation focused on overall emotional perception; a small number of outcomes are concerned affective prosody as it is only one component of emotional perception. Although this may be interpreted as a disadvantage, the interventions more closely replicate daily living compared to interventions that  focus solely on one aspect of emotional perception (e.g., prosody).  Overall, the findings revealed some success with respect to emotional perception and some generalization outcomes.

Bornhofen, C., & McDonald, S. (2008b). Treating deficits in emotion perception following traumatic brain injury. Neuropsychological Rehabilitation, 8 (1), 22-44.  This small group investigation is reviewed despite the fact that one cannot parse out the improvement in prosodic affects, because the measures and intervention treated emotion perception holistically. Overall, the intervention yielded positive changes that were maintained for at least a month.


Bouglé, F., Ryalls, J., & Le Dorze, G.  (1995).  Improving fundamental frequency modulation in head trauma patients:  A preliminary comparison of speech-language therapy conducted with and without IBM’s  SpeechViewer.  Folia Phoniatr Logop, 47, 24-32. The investigators presented two single subject experimental design studies of patients with closed head injury to determine which of two interventions were more effective in improving intonation as measured by fo.  Although the two approaches (visual and auditory) had equivocal results, the  combined intervention was very effective for one P; for the other it was fairly effective.

Brendel, B., & Ziegler, W. (2008).  Effectiveness of metrical pacing in treatment of apraxia.  Aphasiology, 22, 77-102.             The investigators explored the effectiveness of a conventional approach and a metrical approach in aphasia therapy.  They determined that the Metrical Pacing Technique was associated with improvement in duration, fluency, and  speech sounds  while Conventional Therapy was only associated with improvement in speech sounds.

Brooks, P. J., & Ploog, B. O.  (2013). Attention to emotional tone of voice in speech perception in children with autism. Research in Autism Spectrum Disorders, 7,  845-857. ARTICLE:    Overall, Ps with Autism Spectrum Disorder (ASD) did not show evidence of a problem perceiving differences between representative of 2 emotions:  grouchy and enthusiastic.  However, Ps with ASD required approximately two times the number of trials to advance out of the training phase of the experiment than typically developing children (TYP).  TYP peers preferred the enthusiastic prosody to the grouchy prosody but Ps with ASD did not have a preference. (To me this could suggest a problem/difference with linking perception of prosody to meaning.)  REVIEW:

Brown, J. (1974). The psycho-physical responses to music therapy of some very young retarded children. British Journal of Music Therapy, 3, 57-64.  This program description with associated case studies is an example of early work (1974) supporting the view that music can play a role in intervention with children with developmental delays. The author described changes (but not documentary evidence of progress) in the following aspects of communication: imitation, early communication/interaction skills, and pre-speech vocalizations.

Caligiuri, M. P., & Murry, T.  (1983).  The use of visual feedback to enhance prosodic control in dysarthria.  In W. R. Berry (Ed.) Clinical dysarthria (pp. 267-282).  San Diego, CA: College-Hill Press.             The  authors provided fair evidence that the use of visual (oscilloscope and intraoral pressure) feedback shows promise for increasing normalcy ratings in rate, overall prosody, and duration of speakers with dysarthria.  

Cannito, M. P., Suiter, D. M., Beverly, D., Chorna, L., Wolf, T., & Pfeiffer, R. M. (2012). Sentence intelligibility before and after treatment in speakers with idiopathic Parkinson’s disease. Journal of Voice, 26, 214-219. This single group pre-post test intervention experiment yielded results supporting the effectiveness of Lee Silverman Voice Treatment (LVST) in improving intelligibility of patients (Ps) with Parkinson’s disease. Overall, intelligibility significantly improved following LVST and analyses of effectiveness for individuals revealed that 6 of the 8 Ps improved significantly.



Casper, M. A., Raphael, L. J., Harris, K. S., & Geibel, J. M. (2007). Speech prosody in cerebellar ataxia. International Journal of Language and Communication Disorders, 42, 407-426.

  • Participants (P) with cerebellar ataxia and neurotypical adults differed significantly on the following acoustic measures of prosody:

– duration

– fundamental frequency (Fo)

– formant frequencies


Cohen, N. S. (1988). The use of superimposed rhythm to decrease the rate of speech in a brain-damages adolescent.  Journal of Music Therapy, 25 (2), 85-93.              This single subject experimental design provides fair evidence to support the use of rhythmic tasks (with and without melody) to decrease speaking rate. The results suggest that the rhythmic only tasks are more effective than the combined rhythmic plus melody (i.e, music). Unfortunately, changes in medications co-occurred with treatment alternations thus obscuring results.  

Cohen, N. S.  (1995).  The effect of vocal instruction and Visi-Pitch™ feedback on the speech of persons with neurogenic communication disorders:  Two case studies.  Music Therapy Perspectives, 12, 70-74.             The investigator provided evidence from case studies  supporting the effectiveness of a treatment approach combining  vocal instruction and visual feedback for improving  rate (pause time) and loudness in patients diagnosed with aphasia and  dysarthria.

Countryman, S., Ramig, L. O., & Pawlas, A. A. (1994). Speech and voice deficits in Parkinsonian plus syndromes:  Can they be treated? Journal of Medical Speech-Language Pathology, 2, 211-225.                 These three case studies add to the strong body of research supporting the effectiveness of Lee Silverman Voice Treatment.  The participants in this research were diagnosed with Parkinsonian plus syndromes.

Crutchfield, R. (2014). Music therapy efficacy on increasing word length in Spanish dominant children with a phonological process disorder. American International Journal of Contemporary Research, 4 (5), 21-30. Spanish language dominant Mexican American children improved as the result of the traditional phonological process (PP) therapy as well as music-based (phonological process (MT) therapy. There was some evidence suggesting that the children who receive MT therapy progressed more rapidly than the PP therapy.


da Fontoura, D. R., de Carvalho Rodrigues, J., Brandão, L., Monção, A. M., & Fumagalli de Salles, J. (2014.) Efficacy of the Adapted Melodic Intonation Therapy: A case study of a Broca’s Aphasia patient. Distúrbios da Comunicação São Paulo, 26, 641-655.   This single case study investigated the effect of an adapted form of Melodic Intonation Therapy (AMIT) on a patient (P) with Broca’s Aphasia who was a speaker of Brazilian Portuguese. The investigators monitored 73 outcomes before, after, and (in some cases) during intervention. Outcomes that improved were concerned with rate of speech, speech fluency, word finding, speech accuracy, literacy, memory, and imitation. The outcomes that did not improve tended to be concerned with skills not targeted by AMIT such as comprehension of words, directions, or Inferences.

Daly, A. (2009).  Teaching prosody through Readers Theatre.  Capstone Paper for Master of Arts at Hamline University, Saint Paul, MN.    Paper:,d.cWc Review:  This single group investigation revealed that a comprehension-based Readers Theatre intervention for 2nd graders who are English Language Learners can improve timing (phrasing), intonation, and stress (i.e., fluency) of oral reading.

de Azevedo, L. L., de Souza, I. S., de Oliveira, P. M., & Cardose, F. (2015). Effect of speech therapy and pharmacological treatment in prosody of parkinsonians. Arquivos de Neuro-Psiquiatria i, 73 (1), 30 35. DOI: 10.1590/0004-282X20140193     A small group of Brazilian Portuguese speakers diagnosed with Parkinson’s disease (PD) were reported to show improvement in measures of fundamental frequency, duration, and intensity following an intervention that combined the drug Levodopa and an adaptation of the Lee Silverman Voice Treatment (LVST.)

De Letter, M., Santens, P., Estercam, I., Van Maele, G., De Bodt, M., Boon, P., & Van Borsel, J. (2007). Levodopa induced modifications of prosody and comprehensibility in advanced Parkinson’s disease as perceived by professional listeners. Clinical Linguistics and Phonetics, 21, 783-791.  This clinically related investigation determined that participants (Ps) produced significantly better pitch, loudness, and comprehensibility while using Levodopa than when not using Levodopa. There was not a significant change in speaking rate on and off Levodopa conditions.

Diehl, J. J., & Paul, R. (2013). Acoustic and perceptual measurements of prosody production on the Profiling Elements of Prosodic Systems in Children by children with autism spectrum disorders. Applied Psycholinguistics, 34, 135-161.  Analysis of perceptual data revealed that participants (P) with Autism Spectrum (ASD) and Learning Disability (LD) struggled with prosodic comprehension of affect, turn ends/terminal contour, and focus/stress but not chunking/phrasing. In addition, Ps with LD struggled with the production of accurate chunking/phrasing.

Acoustic analysis indicated that the Ps with ASD displayed significant differences from TD peers on duration of utterances for affect (conveying dislike) and turn-end/terminal contour tasks, intensity for stress/focus tasks, average f0 range for focus/stress tasks, and standard deviation (SD) of f0 during focus/stress tasks. Ps with LD produced prosody that differed significantly from the TD peers on average f0 for turn ends/terminal contour, chunking/phrasing, and focus/stress tasks as well as duration for turn-end/terminal contour .


Diekema, E. (2016). Acoustic Measurements of Clear Speech Cue Fade in Adults with Idiopathic Parkinson Disease. (Electronic Thesis or Dissertation). Bowling State University, Bowling Green, OH. Retrieved from This investigation is not classified as an intervention study. The results, however, can inform therapeutic practice. Speech samples of 12 adults with PD were recorded while they read aloud part of the Rainbow Passage following cues to use Clear Speech (CS.) The results indicated that improvements in the following measures decreased throughout the passage suggesting that the gains from CS cues were not maintained: speech rate, articulation rate, percent pause time, fo variability, and intensity throughout the passage. However, gains in the following measures were maintained throughout the passage: intensity associated with word stress and mean fo . The investigator suggested that when using CS with adults with PD, clinicians should consider modifications to enhance the cues effectiveness over time.

Duffy, J. R., Strand, E. A., Clark, H., Machulda, Whitwell, J. L., & Josephs, K. A. (2015). Primary progressive apraxia of speech: Clinical features and acoustic and neurologic correlates. American Journal of Speech-Language Pathology, 24, 88-100.   Two case studies revealed that certain prosodic measures (duration, rate, pauses, segmentation, and stress) as well as nonprosodic measures deteriorate over time in patients diagnosed with Primary Progressive Apraxia of Speech.

Dupis, K., & Pichora-Fuller, M. K. (2015.) Aging affects identification of vocal emotions in semantically neutral sentences. Journal of Speech, Language, and Hearing Research, 58, 1061- 1076.   This investigation involved the comparison 2 groups of typical speakers and, therefore, should not be considered to be intervention research. Nevertheless, it is informative for the practice of speech-language pathology. Two experiments revealed that there are age related differences in the ability to recognize emotion using prosody with younger Ps outperforming older Ps. These differences cannot be explained by hearing acuity as measured by pure tone averages or by auditory processing.


Dworkin, J. P. (1991). Motor speech disorders: A treatment guide. St. Louis, MO: Mosby. (Chapter 7: The Treatment of Prosody, pp. 303 – 343)  Dworkin provides explicit instructions concerning establishing baseline, administering procedures, recording data, and advancing/discontinuing for each exercise. The exercises are logically ordered and linguistic complexity (from single vowels to spontaneous conversation) increases as the patient (P) moves through the treatment hierarchy. Dworkin describes treatments for the following aspects of prosody: pitch, loudness, rate of speech, intonation, and stress.


Dworkin, J., Abkarian, G. G., & Johns, D. F. (1988). Apraxia of speech:  The effectiveness of a treatment regimen. Journal of Speech and Hearing Disorders, 53, 280-294.      This single subject experimental design provides good support for the effectiveness of a lengthy program of treatment designed to speech production with an adult diagnosed with apraxia.

Eier, A. R. (2013). Tune in™ to Reading, an interactive singing program, and children who are deaf or hard of hearing using cochlear implants: Could this program be effective in improving reading fluency. Independent Studies and Capstones. Paper 662. Program in Audiology and Communication Sciences, Washington University School of Medicine (St. Louis, MO.)  Manuscript:   This article explored the feasibility of using Tune in™ to Reading (TITR, a music based interactive software program) to treat children with cochlear implants (CI). The author indicated that TITR may be useful in improving the reading fluency of children with CI because

  • a review of the literature yielded research supporting its effectiveness with children with normal hearing
  • in many cases, the language used in TITR is appropriate for children with hearing loss
  • there is evidence that the interface of the TITR software and CIs can be successful, although some adjustments will be necessary.

Ellis Weismer, S., & Hesketh, L. J. (1993). The influence of prosodic and gestural cues on novel word acquisition by children with specific language impairment. Journal of Speech and Hearing Research, 36, 1013-1025.      This is not an intervention study. Rather, it is an investigation of the effectiveness of prosodic and gestural cues on the comprehension and production of words. It provides good evidence that kindergarteners with SLI (at least 1 standard deviation below the mean) and TD children can improve comprehension and production of nonsense nouns when they are presented at slower rates. Children (SLI and NL) can also improve comprehension of nonsense locative prepositions if they are presented verbally and with gestures.

Ertmer, D. J., & Leonard, J. S., & Pachuilo, M. L., (2002). Communication intervention for children with cochlear implants: Two case studies. Language, Speech, and Hearing Services in Schools, 33, 205- 217.    The authors present an intervention for improving auditory perception, speech production, and oral language for children with cochlear implants. Although only a small portion of the intervention was concerned with prosody outcomes and using prosody to improve treatment outcome, the approach is thorough and can be modified to meet the needs of individual children. Two case studies are presented as illustrations: a child who was moderate high functioning and a child who experience challenges.

Facon, B., Sahiri, S., & Riviére, V.  (2008).  A controlled single-case treatment of severe long-term selective mutism in a child with mental retardation.  Behavior Therapy, 39, 313-321.  doi: 10 1016/j.beth.2007.09.004             The investigators presented a single subject experimental design to support the effectiveness of this behavioral program for increasing loudness and utterance length in a child diagnosed with selective mutism and cognitive impairment.

Farnell, T. L. (2015). The inclusion of music therapy in speech-language interventions. Undergraduate honor thesis. University of Arkansas, Fayetteville, AK. Retrieved from This investigation is not concerned with the effectiveness of prosody interventions. Rather, it is a clinically related survey about the inclusion of music therapy in the practice of speech-language pathology. The results indicate that SLPs use music to treat a variety of outcomes with both children and adults, although music is more likely to be used with children. Music is most likely to be employed for the following purposes calming, focus, vocalization, language, and vocabulary.

Ferré, P., Ska, B., Lajoie, C., Bleau, C., & Joanette, Y. (2011). Clinical focus on prosodic, discursive and pragmatic treatment for right hemisphere damaged adults: What’s right? Rehabilitation Research and Practice, 2011.   doi:10.1155/2011/131820      This article addressed the nature of disorders, assessment, and intervention associated with different aspects of communication (i.e., prosody, discourse, semantics, pragmatics) effected by Right Hemisphere Damage (RHD). This review was concerned only with prosodic intervention. The authors briefly reviewed 4 sources concerned with prosodic intervention. Overall, the sources involved a small number of participants; nevertheless, some of the interventions show promise.

Flaugnacco, E., Lopez, L., Terribili, C., Montico, M, Zoia, S., Schön, D. (2015). Music training Increases phonological awareness and reading skills in developmental dyslexia: A randomized control trial. PLoS ONE, 10 (9), e0138715. doi:10.1371/ journal.pone.0138715   Italian children who had been diagnosed with dyslexia participated in this randomized control trial investigation the effectiveness of 7 months of Music Training on literacy skills. The results revealed significant improvement in text reading, pseudo-word reading, word reading accuracy, phonemic blending, temporal anisochrony, temporal rise time, rhythm reproduction, tapping reproduction, overall cognitive performance, auditory attention, backward digit recall, and self-esteem.

Fox, C. M., & Boliek, C. A. (2012).  Intensive voice treatment (LVST LOUD) for children with spastic cerebral palsy with dysarthria. Journal of Speech-Language-Hearing Research, 55, 930-945.      This investigation, which is supported by a single-subject design, provides initial support the application of Lee Silverman Voice Treatment (LSVT) for children with cerebral palsy. The results indicate that measures of the children’s loudness, pitch variability, and voice quality improved following 16 sessions of LSVT LOUD.

Freeman, S. R., & Garstecki, D. C. (1973). Child-directed therapy for nonorganic voice disorder: A case study. Language, Speech, and Hearing Services in Schools, 4, 8-12.      This investigation provides initial, limited support for the use of a child-directed intervention for the improvement of pitch (level, variability) and  loudness in an 11 year-old with a nonorganic voice problem.


Friedman, M. (1985). Remediation of intonation contours of hearing-impaired students. Journal of Communication Disorders, 18, 259-272. These case studies provide limited support for this academic year-long curriculum to teach adolescents with hearing loss to discriminate, imitate, and produce falling terminal contours.  Although the adolescents involved in these case studies were hearing impaired, the procedures have potential for those whose hearing is within normal limits (WNL).

Gee, S. M. (2010). Pediatric speech-language pathology corner: Improving prosody in childhood apraxia of speech. ARTICLE: Retrieved on August 16, 2016 from REVIEW: This brief, thoughtful discussion of role of prosody in the treatment of childhood apraxia of speech (CAS) provides a rationale for targeting prosody relatively early in the intervention process to reduce, or even prevent, the atypical prosody often observed in the speech of children with CAS. The author recommends focusing on coarticulation or concordance (which involves the smooth transition from one speech sound to the next) by targeting tempo (blending phonemes, pausing) and stress (weak strong forms). ARTICLE:

Geist, K., McCarthy, J., Rodgers-Smith, A., & Porter, J.  (2008). Integrating music therapy services and speech-language therapy services for children with severe communication impairments: A co-treatment model.  Journal of Instructional Psychology, 35  ARTICLE:  ABSTRACT:  The authors explained the rationale for co-treatment of communication disorders by music therapists (MT) and speech-language pathologists (SLP) and described the strategy using a single case. The dependent measure was classroom engagement.

Gilbert, J. (2008).  Teaching pronunciation using the prosody pyramid. New York: Cambridge University Press      This booklet highlights the Prosody Pyramid and its associated treatment procedures which are presented in Gilbert’s book Clear Speech (2005). Prosody Pyramid procedures were designed for second language learners; nevertheless, they have potential to guide SLPs in treating adolescents and adults with prosodic problems and, perhaps, those with intelligibility issues. Data were not provided to support the procedures.

Gilsenan, E. (2011). What are the effects of music therapy on the communication of children diagnosed with autism.  University of Western Ontario.      This critical review critiques and summarizes nine research articles concerned with the use of music therapy to improve the communication skills of children with autism. It is difficult to generalize the findings because of the diversity of procedures, dosages, and participants.  Nevertheless, as the result of music therapy children of varying ages and varying degrees of severity of autism improved on some communication variables including turn taking, joint attention, vocalization, verbal expression, producing phrases, performance on testing instruments, singing songs, initiation, imitation, interacting, pointing, academic achievement, and attention.  Only did not respond positively to music therapy in a least one of the sources. The author of the critical review provided several recommendations including (1) consider using music therapy to facilitate verbal communication in nonverbal children, (2) low functioning children may benefit from a combination of speech therapy and music therapy, (3) child directed procedures appear to be facilitative, (4) children with echolalia may benefit from music therapy to facilitate communication development. In addition, clinicians should consider pairing tactile  (e.g., bells or drums) and visual (i.e., pictures/object representing targeted words) when using music to teach vocabulary.

Goldfarb, R. (2015). Modifying Melodic Intonation Therapy. Journal of Communication Disorders, Deafness & Hearing Aids, 3 (2). ARTICLE:   This article is expert opinion; there was no attempt to provide original data. The author thoughtfully described problems he noted in a previously published case study involving the administration of Melodic Intonation Therapy (MIT) by a spouse and provided potential solutions for the problems.  REVIEW:

Groß, W., Linder, U., & Ostermann, T. (2010).   Effects of music therapy in the treatment of children with delayed speech development—Results of a pilot study.  BMC Complementary and Alternative Medicine, 10, 39.  Retrieved 11.10 from This investigation provides limited support for the use of Music Therapy in conjunction with speech-language therapy to improve selected communication and cognitive outcomes. REVIEW:

Grossman, R. B., Bemis, R. H., Skwerer, D. P., & Tager-Flusberg, H. (2010.) Lexical and affective prosody in children with high-functioning autism. Journal of Speech, Language, and Hearing Research, 53, 778- 793. This investigation of lexical and affective prosody in children and adolescents with high functioning autism (HFA) comprises 3 experiments: perception of affective prosody, perception of lexical prosody, and production of lexical prosody. The results indicate that children and adolescents with HFA are similar to TD peers with respect to their perception of affective prosody and lexical stress as well in their ability to mark correctly the stressed syllable in compound words (e.g., greenhouse) and noun phrases (green house.) However, the Ps with HFA differed from their TD peers with respect to how they marked the stressed syllable. Specially, the productions of Ps with HFA were of longer duration which was perceived be slower, more labored, containing longer pauses than TD peers.

Grossman, R. B., Edelson, L. R., & Tager-Flusberg, H. (2013). Emotional facial and vocal expressions during story retelling by children and adolescents with high-functioning autism. Journal of Speech, Language, and Hearing Research, 56, 1035-1044. This preliminary investigation is concerned with prosodic and facial affect associated with autism spectrum disorders (ASD); it is not an intervention or assessment investigation. The accuracy of participants (Ps) with HFA and their typically developing (TD) peers in representing emotion using facial gestures was similar. However, Ps with HFA are more accurate than TD peers when using prosody to express emotion. The investigators suggested that because TD peers’ prosody was rated as being closer to neutral expressively, they may have been more difficult to interpret. There was positive correlation between judges’ perception of Ps with HFA facial and prosodic awkwardness with their social communication skills on the Autism Diagnostic Observation Scale (ADOS.) The results cannot be used to describe behavior of females with HFA because there were no females with HFA in the sample.

Grube, M. M., & Smith, D. S. (1989).  Paralinguistic intonation-rhythm intervention with a developmental stutterer.  Journal of Fluency Disorders, 14, 185-208. This clearly written case study provides strong documentation about the administration of prosody-based intervention to reduce the stuttering of a 5 year-old boy. The design of the study prevented the investigators from claiming that the treatment was effective but the child evidenced marked improvement during and following intervention.

Grube, M. M., Spiegel, B. B., Buchhop, B. A., & Lloyd, K. L. (1986).  Intonation training as a facilitator of intelligibility. Human Communication Canada, 10  (5), 17-24.      These case studies lend moderate support for the contention that intonation intervention can result in improved intonation and intelligibility as well as the reduced use of a target phonological process (omission of postvocalic obstruents). The investigators compared the outcomes of a phonological process approach and an intonation approach. Although the results indicate that the intonation approach was more effective, this only should be considered weak evidence because these were case studies. In addition, the investigators’ definition of intelligibility was unique and the amount of progress in 20 weeks of overall intervention (40 sessions) was limited.

Habib, M., Lardy, C., Desiles, T., Commeiras, C., Chobert, J., & Besson, M. (2016.) Music and dyslexia: A new musical training method to improve reading and related disorders. Frontiers in Psychology, 7:26, doi: 10.3389/fpsyg.2016.00026    French children diagnosed with reading impairments responded positively to music based interventions in two experiments. Overall, the results indicated that intensive (Experiment 1) and Traditional (Experiment 2) dosages of Cognitive-Musical Training (CMT) yielded improvements in measures associated with categorical perception, literacy, perception of duration and pitch, auditory attention. The improvements tended to be maintained 6 weeks after the termination of the intervention.

Hanson, W. R., & Metter, E. J. (1983).  DAF speech rate modification in Parkinson’s disease:  A report of two cases.  In W. R. Berry (Ed.), Clinical dysarthria (pp. 231-251). San Diego:  College Hill Press.             These case studies provide promising support for the use of DAF, independent of therapy, to reduce rate, intensity, and intelligibility in speakers with Parkinson’s disease (PD).  The evidence from these case studies supports DAF’s use as a compensatory device.

Harding, C., & Ballard, K.D. (1982). The effectiveness of music as a stimulus and as a contingent reward in prompting the spontaneous speech of three physically handicapped preschoolers. Journal of Music Therapy, 19, 86-101.      These 3 single subject experimental design investigations provide moderate support for the use of music as a stimulus and as a contingent reward for improving responses to questions, spontaneous verbalizations during story telling, and the number of utterances during a story retelling task.

Hargrove, P. M., Dauer, K. E., & Montelibano, M. (1989a). Reducing vowel and final consonant prolongations in twin brothers. Child Language Teaching and Therapy, 5, 49-63.             These 2 case studies provide initial, limited support for procedures for reducing the prolongation of vowels and consonants in preschool children. The authors make the case that the prolongations were prosodic rather than segmental in nature.

Hargrove, P. M., Roetzel, K., & Hoodin, R. B. (1989).  Modifying the prosody of a language-impaired child.  Language, Speech, and Hearing Services in Schools, 20, 245-258. This case study provides limited evidence that stress patterns can be modified in the speech of a language-impaired child using an elicitation task.

Hartelius, L., Wising, C., & Nord, L.  (1997). Speech modification in dysarthria associated with Multiple Sclerosis: An intervention based on vocal efficiency, contrastive stress, and verbal repair strategies. Journal of Medical Speech-Language Pathology, 5, 113-140.             The investigators present a case series design to support the effectiveness of an intervention to improve contrastive stress, voice quality (pitch and loudness), articulatory precision, and naturalness for P’s with MS.

Heikkinen, J., Jansson-Verkasalo, E., Toivanen, J., Kalervo, S., Väyrynen, E., Moilanen, I., & Seppänen, T. (2010). Perceptions of basic emotions from speech prosody in adolescents with Asperger’s syndrome. Logopedics Phonatrics Vocology, 35, 113-120. Finnish adolescents diagnosed with AS performed similarly to TYP peers on a task requiring them to discriminate which prosody signals basic emotion in a read passage.

Helfrich-Miller, K. R. (1984). Melodic Intonation Therapy with developmentally apraxic children. Seminars in Speech and Language, 5, 119-126.

To support this program description of an adaptation of Melodic Intonation Therapy (MIT) to Childhood Apraxia of Speech (CAS) the investigator included 3 brief summaries of previously presented cases. The cases indicate that MIT results in change in articulation measures and one measure of duration and, to a lesser degree, listener perception.

Helfrich-Miller, K. R. (1994). A clinical perspective: Melodic intonation therapy for developmental apraxia. Clinics in Communication Disorders, 4, 175-182.       The investigator provided a clear description of modified melodic intonation therapy (MIT) procedures for the treatment of childhood apraxia of speech (CAS). The illustrative case studies provide initial (limited) support for the use of MIT in conjunction with other speech therapies.

Helm, N. (1979). Management of palilalia with a pacing board.  Journal of Speech and Hearing Disorders, 44, 350-353.      This brief report provides limited evidence for the use of a pacing board to reduce palilalia. Despite the limited evidence, the procedure shows promise.

Herd, C. .P, Tomlinson, C. L., Deane, K. HO., Brady, M. C., Smith, C. H., Sackley, C., Clarke, C. E. (2012) Speech and language therapy versus placebo or no intervention for speech problems in Parkinson’s disease. Cochrane Database of Systematic Reviews, 2001, Issue 2. Art. No.: CD002812. DOI: 10.1002/14651858.CD002812. Update 2012.   This well-executed SR is a revision/update of a previously published SR. The authors of the SR identified 3 new investigations that met their narrow criteria and described the overall methodological quality of the 3 investigations as “poor.” The authors provided thorough analyses of the investigations and clearly justified their ratings. However, considering the scope of intervention research in Communication Sciences and Disorders, a speech-language pathologist (SLP) might be more generous with respect to grading of the 3 new investigations described in this SR. Each of the 3 interventions resulted in improvement in one or more of the following outcomes: loudness, monotonicity, pitch, and ratings of speech impairment. In addition, one of the interventions explored maintenance and determined that progress was maintained.

Hester, E. J., Rasmussen, H., & Warner, D.  (1997, November).  Efficacy of a prosodic approach in the treatment of cluttering. Paper presented at the annual convention of the American Speech-Language Hearing Association (Boston).      This case study is summarized in a handout from an ASHA convention;  therefore, only limited information is available. Nevertheless, the results suggest that speaking rate and intelligibility can improve in a speaker with the diagnosis of stuttering following a prosodic intervention using visual feedback (Visi Pitch).          

Holck, U. (2004). Turn-taking in music therapy with children with communication disorders. British Journal of Music Therapy, 2, 45-53.  In this case study, the investigator provides a thoughtful guide for using music to facilitate turn taking with a Danish speaking child who did not show interest in interactions and did not signal communicative intent.

Hoque, M. E. (2008). Analysis of speech properties of neurotypicals and individuals diagnosed with autism and Down syndrome. Proceedings of the 10th International ACM SIGACCESS Conference on Computers and Accessibility (Assets ’08). ACM, New York, NY, USA, 311-312. ARTICLE: DOI=      Neurotypical (NT) participants (Ps) exhibited longer speaking turns than peers with Autism Spectrum Disorders (ASD) and Down syndrome (DS) and they were most likely to produce pause features that corresponded to typical pause strategies. DS Ps produced speech with higher energy values than DS or NT peers. In addition, ASD (but not DS Ps) and NT Ps produced the same number of rising and falling edges in conversation. Finally, both the ASD and DS Ps differed from the NT peers in their execution of rising and falling edges with NT Ps producing higher maximum. Interestingly, the DS Ps productions of edges also were higher than the ASD Ps. REVIEW:

Hoque, M. E., Lane, el Kaliouby, R., Goodwin, M., & Picard, R. W. (September, 2009).  Exploring speech therapy games with children on the autism spectrum. Paper presented at the 10th  Annual Conference of the International Speech Communication Association, Brighton UK. Retrieved from DSpace@MIT:             This preliminary report provides limited support for a promising approach for modifiying the prosody of children with ASD using computer presented acoustic feedback in a game format.

Horley, K., Reid, A., & Burnham, D. (2010). Emotional prosody perception in Dementia of the Alzheimer’s Type. Journal of Speech, Language, and Hearing Research, 53, 1132-1146. Speakers with moderate Dementia of the Alzheimer’s Type (DAT) when compared to typically aging (TA) participants (Ps) produced similar average fundamental frequencies (F0) for affective prosody tasks. TA Ps, however, produced significantly more pitch variation (i.e., F0 standard deviations) than did their DAT peers. For rate, the DAT and TA Ps did not differ during a modeling task but Ps with DAT produced significantly slower sentences during a reading task. The ordering of difficultly of producing the targeted emotions was similar for the DAT and TA groups. With respect to perception, Ps with DAT consistently underperformed compared to TA peers.


Hoskins, C. (1988). Use of music to increase verbal response and improve expressive language abilities of preschool language delayed children. Journal of Music Therapy, 25 (2), 73-84.  The results of this small group investigation suggest that a music-based intervention to improve expressive language in preschool children was successful in improving receptive vocabulary scores.


Jalled, F., Skik, H., & Mrabet, A. (2000). Arabic melodic and rhythmic therapy: A method of severe aphasia therapy. Neurosciences, 5 (2), 91- 93.   In a Narrative Review, the authors describe a Tunisian Arabic adaptation (AMRT) of Melodic and Rhythmic Therapy (MRT) which is a French adaptation of Melodic Intonation Therapy (MIT). The authors provided the linguistic basis of the modifications, procedures for the AMRT, and a summary of some research supporting AMRT.

Johnson, J. A., & Pring, T. R. (1990). Speech therapy and Parkinson’s disease: A review and further data. British Journal of Disorders of Communication, 25, 183-194.      This investigation provides moderate support for the use of Robertson and Thomson’s (1986) approach for treating dysarthria associated with Parkinson’s disease in English Ps. Loudness and pitch outcomes were measured in a variety of linguistic contexts.

Jones, H. N., Plowman-Prine, E. K., Rosenbek, J. C., Shrivastay, R., & Wu, S. S.  (2009).  Fundamental frequency and intensity mean and variability before and after two behavioral treatments for aprosodia.  Journal of Medical Speech-Language Pathology, 17 (1), 45-52.             These 3 single subject experimental designs provides acoustic evidence supporting change in emotional prosody using either of Rosenbek’s 6 step continuum programs:  Imitative or Cognitive-Linguistic.  This investigator is one of numerous investigations supporting the effectiveness of the programs.

Joyal, M., Bonneau, A., & Frecteau. S. (2016.) Speech and language therapies to improve pragmatics and discourse skills in patients with schizophrenia. Psychiatry Research, 240, 88-95. This Systematic Review (SR) investigated the effectiveness of speech and language therapy with patients (Ps) with schizophrenia. Only 3 of the sources reviewed in the SR were concerned with prosody. In 2 of the 3 sources, Ps with schizophrenia did not exhibit progress in prosodic therapy. The results were not clear in the third source. Therefore, current evidence does not support the treatment of prosody in Ps with schizophrenia. It should be noted that the therapies were not administered by speech-language pathologists.

Kargas, N., López, B., Morris, P., & Reddy, V. (2016). Relations among detection of syllable stress, speech abnormalities, and communicative ability in adults with autism spectrum disorders. Journal of Speech, Language, and Hearing Research, 59, 206-215. The investigators compared adults diagnosed with autism spectrum disorders to typical peers on a task tapping the perception of syllable stress (primary speech perception). The results revealed that adults with ASD have significantly lower scores on the Syllable Stress Perception Task compared to TD peers, although perception varied markedly within the ASD group. Also, within the ASD group, poor stress perception was associated with increased speech production (i.e., stress, intonation, rate) problems but not communication/language problems.

Keith, R. L., & Aronson, A. E. (1975). Singing as therapy for apraxia of speech and aphasia: Report of a case. Brain and Language, 2, 483-488. This case study is reviewed to focus attention on the history of music in speech-language pathology. The authors provided some references to the historical use of singing with people with aphasia. They also described a case in which a woman with aphasia and apraxia profited from the addition of singing into her therapy programming when traditional therapy had failed. Evidence of progress took the form of performance on the Profile of Communicative Ability (PICA) and summaries of clinical notes.


Kerem, D. (2009). The effect of music therapy on spontaneous communicative interactions of young children with cochlear implants (Unpublished doctoral dissertation). Aalborg University, Denmark.  DISSERTATION downloaded from:דוקטורט-של-דקלה-כרם.pdf   REVIEW:   Young Hebrew speaking children with cochlear implants (CI) produced significantly more early communicative behaviors (turn taking, imitation, initiation, synchronization) in music therapy as opposed to play sessions.

Khetrapal, N. (2009). Why does music therapy help in autism? Empirical Musicology Review, 4 (1), 11-18.   Article downloaded from :  This expository article logically supports the use of music therapy using a narrative review of the literature. The author presents research indicating that while people with ASD may experience difficulty interpreting emotional prosody, their (musical) tonal pitch tends to be intact and suggests that MT interventions may use this intact skill to improve emotional prosody comprehension. No specific procedures were recommended but the author encouraged additional research.

Kilcoyne, S.C., Carrington, H., Walker-Smith, K., Morris, H., & Condon, A. (2014). Perspectives on Speech Science and Oral Facial Disorders, 24, 59-66. doi:10.1044/ssod24.2.59  Article: Downloaded From:   This brief description of preliminary data supports the use of a parent-based intervention that integrates speech and music therapy to improve the speech sound production of Australian children with cleft palate and velopharyngeal insufficiency (VPI). The results in this paper report positive parental perceptions about implementation and the resources’ quality.  Review:

Kjelgaard, M. M., & Tager-Flusberg, H. (2013). The perception of the relationship between affective prosody and the emotional content in utterances in children with autism spectrum disorders. Perspectives on Language Learning and Education, 20, 20-32. doi:10.1044/lle20.1.20     Although children with ASD can attend to emotional prosody in comprehension task, they do experience difficulty in (1) identifying the emotional state using prosody alone and (2) delinking prosody and semantic content in identifying emotional status.

Kobayashi, N., Hirose, H., Horiguchi, S., & Mori, H. (2004). Changes in prosodic characteristics after speech therapy for patients with motor speech disorders. 2004 SproSIG Conference Proceedings in Nara Japan. Retrieved from This investigation is an initial exploration comparing two interventions for Japanese speakers with dysarthria resulting from different etiologies. The sessions were very brief (5 minutes each) and therefore, the applicability of the findings is minimal. Fo range and perceptual measures of both Ps improved following both of the interventions.

Kollman, P. A. (1991). Modifying the prosody of a child with impaired phonology. (Unpublished Master’s Thesis). Kansas State University, Manhattan, Kansas.      This replication of Hargrove et al. (1989) supports and extends the findings of the original research. The multiple baseline single subject experimental design study determined that the procedure was successful in improving the use of contrastive stress on words in the subject and object position of sentences, although acquisition of stress on verbs was less successful. These findings were similar to the original study. The investigator also presented data indicating positive results for generalization (speaker, lexical items, location, intelligibility, phonological errors) and follow-up sessions.

Kouri, T. A., & Winn, J. (2006). Lexical learning in sung and spoken story script contexts. Child Language Teaching and Therapy, 22, 293-313.     This brief (2 session) intervention provides moderate support for the use of sung scripts for increasing the number of spontaneous verbalizations by  preschool children with developmental delay and/or language delay.

Krauss, T., & Galloway, H. (1982). Melodic Intonation Therapy with language delayed apraxic children. Journal of Music Therapy, 19, 102-113.      These 2 case studies provide limited support for using Melodic Intonation Therapy (MIT) as a warm-up prior to traditional therapy session for children who have been diagnosed with delayed expressive language and childhood apraxia of speech. The nature of the design limits the grade; however, the investigation is clearly presented and the investigators provided helpful insights about MIT with children. One intriguing factor is that the changes in communication skills (with the exceptions of intelligibility issue) of children parallel changes for adults.

Kuschke, S., Vinck, B. & Geertsema, S. (2016.) A combined prosodic and linguistic treatment approach for language-communication skills in children with autism spectrum disorders: A proof-of-concept study. South African Journal of Childhood Education, 6(1), a290. http://dx.doi. org/10.4102/sajce.v6i1.290  This preliminary investigation into the effectiveness of a linguistic-prosodic intervention with South African children diagnosed with autism spectrum disorders (ADS) revealed that a short dose of therapy was associated with improvement in listening, pragmatic, and social interaction outcomes.

Lacava, P., Golan, O., Baron-Cohen, S., & Myles, B. S. (2007). Using assistive technology to teach emotion recognition to students with Asperger syndrome: A pilot study. Remedial and Special Education, 28, 174-181. This pilot investigation compared the pre- and post-tests scores of a single group of children with Asperger syndrome (AS.) The investigators determined that a self-administered computer based program (Mind Reading software) has potential for improving the recognition of prosodic affect.

Lacava, P. G., Rankin, A., Mahlios, E., Cook, K., & Simpson, R. L. (2010). A single case design evaluation of a software and tutor intervention addressing emotion recognition and social interaction in four boys with ASD. Autism, 14 (3), 161- 178.  Four single subject experimental design investigations revealed that a computer based intervention administered by a “tutor” was associated with moderate improvements on formal tests of prosodic and facial affect recognition. However, there only was limited support for generalization to social interaction with peers of the participants with Autism Spectrum Disorder (ASD.)

Le Dorze, G., Dionne, L. Ryalls, J., Julien, M., & Ouellet, L. (1992). The effects of speech and language therapy for a case of dysarthria associated with Parkinson’s disease. European Journal of Disorders of Communication, 27, 313-324.             The investigators present a single-subject experimental design investigation with moderately strong support for a promising intervention (involving auditory and visual feedback) to modify terminal contours, mean fo, duration, intelligibility, and respiration in a speaker with Parkinson’s disease (PD).

Lee, L. L. (2008). Music enhances attention and promotes language ability in young special needs children. In L. E. Schraer-Joiner & K. A. McCord (Eds.), Selected Papers from the International Seminars of the Commission on Music in Special Education, Music Therapy, and Music Medicine (pp. 34- 45). Malvern, Victoria, Australia. Malvern, Victoria, Australia: International Society for Music Education. Retrieved from     This multiple baseline investigation demonstrates the effectiveness music therapy in improving attention and language in developmentally delayed children from Taiwan who were speakers of Mandarin Chinese. The investigator provided a clear description of the phases of treatment.

Lee, E-K, & Son, Y-I. (2005). Muscle tension dysphonia in children: Voice characteristics and outcome of voice therapy. International Journal of Pediatric Otorhinolaryngology, 69, 911-917. doi: 10.1016/j.ijporl.2005.01.030  Korean speaking boys with muscle tension dysphonia (MTD) received an intervention focusing on awareness, relaxation, breathing, phonation, and homework. The results of this retrospective, descriptive, single group investigation revealed progress in voice quality, pitch, and the reduction of hypercontraction.


Lenden, J. M., & Flipsen Jr., P. (2007). Prosody and voice characteristics of children with cochlear implants. Journal of Communication Disorders, 40, 66-81.  Children with cochlear implants (CI) did not display problems with phrasing and pitch typically noted in children with hearing impairment (HI). However, resonance and stress continued to be problematic for most children with HI and did not improve with age.

Leon, S. A., & Rodriquez, A. D. (2008). Aprosodia and its treatments. Perspectives on Neurophysiology and Neurogenic Speech and Language Disorders, 18, 66-72.  doi:10.1044/nnsld18.2.66   The authors described upcoming research in which research are combining two expressive affective aprosodia approaches they have previously researched (i.e., Cognitive-Linguistic and Imitative approaches) with motor learning enhancement procedures.

Leon. S. A., Rosenbek, J. C., Crucian, G. P., Hieber, B., Holiway, B., Rodrigues, A. D., Ketterson, T. U., Ciampitti, M. Z., Freshwater, S., Heilman, K., & Gonzalez-Rothi, L. (2005). Active treatments for aprosodia secondary to right hemisphere stroke.  Journal of Rehabilitation Research and Development, 42 (1), 93-102.      This investigation provides support for two approaches to treating expressive aprosodia associated with right hemisphere stroke. Both approaches resulted in marked changes in the outcome measure. The Imitative approach was more likely to result in improvement for two of the Ps and the Cognitive-Linguistic approach was superior for the third P. This adds to the considerable body of literature that providing strong support for these two approaches in the treatment expressive aprosodia.

Lewis, D. (2015). Reading intervention using interactive metronome treatment. Masters Thesis & Specialists Project. Project 1541 Western Kentucky University, Bowling Green, KY. Thesis:   The results of these 3 single subject experimental design investigations indicate that Interactive Metronome training paired with traditional training does not result in improved reading fluency in children. REVIEW:


Lim, H. A. (2010).  Effect of developmental speech and language training through music” on speech production in children with autism spectrum disorders.  Journal of Music Therapy, 47 (1) 2-26.      Although this was a group study there were several design issues which limit claims of effectiveness including a very brief treatment dosage and unequal amount of time devoted to each of the interventions investigated. Nevertheless, there were large treatment effects for both interventions.

Lowit-Leuschel, A., & Docherty, G. J. (2001).  Prosodic variation across sampling tasks in normal and dysarthric speakers. Logopedics Phoniatrics Vocology, 26, 151-164.  Changes in 3 of 10 acoustic measures of prosody  (percentage of stressed vowels, Fo range, and Fo variation) in conversation compared to reading of typical peers were noted. However, speakers with dysarthria did not produce any significant changes any of the 10 measures. There were significant differences in the degree of change in performance in reading compared to conversation for the two groups (Dys and TP). Qualitative analysis of individual group performance revealed no patterns of performance for individual Ps within either group. Performance on a single measure was not predicted from other measures.

Magee, W. L., Brumfitt, S. M., Freeman, M., & Davidson, J. W. (2006).  The role of music therapy in an interdisciplinary approach to address functional communication in complex neuro-communication disorders:  A case report. Disability and Rehabilitation, 28, 1221-1229.  This case study indicates that music therapy used with an English P with a complex neurological background can improve several aspects of his prosody (pitch level, pitch range/variability, duration) and self-perception of well-being) but not  melodic contour (intonation).

Manor, Y., Posen, J., Amir, O., Dori, N., & Giladi, N. (2005). A group intervention model for speech and communication skills in patients With Parkinson’s Disease: Initial observations. Communication Disorders Quarterly, 26, 94 – 101.   DOI: 10.1177/1525740105026002080       This investigation was conducted with Israeli Ps with Parkinson’s disease. The investigators provided clear descriptions of the procedures in the prose which was supported by an explicit table. The results provide initial support for the intervention and reveal significant improvements in pitch range, turn taking, and self-perception of intelligibility.

Maas, E., & Farinella, K. A. (2012). Random versus blocked practice in treatment for childhood apraxia of speech. Language, Speech, and Hearing Services in Schools, 55, 561-578.  The focus of these single subject experimental design investigations was to determine if there was an advantage for blocked versus random practice for children with childhood apraxia of speech (CAS). The investigation is relevant to this blog because the intervention involved the manipulation of rate. The investigators included a thorough description of the participants (Ps), intervention, and scoring of P responses to treatment conventions. The intervention was judged to be effective for 3 of the 4 Ps but the results regarding the practice schedule were equivocal.

Marshall, N., & Holtzapple, P. C. (1978). Melodic Intonation Therapy: Variations on a theme. In R. Brookshire (Ed.), Clinical aphasiology collected proceedings 1972-1976 (pp. 285-308.) Minneapolis: BRK Publications. These illustrative case studies described modifications (M-Modification) of Melodic Intonation Therapy (MIT) that may be used when patients (Ps) do not response to traditional MIT. The P who received traditional MIT did not evidence improvement on Porch Index of Communicative Abilities (PICA) scores from pre to post intervention; however, he did produce noticeable improvement on PICA modality scores and on cell scores as well as improvement on PICA scores 3 and 6 months post intervention. The other 3 Ps, who were administered M-Modification, displayed varying degrees of success.

Martens, H., Van Nuffelen, G., Dekens, T., Hernández-Díaz Huicia, M., Arturo Kairuz Hernández-Díaz, M., De Letter, M., &, De Bodt, M. (2015). The effect of intensive speech rate and intonation therapy of intelligibility of Parkinson’s disease. Journal of Communication Disorders, 58, 91 -105.   Eleven Dutch speakers diagnosed with hypokinetic dysarthria due to Parkinson’s disease received an intensive course of speech therapy focusing on rate and intonation to improve intelligibility. Intelligibility improved significantly with a large effect size. Several other measures also improved including measures associated with the perception of intonation representingquestions or statements, the frequency of pauses, and maximum fundamental frequency of the last syllable (Fo-max last syllable) of questions in reading and repetition tasks.

Matsuda, S., & Yamamoto, J. (2013). Intervention for increasing comprehension of affective prosody in children with autism spectrum disorders. Research in Autism Spectrum Disorders, 7, 938-946.  Four single-subject experimental design studies explored the effectiveness of a cross-modal matching to sample intervention designed to improve the comprehension of affective prosody of Japanese children diagnosed with autism spectrum disorders. The children improved their rate of correct responses to an adult’s direction to indicate which picture represented a targeted emotion produced using a single word.

McCann, J., & Peppé, S. (2003). Prosody in autism spectrum disorders: A critical review. International Journal of Language and Communication Disorders, 38, 325-350.

• The authors were not able to identify a single prosodic disorder or patterns of disordered prosody in their critical review of the research concerned with ADS.

• In fact, there was considerable variability, or even conflict, among the existing research.

• The authors suggested that this could be due, at least in part, to methodological differences.

• The authors reviewed research concerned with expressive and receptive prosodic function (stress, phrasing/chunking, affect) and form (intonation patterns), prosodic change, neurological processing of prosody, and echolalia.

McDonald, S. , Togher, L., Tate, R., Randall, R., English, T., & Gowland, A (2012). A randomised controlled trial evaluating a brief intervention for deficits in recognising emotional prosody following severe ABI. Neuropsychological Rehabilitation: An International Journal DOI:10.1080/09602011.2012.751340 The support for the effectiveness of this promising program to treat comprehension of affective prosody problems in speakers with non-progressive brain injury (traumatic brain injury, cerebral vascular accident, medical injury) is fair to weak. The limited effectiveness of the program may have been associated with the small number of patients and the small dosage. This is the first investigation that I have found that provides empirical research to support the effectiveness of treating the comprehension of affective prosody.  


McMicken, B. L., Ostergren, J. A., & Vento-Wilson, M. (2011). Therapeutic intervention in a case of ataxic dysarthria associated with a history of amateur boxing. Communication Disorders Quarterly, 33, 55-64. doi: 10.1177/1525740110397829  This case study describes an intervention combining Lee Silverman Voice Treatment (LSVT) and the Ryan Fluency Program (RFP) for the treatment of speech associated with ataxic dysarthria in a patient (P) with a history of boxing. The results suggest the combined intervention was moderately successful in improving perception of severity and intelligibility as well as diadokokenesis skills. However, the patient’s self-perception of his communication skills decreased markedly

Michel, D. E., & May, N. H. (1974). The development of music therapy: Procedures with speech and language disorders. Journal of Music Therapy, 11, 74-80. This Narrative (or Traditional) review of the literature contains contains reviews of several investigations involving children with a variety of clinical conditions. Overall, the results of these investigations suggest that the inclusion of music/singing in intervention directed toward the development of language, production of speech sounds, intonation, rhythm, attention, discrimination, and/or coordination can be associated with improvement.

Miller, S. B., & Toca, J. M. (1979). Adapted Melodic Intonation Therapy: A case study of an experimental language program for an autistic child. Journal of Clinical Psychiatry, 40, 201-203. This case study provides limited support for the use of an adapted form of Melodic Intonation Therapy (including signing) in establishing meaningful speech in a preschooler with autism.

Minskoff, E. H. (1980a). Teaching approach for developing nonverbal communication skills in students with social perceptual skills. Part I. The basic approaches and body language clues. Journal of Learning Disabilities, 13, 118-124. and Minskoff, E. H. (1980b). Teaching approach for developing nonverbal communication skills in students with social perceptual skills. Part II. Proxemic, vocalic, and artifactual cues. Journal of Learning Disabilities, 13, 203-208.      This description of a logical strategy for introducing prosody to school-aged children is intriguing. It is clearly written and logically ordered. However, it awaits verification.

Mira, W. A., & Schwanenflugel, P. J. (2013). The impact of reading expressiveness on listening comprehension of storybooks by prekintergarten children. Language, Speech, and Hearing Services in Schools, 44, 183- 194.   This is not an intervention study; rather it is a comparison of the effectiveness of expressive reading on the comprehension of storybooks. The investigators demonstrated a moderate improvement in reading comprehension as assessed using a cued recall, but not a free recall task, following expressive storybook reading.

Mitchell, E., Rearden, K. T., & Stacy, D. (2011).  Comedy hour: Using audio files of joke recitations to improve elementary students’ fluency.  Current Issues in Education, 14 (2). . Retrieved 3.09.2013 from Because the evidence was derived from a case study and the prosodic measures were vaguely described, the overall evidence for this approach to modifying the prosody of children whose reading was not grade appropriate is not impressive.  Nevertheless, the intervention appears to be promising not only to the population described in this investigation but also to children with prosodic problems.

Morra, J., & Tracey, D. H. (2006). The impact of multiple fluency interventions on a single subject.  Reading Horizons Journal, 47, 175- 198.  This single subject study describes an approach to improving oral reading fluency as measured by the number of words read correctly in a minute that has potential for improving phrasing and rate in connected speech. Although the investigators described the intervention adequately, I had difficulty understanding supporting evidence, dosage information, and some of the terminology.

Murray, E., McCabe, P., & Ballard, K. J. (2014). A systematic review of treatment outcomes for children with childhood apraxia of speech. American Journal of Speech-Language Pathology, 23, 486-504. This SR is concerned with a variety of treatment outcomes. Only those outcomes or treatments concerned with prosody will be analyzed and summarized in this review. The SR reviewers recommended two prosody-related interventions.


Murray, E., McCabe, P., & Ballard, K. J. (2015.) A randomized controlled trial for children with Childhood Apraxia of Speech comparing Rapid Syllable Transition Treatment and the Nuffield Dyspraxia Programme-Third Edition. Journal of Speech, Language, and Hearing Research, 58, 669-686. Two treatments (Rapid Syllable Transition Treatment, ReST, and the Nunffield Dyspraxia Programme-Third Edition, NDP3) for Childhood Apraxia of Speech (CAS) resulted in significant improvements in articulation and prosody outcomes immediately following the termination of treatment and at 1 month and 4 month follow-ups. Moreover, gains generalized to untreated stimuli.


Nadig, A., & Shaw, H. (2011). Acoustic and perceptual measurement of expressive prosody in High-Functioning Autism: Increased pitch range and what it means to listeners. Journal of Autism and Developmental Disorders, 42, 499-511.  Findings support the contention that Ps with High Functioning Autism (HFA) produced larger than typical pitch ranges in speech of Ps with although group data revealed that listeners did not perceive the pitch variability of speakers with HFA and their typically developing peers to be significantly different. Other measures (mean pitch and rate) were not significantly different in HFA children/adolescents and their typically developing peers (TYP.) Although there were moderate correlations between perceptual and acoustic measures of mean pitch and speaking rate, the correlation between the acoustic and perceptual measure of pitch change/variability was not significant.


Norton, A., Zipse, L., Marchina, S., & Schlaug, G. (2009). Melodic Intonation Therapy: Shared insights on how it is done and why it might help. Annals of the New York Academy of Sciences, 1169, 431-436.  ARTICLE: doi: 10.1111/j.1749-6632.2009.04859.x  REVIEW:     The authors describe, but present no supporting evidence for, an alternative version to Melodic Intonation Therapy (MIT) for patients (Ps) with nonfluent aphasia. SLPs may find the augmentations (Inner Rehearsal and Auditory Motor Feedback Training) to be helpful additions to standard MIT.

O’Halpin, R. (2001). Intonation issues in the speech of hearing impaired children: Analysis, transcription, and remediation. Clinical Linguistics & Phonetics, 15, 529-550. Overall, the case information provides initial support for an adaptation of King and Parker’s intervention program using visual feedback. Following the adapted intervention, the production of SVO sentences of an 8-year-old with impaired hearing more closely resembled a typical peer with respect to pitch patterns associated with contrastive stress.

Ouellette, J. (2015.) The effect of a Rhythmic Speech Cuing protocol on speech intelligibility in Parkinson’s disease. Unpublished Theses presented to the University of Miami, Miami (FL.) Open Access Thesis. Paper 585. ARTICLE: Problems with recruitment resulted in selection of several Ps with Parkinson’s disease (PD) who did not benefit from procedure. Therefore, the results will be described in 2 ways: Group comparison and Description of 1 participant with severe dysarthria. The results suggest that Rhythmic Speech Cuing (RSC) can be useful in improving intelligibility with Ps with severe dysarthria as the result of PD. REVIEW

Pack, A., Colozzo, P., Bernhardt, B. M., Radanov , B., Rosebush, R., Marinova-Todd, S. H. (2015). A case study on vocal loudness with a young adult with Autism Spectrum Disorder and developmental delay. American Journal of Speech-Language Pathology, 24, 587-593. In this case study, the participant who was diagnosed with autism spectrum disorder and developmental delay improved his rate of the production of acceptable loudness levels during treatment sessions in a generalization context.


Park, S., Theodoros, D., Finch, E., & Cardell, E. (2016). Be Clear: A new intensive speech treatment for adults with nonprogressive dysarthria. American Journal of Speech-Language Pathology, 25, 97-110. This preliminary investigation determined the feasibility of using Clear Speech as a treatment for adults with nonprogressive dysarthria. The results indicated that there was statistical or clinical improvement in 8 participants’ (Ps) intelligibility and some improvements in perceived (by P or by a communicative partner) communication status. It should be noted that statistical and clinical interpretations did not always agree. In addition, there was a decrease in speaking rate for the Ps. 

Penner, H., Miller, N, Hertrich, I., Ackermann, H., & Schumms, F. (2001). Dysprosody in Parkinson’s disease: An investigation of intonation patterns. Clinical Linguistics and Phonetics, 15, 551-566.   Compared to typical adults (TA), German speakers with PD tended to

  1. produce reduced Fo at the peak of the intonation contour and
  2. locate Fo peak on the targeted accented syllable more frequently. (This second factor is noted in the abstract but I could not find it in the results.)

Medication had variable effects on the Fo peaks of Ps with PD.

Pennington L, Miller N, & Robson S. (2009). Speech therapy for children with dysarthria acquired before three years of age. Cochrane Database of Systematic Reviews 2009, Issue 4. Art. No.: CD006937. DOI: 10.1002/14651858.CD006937.pub2  Because the search revealed no experimental or quasi-experimental studies, some of the components of a Systematic Review were not completed. The authors did review 10 observational sources that provided some level of evidence but only six were clearly concerned with prosody. The SR noted that treating certain aspects of prosody may result in improved intelligibility, certain aspects of voice quality, and articulation.

Pennington, L., Miller, N., Robson, S., & Steen, N. (2010). Intensive speech and language therapy for children with cerebral palsy: A systems approach. Developmental Medicine and Child  Neurology, 52, 337-344.      This investigation provides initial, limited support of the effectiveness of a systems approach to treating dysarthria in English adolescents with cerebral palsy. Selected aspects of prosody (loudness, rate, pause) were used for outcomes concerned with intelligibility and P perceptions of the effectiveness of the intervention. Follow-up testing indicated that improvements were maintained for at least 6 weeks. pennington-et-al-2010

Pennington, L., Roelant, E., Thompson, V., Robson, S., Steen, N., & Miller, N. (2013). Intensive dysarthria therapy for younger children with cerebral palsy. Developmental Medicine & Child Neurology. DOI: 10.1111/dmcn.12098  This 6-week, intensive intervention resulted in increased intelligibility and communicative interactions in young children with dysarthria associated with cerebral palsy. The improvements in intelligibility were maintained for up to 12 weeks following the termination of the intervention.

Pennington, L., Smallman, C., & Farrier, F. (2006). Intensive dysarthria therapy for older children with cerebral palsy:  Findings from six cases.  Child Language Teaching and Therapy, 22, 255-273.      These 6 case studies indicate that a systems approach to improving the speech of 10-18 year olds with cerebral palsy may have potential to improve intelligibility of single words but not connected speech. The investigators described the procedures in only general terms.

Persicke, A., Tarbox, J., Ranick, J., & St. Clair, M. (2013). Teaching children with autism to detect and respond to sarcasm. Research in Autism Spectrum Disorders, 7, 193-198.  This single subject experimental design investigation provides good support of an intervention teaching children with Autism Spectrum Disorders (ASD) to comprehend sarcasm.  

Ploog, B. O., Scharf, A., Nelson, D., & Brooks, P. J. (2013). Use of computer-assisted technologies (CAT) to enhance social, communicative, and language development in children with autism spectrum disorders. Journal of Autism and Developmental Disorders, 43, 301 – 322. Computer-assisted technologies (CAT) have potential to improve comprehension of prosodic affect and sarcasm/metaphors in children with autism spectrum disorders (ASD) but it is not clear that CAT is more effective than conventional interventions.

Poore, M. A., & Ferguson, S. H. (2008.) Methodological variables in choral reading. Clinical Linguistics & Phonetics, 22 (1), 13-24. The investigators explored prosody of typical adults in a variety of reading contexts (3 scripts and 3 reading conditions.) Compared to Solo reading, Choral reading resulted in smaller fundamental frequency (fo) variability, smaller amplitude variability, and smaller vowel duration variability. Track reading (i.e., in unison with prerecorded scripts) resulted in significantly more vowel errors, suggesting that Track reading might not be a feasible alternative to Choral reading. .


Puyuelo, M., & Rondal, J. A. (2005). Speech rehabilitation in 10 Spanish-speaking children with severe cerebral palsy: A 4-year longitudinal study. Developmental Neurorehabiliation (Pediatric Rehabilitation), 8 (2), 113-116.      This single group pre-post test study provides initial, limited support for a long-term intervention (total of 4 years) treatment of speech (i.e., respiration, voice/resonance, articulation, intelligibility) and prosody of preschoolers with cerebral palsy. The treatment was described in general terms only.

Radice-Neumann, D., Zupan, B., Tomita, M., & Willer, B. (2009). Training emotional processing in persons with brain injury. Journal of Head Trauma Rehabilitation, 24, 313-323.   The findings suggest that affective prosody needs to be directly treated.

Ramdoss, S., Machalicek, W., Rispoli, M., Mulloy, A. Russell Lang, R., & O’Reilly, M. (2012). Computer-based interventions to improve social and emotional skills in individuals with autism spectrum disorders: A systematic review. Developmental Neurorehabilitation , 15, 119-135.   The systematic review summarized and analyzed the literature pertaining to the use of computer-based interventions to treat social and emotional outcomes for children, adolescents, and adults with Autism Spectrum Disorders. All the direct treatments of recognition of prosodic emotion employed “Mind Reading” software. Gains were moderate to large. When prosody was used as part interventions designed to improve social skills, the gains were large.

Ramig, L. O., Bonitati, C. M., Lemke, J. H., & Horii, Y. (1994). Voice treatment for patients with Parkinson disease: Development of an approach and preliminary efficacy data. Journal of Medical Speech-Language Pathology, 2, 191-209.   This is one of the earlier investigations documenting the effectiveness of Lee Silverman Voice Treatment (LSVT). The investigators presented evidence that significant differences occurred in the following speech measures of individuals with Parkinson’s disease immediately following LSVT:

– maximum duration of sustained vowel phonation

– fundamental frequency (fo) variability

– speech-language pathologist (SLP) rating of loudness, voice monotony, and intelligibility

– self rating of increase in loudness

– spousal rating of intelligibility.

In addition, the investigators statistically analyzed follow-up data 6 and 12 months after the initial 4-week training course. They determined progress was maintained with and without additional intervention.


Ramig, L. O., Countryman, S., Thompson, L. L., & Horii, Y. (1995). Comparision of two forms of intensive speech treatment for Parkinson disease. Journal of Speech and Hearing Research, 38, 1232-1251.   This investigation is part of the body of literature providing strong support for Lee Silverman Voice Treatment (LSVT) to improve loudness of speakers with Parkinson’s disease. In this investigation, the investigators compared LSVT to respiration-based (R) therapy.  Both approaches yielded significant changes in loudness as well as other outcomes (i.e., rate (utterance duration), pause duration, duration, pitch variability, fo, initiation of conversation, monotonicity, hoarseness, intelligibility.


Ramig, L. O., Sapir, S., Countryman, A. A., O’Brien, C., Hoehn, M., & Thompson, L. L. (2001b). Intensive voice treatment for patients with Parkinson’s disease: A 2 year follow up. Journal of Neurological and Neurosurgical Psychiatry, 71, 493-498.

     The investigators compared outcomes from Lee Silverman Voice Treatment (LSVT) and respiratory therapy (RET) for speakers with Parkinson’s disease. LSVT outperformed RET on acoustic outcomes measuring loudness and intonation. The gains made using LSVT persisted for 2 years following treatment.

Ramig, L. O., Sapir, S., Fox, C., & Countryman, S. (2001). Changes in vocal loudness following intensive voice treatment (LSVT®) in individuals with Parkinson’s disease: A comparison with untreated patients and normal age-matched controls.  Movement Disorders, 16, 79-83.      Good evidence that Lee Silverman Voice Treatment (LSVT) results in increases in SPL for Ps with Parkinson’s disease (PD) that are sustained 6 months after intervention.


Raymer, A. M., Bandy, D., Adair, J. C., Schwartz, R. L., David J.G. Williamson, D. J. G., Gonzalez Rothi, L. J. ,& Heilman, K. M. (2001). Effects of Bromocriptine in a patient with crossed nonfluent aphasia: A case report. Archives of Physical Medicine and Rehabilitation, 82, 139 -144.

This investigation involved the administration of Bromocriptine to a patient (P) with crossed nonfluent aphasia using a single-subject experimental design. The P’s number of words per minute and number of named words beginning with a specific letter improved markedly but there were no changes in the percentage of correct production of targeted affective prosody.


Rinta, T., & Welch, G. F. (2008). Should singing activities be included in speech and voice therapy for prepubertal children. Journal of Voice, 22, 100- 112.  The authors summarized evidence from previous research that supports the use of singing in speech and voice therapy with children.  This was not a comprehensive review as the authors only reviewed sources supporting their arguments. However, the authors did make a logical argument that was supported by the evidence.

Robin, D. A., Klouda, G. V., & Hug, L. N. (1991). Neurogenic disorders of prosody. In D. Vogel & M. P. Cannito (Eds.), Treating disordered speech motor control: For clinicians by clinicians (pp. 241-271). Austin, TX: ProEd.   The authors provide thoughtful treatment recommendations for receptive and expressive goals associated with linguistic and affective prosody. The recommendations are accompanied by 3 illustrative case studies in which real and/or potential treatment plans are presented.

Rodriguez, A. D., Patel, S., Bashiti, N., Shrivastav, R., & Rosenbek, J. (2011, May June).
The effect of incorporating knowledge of performance in the treatment of aprosodia. Paper presented at the 41st Clinical Aphasiology Conference (Fort Lauderdale, FL).  PAPER:  This summary of a small single group investigation provides initial support for an intervention for aprosodia using cognitive-linguistic, imitative, and knowledge of performance (auditory and visual feedback) procedures.

Rogers, A., & Fleming, P. L. (1981). Rhythm and melody in speech therapy for the neurologically impaired. Music Therapy: The Journal of the American Association for Music Therapy, 1(1), 33-38.   This case illustration provides limited support for the use of an intervention using music (rhythm, melody/pitch) to improve speech in an adult with apraxia and aphasia following a cerebral vascular accident (CVA.)

Rosenbeck, J. C., Crucian, G. P., Leon, S. A., Hieber, B., Rodriguez, A. D., Holiway, B., Ketterson, T. U., Ciampetti, M., Heilman, K., & Gonzalez-Rothi, L. (2004). Novel treatments for expressive aprosodia: A phase I investigation of cognitive linguistic and imitative intervention. Journal of the International Neuropsychological Society, 10, 786-793.  The results of 3 single subject experimental design studies indicated that both the cognitive-linguistic and imitative intervention approaches were effective in improving the rate of correct productions of 3 affects/emotions: happy, sad, angry. The investigators provide thorough descriptions of both intervention procedures as well as the participant characteristics.

Rosenbek, J., Hansen, R., Baughman, C. H., & Lemme, M. (1974). Treatment of developmental apraxia of speech: A case study. Language, Speech, and Hearing Services in Schools, 5, 13-22      This case study provides limited evidence that an intervention program for childhood apraxia of speech that incorporated selected aspects of prosody (i.e., rate, stress) has potential for improving speech.

Rosenbek, J. C., Rodriguez, A. D., Hieber, B., Leon, S. A., Crucian, G. P., Ketterson, T. U., Ciampitti, M., Singletary, F., Heilman, K. M., & Gonzalez-Rothi, L. J. (2006). Effect of two treatments for aprosodia secondary to acquired brain injury. Journal of Rehabilitation Research and Development, 43, 379-390.      This investigation provided moderate to good support for the effectiveness of two interventions for aprosodia each of which involved a 6 step continuum.  Outcomes for presentation via imitative or cognitive linguistic techniques were similar. This investigation is one of several supporting the two approaches.

Russell, S., Laures-Gore, J., & Patel, R.  (2010).  Treating expressive aprosodia:  A case study.  Journal of Medical Speech-Language Pathology, 18 (4), 115-120. Limited support from a case study for this imitative 6 step approach in improving the production of contrastive stress.

Russo. N. M., E. Skoe, E., Trommer, B., Nicol, T., Zecker, S., Bradlow, N., Kraus, N. (2008). Deficient brainstem encoding of pitch in children with Autism Spectrum Disorders. Clinical Neurophysiology, 119, 1730-1731.  As a group, children with Autism Spectrum Disorders (ASD) encoded pitch less accurately and less robustly than typically developing peers. However, subgroup analysis of the ASD group revealed that a small group of children with ASD (i.e., ASD OUT) accounted for the poor pitch tracking performances. The ASD OUT group was labeled as having deficient pitch tracking skills and included 5 Ps (about 20% of the overall ASD group.)

Saban-Bezalel, R., & Mashal, N. (2015). The effects of intervention on the comprehension of irony and on hemispheric processing of irony in adults with ASD. Neuropsychologia,  The intervention improved the irony comprehension of Hebrew-speaking adults as measured by a reading task as well as response and accuracy time in a visual field task.    ARTICLE:  REVIEW:

 Samuelsson, C. (2010). Prosody intervention for children. In H. Roddam & J. Skeat (eds.) Embedding evidence-based practice in speech and language therapy: International examples (pp. 189-194). Chichester, UK: Wiley-Blackwell.      This very brief chapter consists of a description of a strategy for decision-making about prosodic intervention in a context of having little or no evidence supporting a particular approach. The author provided a brief presentation of a successful intervention program for a child who spoke Swedish.

Samuelsson, C. (2011). Prosody intervention: A single subject study of a Swedish boy with prosodic problems. Child Language Teaching and Therapy, 27 (1), 56-67.      The evidence supporting this investigation was a multiple baseline single subject experimental design good. This promising intervention prosodic intervention (in Swedish) with a child at the word and phrase level is good.


Samuelsson, C., Nettelbladt, U., & Löfqvist, A. (2005). On the relationship between prosody and pragmatic ability in Swedish children with language impairment. Child Language Teaching and Therapy, 21, 279-304.  In these case studies, neither participant (P) exhibited prosodic problems at the word or phrase level, but they experienced pervasive trouble at the discourse level. The following aspects of prosody were a challenge for one or both of the Ps: general intonation, intonation –terminal contour, stress, loudness, and monotony. The investigators suggest that in these Ps the prosodic problems noted by the analyzers/judges (i.e., researchers in logopedics and phoneticians) were secondary to pragmatic problems.

Samuelsson, C., Reuterskiöld, C., Nettelblatt, U., & Sahlén, B. (2011.) Production and perception of metrical patterns in Swedish children with language impairment. Logopedics Phonatrics Vocology, 36, 1-11.  Swedish children with SLI more frequently omitted unstressed syllable than TD peers.

  • There may be 3 subgroups of prosody among children with SLI:

– stronger perception/comprehension than production/imitation,

– stronger production/imitation than perception/comprehension, and

– equivalent production/imitation and perception/comprehension.


Saperston, B. (1973). The use of music In establishing communication with an autistic mentally retarded child. Journal of Music Therapy, 10, 184-188.  This descriptive case study, with limited data, describes a music therapy approach to initiating communication interactions. The intervention involves the clinician following the child’s lead and making music contingent on the child’s behaviors. The child established a link between the his actions and the music played by the music therapist and eventually established eye contact and beginning forms of interpersonal communication.

Sapir, S., Pawlas, A. A., Ramig, L.O., Seeley, E., Fox, C., & Corboy, J.  (2001). Effects of intensive phonatory-respiratory treatment (LSVT) on voice in two individuals with multiple sclerosis.  Journal of Medical Speech-Language Pathology, 9, 141-151.      This investigation provides fair support for use of LSVT to increase loudness of Ps with MS.  This combined with other research provides strong support for the use of LSVT for Ps with a variety of neurological conditions.   

Sapir, S., Ramig, L., Hoyt, P., Countryman, S., O’Brien, C., & Hoehn, M. (2002).  Speech loudness and quality 12 months after intensive voice treatment (LSVT®) for Parkinson’s disease: A comparison with an alternative speech treatment. Folia Phoniatrica et Logopaedica, 54, 296-303.      This prospective, randomized group design provides good support for the long term effectiveness of Lee Silverman Voice Treatment (LSVT®) for improving loudness and voice quality in speakers with Parkinson’s disease.  The research is part of a body of literature that provided strong support for LVST.  


Sapir, S., Spielman, J., Ramig. L. O., Hinds, S., Countryman, S., Fox, C., & Story, B. (2003). The effects of intensive voice treatment (the Lee Silverman Voice Treatment [LSVT]) on ataxic dysarthria: A case study. American Journal of Speech-Language Pathology, 12, 387-399.  This case study presented evidence of the effectiveness of Lee Silverman Voice Treatment (LSVT) in improving loudness, intonation, rate, articulation, intelligibility and social functioning of a patient (P) with ataxic dysarthria.

Schuster, D. H., & Mouzon, D. (1982). Music and vocabulary learning Journal of the Society for Accelerative Learning and Teaching, 7 (1), 82-108. This investigation was not concerned with intervention. Rather, it explored the relationship between music and vocabulary learning in college students. The investigators were extending research seeking to confirm the contention that baroque music facilitated learning of vocabulary and they did confirm the contention.

Scott, S., & Caird, F. (1983). The speech therapy for Parkinson’s disease to speech therapy. Journal of Neurology, Neurosurgery, and Psychiatry, 46, 140-144.      The results of this prospective randomized group experimental design indicates that short term therapy (1 hour per day; 5 days a week; 2 weeks) can result in improved prosody and intelligibility. The investigators compared two intervention; one solely based on Halliday (1980) and the other adding visual feedback (Vocalite) to the intervention. The group that did not receive Vocalite intervention received an extra week of  herapy with the Vocalite after the posttest. Although both intervention groups did improve on all or most of the outcomes at posttest, the degree of change did not persist over 3 months for the group that had received only Vocalite. The intervention group that received both types of therapy (initial intonation treatment and during the extended time Vocalite therapy) was significantly better for some measures at follow up.

Scott, S., & Caird, F. (1984). The response of the apparent receptive speech disorder of Parkinson’s disease to speech therapy. Journal of Neurology, Neurosurgery, and Psychiatry, 47, 302-304.      Due its design, this investigation provides limited support for an intervention that focuses on expressive prosody but yields improvement in receptive and expressive affective prosody.


Seybold, C. D. (1971). The value and use of music activities in the treatment of speech delayed children. Journal of Music Therapy, 8, 102-110. The investigator provides a clear description of music activities designed to facilitate spontaneous communication in preschoolers diagnosed as speech delayed. However there are some problems with this investigation comparing Music Therapy and Speech Therapy with speech delayed preschoolers.


Shea, R. L., & Tyler, A. A. (2001).  The effectiveness of a prosodic intervention on children’s metrical patterns. Clinical Teaching and Therapy, 17, 55-76. These two single subject experimental design studies provide for this cognitive-linguistic approach to teaching w-S stress patterns in multisyllable words and, to a lesser degree, in phrases for children with MLU

Shriberg, L. D., Paul, R., McSweeney, J. L., Klin, A., Cohen, D. J., & Volkmer, F. R. (2001). Speech and prosody characteristics of adolescents and adults with High-Functioning Autism and Asperger syndrome. Journal of Speech, Language, and Hearing Research, 44, 1097-1115.  For the most part, speakers with AS and HFA present with similar prosodic pattern. However, both groups tend to differ from a comparison group of adolescent and adult males who are considered to be typical speakers (TS).

  • The investigators found that the AS and/or HFA groups differed from the TS group on the following prosodic variables:

– Overall Phrasing errors such as

  1. sound repetition errors
  2. word repetition errors
  3. 1 word repetition errors

– Slow/pause time errors (within the Rate category)

– Overall Stress errors

– Excessive/equal/misplaced stress (within the Stress category)

– Too loud (within the Loudness category)

  • The exceptions to the characterizations of similar prosody among speakers with AS and HAS are

– sound syllable repetitions (AS Ps produced significantly more)

– repetition and revision errors (AS Ps produced significantly more)

– slow articulation/pause errors (HFA Ps produced significantly more)

Shriberg, L. D., & Widder, C. J. (1990). Speech and prosody characteristics of adults with mental retardation. Journal of Speech and Hearing Rsearch, 33, 627-653.

  • prosody (and speech skills) were significantly not different based on gender or level of disability
  • certain aspects of prosody (phrasing/fluency, loudness, pitch) tended to be more accurate in participants (P’s) with higher perceived probability of independence than Ps with lower perceived probability of independence. The trends were not significant.
  • other aspects of prosody (rate and stress) tended to be more accurate in Ps with lower perceived probability of independence. Although the investigators labeled one of these trends to be significant (stress), the p level did not reach the standard level (≤ 0.05.)
  • More than 80% of the Ps experienced challenges with Quality.
  • Many of the Ps experienced difficulty with phrasing/fluency, rate, and stress.

Simmons, E. S., Paul, R., & Shic, F. (2016.) A mobile application to treat prosodic deficits in autism spectrum disorder and other communication impairments. Journal of Autism and Developmental Disorders, 46, 320-327. This preliminary investigation explores whether a software program (SpeechPrompts) has potential for treating prosodic problems in children and adolescents. Basic issues (e.g., student engagement, use pattern, perceive improvement, ease of use) about the intervention were investigated and it was determined that speech-language pathologists (SLPs) found SpeechPrompts enjoyable and easy to use in a school setting and they perceived that it resulted in perceived improvements in the Ss’ ability to produce stress, loudness, and intonation, but not speaking rate. These improvements were reported despite a low dose of the intervention over an 8 week period.

Solomon, N. P., McKee, A. S., & Garcia-Barry, S. (2001). Intensive voice treatment and respiration treatment for hypokinetic-spastic dysarthria after traumatic brain injury. American Journal of Speech-Language Pathology, 10, 51-64.  This thorough case study provides guidance about use of Lee Silverman Voice Treatment (LSVT) and Combination therapy (LSVT plus Respiration Treatment and Physical therapy) with a P with hypokinetic and spastic dysarthria as the result of traumatic brain injury (TBI). Some measures of breathing, intelligibility, and sound pressure level (SPL) improved.

Stahl, B., Kotz, S. A., Henseler, I., Turner,R., & Geyer, S. (2011). Rhythm in disguise: Why singing may not hold the key to recovery from aphasia.  Brain: A Journal of Music, 134, 3083-3093. doi:10.1093/brain/awr240  This is a comparison study, not an intervention study. It is included to provide evidence supporting the inclusion of music-based intervention in evidence-based practice analyses and summaries of prosodic therapies. The investigators determined that nonfluent German-speaking participants with larger basal ganglia lesions were most likely to benefit from rhythmic interventions.

Staum, M. J. (1987).  Music notation to improve the speech prosody of hearing impaired children.  Journal of Music Therapy, 24, 146-159.      The procedure of pairing music notation with imitation and/or reading of selective linguistic units could have potential for elementary school age children who have limited speech rhythm and intonation.  Application is limited by the need for a clearer description of intervention and evaluation procedures.

Stringer, A. Y. (1996). Treatment of motor aprosodia with pitch biofeedback and expression modeling. Brain Injury, 10, 583-590.             This investigation provides limited empirical support for a procedure involving modeling and biofeedback (Visipitch) to improve expressive aprosodia.

Tamplin, J. (2008). A pilot study into the effect of vocal exercises and singing on dysarthric speech. NeuroRehabilitation, 23, 207-216.      These case studies provide promising information that music therapy with concurrent speech-language therapy can result in limited to moderate improvement in rate, pausing, and naturalness in reading and spontaneous speech as well as strong improvement in intelligibility of spontaneous speech.

Thaut, M. H. (1985). The use of auditory rhythm and rhythmic speech to aid temporal muscular control in children with gross motor dysfunction. Journal of Music Therapy, 22 (3), 108-128. This investigation focuses on clinically relevant issues rather than solely on clinical effectiveness. The investigator found that a short intervention (3 session) of Auditory Rhythm plus Speech Rhythm cues was more successful than Visual Modeling in improving performance of a gross motor sequence.

Thaut, M. H., McIntosh, K. W., McIntosh, G. C., & Hoemberg, V. (2001). Auditory rhythmicity enhances movement and speech motor control in patients with Parkinson’s disease. Functional Neurology, 16(2), 163-172. Both metered and patterned rhythmic speech resulted in improved word accuracy in participants (Ps) with Parkinson’s disease (PD.) Neither form of rhythmic speech cueing was more effective. However, both forms of rhythmic cueing was most effective with Ps who were classified as severely impaired speakers and the optimum rate of speech was the habitual speaking rate or 60% of habitual speaking rate.

Theodoros, D. G., Hill, A. J., & Russell, T. G. (2016.) Clinical and quality of life outcomes of speech treatment for Parkinson’s Disease delivered to the home via telerehabilitation: A noninferiority randomized controlled trial. American Journal of Speech-Language Pathology, 25, 214-232.   Patients (Ps) with Parkinson’s disease (PD) enrolled in Lee Silverman Voice Treatment either face-to-face (FTF) or online. The FTF and Online interventions resulted in similar changes. Thus, as the result of both Online and FTF LVST, Ps experienced improvement in several loudness outcomes, ease of being understood, and reduced repetition requests. However, significant improvements in the following types of outcomes were not reported: pitch variability, intelligibility, and most quality of life indicators.


Theodoros, D., & Ramig, L.  (2011, October).  Telepractice supporteddelivery of LSVT®Loud. Perspectives on Neurophysiology and Neurogenic Speech and Language Disorders,21, 107-119.   doi:10.1044/nnsld21.3.107     This traditional narrative review provides a guide to incorporating Lee Silverman Voice Treatment (LVST-Loud) into telepractice and reviews research documenting its effectiveness as well as its costs and P satisfaction


Thomas-Stonell, N., McClean, M., & Hunt, E. (1991). Evaluation of the SpeechViewer computer-based speech training system with neurologically impaired individuals. Journal of Speech-Language Pathology and Audiology, 15 (4), 47-56.        This research provides moderate support for a computer based intervention for the improvement of rate and intelligibility in one child and two adolescents with neurological impairment.

Thompson, G. A., & McFerran, K. S. (2015). Music therapy with young people who have profound intellectual and developmental: Four cases exploring communication and engagement with musical interactions. Journal of Intellectual and Developmental Disability, 40, 1-11.  Behaviors that were observed during music therapy in school-aged Australian children included answering, rejecting/protesting, choice making, and producing social conventions.

Thompson, W. F., Schellenberg, E. G., & Husain, G. (2004). Decoding speech prosody: Do music lessons help? Emotion, 4 (1), 46-64. DOI: 10.1037/1528-3542.4.1.46   The investigation reviewed here was a retrospective experiment which compared 4 groups of typically developing Canadian children who had been divided into 4 groups: keyboard instruction, singing instruction, drama instruction, and no treatment for 1 year. The results indicated that the keyboard and drama groups exhibited superior skills in distinguishing fearful and angry affective prosody.

Tjaden, K. (2000). Exploration of a treatment technique for prosodic disturbance following a stroke. Clinical Linguistics and Phonetics, 14, 619-614.      The results of this case study suggest this computer-based intervention was not effective in reducing scanning speech by increasing the temporal variability (duration) of adjacent syllables. Nevertheless, the investigator presented thoughtful procedures for perceptually and acoustically measuring  scanning speech and for clinical decision making.

Tosto, G., Gasparini, M., G.L. Lenzi, G. L., & Bruno, G. (2011). Prosodic impairment in Altzheimer’s disease: Assessment and clinical relevance. Journal of Neuropsychiatry and Clinical Neuroscience, 23 (2), E21-E23.

Journal Address:

In this case study of an adult Italian speaking male diagnosed being in the early stages of early onset Altzheimer’s disease (AD), the participant displayed significant impairment in the production and comprehension of emotional prosody. These finding diverge from the clinical literature on prosody in dementia. The investigators recommend that clinicians should carefully monitor the emotional prosody skills of patients with AD and consider emotional prosody skills when working with AD individuals and their families.

Trauner, D. A. (2008). Right hemisphere brain damage in children. Perspectives on Neurophysiology and Neurogenic Speech and Language Disorders, 18, 73-81. Only 2 investigations concerned with prosody were reviewed in the overall description of cognitive and linguistic functions affected by right hemisphere brain damage in children. The 2 investigations suggest that children with RHBD are likely to experience problems with the production of linguistic prosody as well as the comprehension and production of affective prosody.


van de Sandt-Koenderman, M., van der Meulen, I., Heijenbrok-Kal, M., Visch-Brink, E. G., & M Ribbers, G. (2013). Melodic Intonation Therapy in subacute aphasia. In 43rd Clinical Aphasiology Conference 2013. Tucson, AZ (May 28- June 2, 2013.) On February 20, 2016 retrieved from   This investigation of the effectiveness of Melodic Intonation Therapy (MIT) with Dutch participants (Ps) with subacute aphasia revealed that MIT was more effective than a control intervention on a language repetition task and that MIT, but not the control intervention, generalized to measures of naming, story retelling, and everyday conversation. REVIEW:

Van Nuffelen, G. (2011). Speech prosody in dysarthria. In V. Stojanovik & J. Setter (Eds.), Speech prosody in atypical populations: Assessment and remediation (pp. 147- 167). Surry, UK: J & R Press.  The author provides background information about prosody’s relevance to speech-language pathology and analyzes assessment procedures (these will be reviewed in this blog at a later date when we add a section on assessment issues.) This review is concerned with the recommendations for using prosody to improve intelligibility and/or comprehensibility. Prior to working on expressive prosody, the author recommends that receptive prosody be targeted if assessment suggests this is skill is a challenge. The author provides techniques and content for treating intonation, stress, and rate as they relate to intelligibility/comprehensibility.

Wambaugh, J., Nessler, C., Cameron, R., & Mauszycki, S. C. (2012). Acquired apraxia of speech: The effects of repeated practice and rate/rhythm control treatments on sound production accuracy. American Journal of Speech-Language Pathology, 21, S5- S27.

     The focus of these single subject experimental design studies was primarily on repeated practice with investigators employing and analyzing rate/rhythm as a strategy to increase effectiveness after the primary intervention. Rate/rhythm intervention was successful in increasing the production of speech sound accuracy following repeated practice intervention.

Wenke, R. J., Theodoros, D., & Cornwall, P.  (2011).  A comparison of the effects of the Lee Silverman Voice Treatment and traditional therapy on intelligibility, perceptual speech features, and everyday communication in nonprogressive dysarthria.  Journal of Medical Speech-Language Pathology, 19 (4), 1-25.             The results of this investigation adds to the body of research indicating that LSVT can successfully improve rate and loudness as well as other aspects of communication in Ps with dysarthria, in this case nonprogressive dysarthria. 

Whipple, J. (2004).  Music in intervention for children and adolescents with autism: A meta-analysis.  Journal of Music Therapy, 41, 90-106.  This meta-analysis supports the effectiveness of music therapy (pitch and rhythm) for the improvement of a variety of skills (i.e., communication, social/behavioral skills, cognition.)

Witt, A. E., & Steele, A. L. (1984). Music therapy for infant and parent: A case example. Music Therapy Perspective, 1(4), 17-19. This case study is reviewed to focus attention on the history of music in speech-language pathology. Although the supporting evidence in this case study is limited, the authors provide objectives and strategies for clinicians wishing to include music in their treatment of children in the early stages of communication development.

Wymer, J. H., Lindman, L. S., & Booksh, R. L. (2002). A neuropsychological  perspective of aprosody: Features, function, assessment, and treatment. Applied Neuropsychology, 9, 37-47.      This narrative review of the literature is over 10 years old.  The investigators covered variety of topics related to aprosodia, but  this analysis and summary will only be concerned with the section relevant to treatment. The authors described issues related to aprosodia intervention and provided practical recommendation:  treating prosodic aspects of communication, using compensatory strategies, and adapting to aprosodia.

Yashim, N. M. K. M., Mustafa/Dain, W. B., Isa, R., & Manaf. N. R. (2015). Mobile application can be treated authistic (sic) children. Paper: DOI: 10.13140/RG2.1.3041.6085   or  The authors provide a brief description of SpeechPrompts™ which is a mobile app that can be used in speech therapy and in treating prosody. REVIEW:

Yorkston, K., & Beukelman, D. R.  (1981).  Ataxic dysarthria:  Treatment sequences based on intelligibility and prosodic considerations.  Journal of Speech and Hearing Disorders, 46, 398-404.      The investigators used four case studies to illustrate p romising insights regarding improving rate and intelligibility among speakers with ataxic dysarthria.

Yorkston, K. M., Hakel, M., Beulelman, D. R., & Fager, S. (2007). Evidence for effectiveness of treatment of loudness, rate, or prosody in dysarthria: A systematic review. Journal of Medical Speech-Language Pathology, 15 (2), xi – xxxvi.      This well-executed Systematic Review is limited by the small number of sources. Loudness targets had the strongest evidence supporting the LSVT approach. Rate and prosody interventions as well as clarity/intelligibility also were reviewed.

Yorkston, K. M., Hammen, V. L., Beukelman, D. R., & Traynor, C. D. (1990). The effect of rate control on the intelligibility and naturalness of dysarthric speech. Journal of Speech and Hearing Disorders, 55, 550-560.  This investigation is concerned with learning and should not be considered evidence of the effectiveness of an intervention. Nevertheless, learning research can provide guidance to clinicians (C). The findings from this investigation indicated that slowing the rate of speech can result in improvements in the speech of participants (Ps) with ataxic or hypokinetic dysarthria. Metered strategies are more likely to improve sentence intelligibility, although one type (Additive Rhythmic) of rhythmic rate control strategy also results in sentence intelligibility improvement. On the other hand, metered strategies tend to be associated with the more severe degrading of ratings of speech naturalness than rhythmic approaches.


Ziegler, W., Aichert. I., & Staiger, A. (2010). Syllable- and rhythm-based approaches in the treatment of apraxia of speech. Perspectives on Neurophysiology and Neurogenic Speech and Language Disorders, 20, 59-66. doi:10.1044/nnsld20.3.59  Evidence from a narrative review of an intervention study concerned with treating speakers with apraxia (AOS) supports using prosody (naturalistic rhythmic cueing) to improve speech sounds, rate, and fluency.

Zumbansen, A., Peretz, I., & Herbert, S. (2014). The combination of rhythm and pitch can account for the beneficial effect of melodic intonation therapy on connected speech improvements in Broca’s aphasia. Frontiers in Human Neuroscience, 8, 592. doi: 10.3389/fnhum.2014.00592   These single subject studies explored the relative contribution of rhythm and pitch to the effectiveness of Melodic Intonation Therapy (MIT) for use in Broca’s aphasia. MT yielded significantly better outcomes of discourse informativeness than MIT adaptations using rhythm only (RT) or spoken words only (ST.) All 3 adaptations of MIT (MT, RT, ST) resulted in significant improvements in the imitation of trained words but improvement with untrained words was consistently better with MT than with RT or ST. None of the interventions resulted in improved measures of diadochokinetic rate or of mood.

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