Benway & Preston (2020)

January 31, 2022

ANALYSIS GUIDELINES

Comparison/Nonintervention Research 

KEY:

CAS = childhood apraxia of speech

eta =   partial eta squared 

MSWR = multisyllable word repetition 

NA = Not Applicable

nonCAS SSD = speech sound disorder without the diagnosis of childhood apraxia of speech

P = participant or patient

PCC = Percent Consonants Correct 

pmh = Patricia Hargrove, blog developer

SD = standard deviation(s)

SLP = speech-language pathologist

SS = standard score

SSD = speech sound disorders

SOURCE:  Benway, N. R., & Preston, J. L. (2020). Differences between school-age children with apraxia of speech and other speech sound disorders on multisyllable repetition. Perspectives of the ASHA Special Interest Groups, 5(4) 794-808 2020. https://doi.org/10.1044/2020_PERSP-19-00086

REVIEWER(S): pmh

DATE: January 29, 2022

ASSIGNED GRADE FOR OVERALL QUALITY:  Not Applicable

TAKE AWAY:  This investigation compared 7 to 17 year-old children with childhood apraxia of speech (CAS) with children with other speech sound disorders (SSD) on a task involving the repetition of multisyllabic words. The purpose of the investigation was to determine which of 15 features derived from the extant research could be used to distinguish the 2 groups of school-aged children. The investigators analyzed previously recorded imitations of multisyllable words of children with CAS and SSD using the 15 features. They determined that the children’s production 4 of the perceptual features differed significantly. One of these features was correct lexical stress. (The others were prevalence of voicing changes, percentage of structurally correct words, and syllable deletions.) Thus, incorrect stress may continue through childhood and has potential for distinguishing children with CAS and SSD (along with the other perceptual features.)

1.  What type of evidence was identified? 

• What was the type of design? Comparison Research and Retrospective, Nonrandomized Group Design with Controls

• What was the focus of the research? Clinically Related

• What was the level of support associated with the type of evidence?  Level = not applicable (NA). This was not an intervention study.

2.  Group membership determination: 

• If there were groups, were participants randomly assigned to groups? No 

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

3.  Were experimental conditions concealed?

• from participants? No 

• from administrators of experimental conditions? No 

• from analyzers/judges? Yes 

4.  Were the groups adequately described?  Variable 

 How many participants were involved in the study? 

•  total # of Ps: 61

•  # of groups: 2

•  List names of groups and the number of Ps in each group:  

     – CAS = 21

     – nonCAS SSD = 40

•  Did all groups maintain membership throughout the investigation? Yes  

CONTROLLED CHARACTERISTICS

•  age:  7 to 17 years

•  cognitive skills:  nonverbal IQ of not less than 1.33 standard deviations (SD) below the mean

:  

•  receptive language:  not less than 1.33 standard deviations (SD) below the mean

•  articulation:  below the 7th percentile on a standardized articulation test

•  Hearing:  passed a hearing screening

DESCRIBED CHARACTERISTICS

•  age:  

     – CAS = 11.92 (mean)

     – nonCAS SSD =  11.06 (mean)

•  gender: 

     – CAS = 16 (80%, male); 4 (20%, female) 

     – nonCAS SSD = 23 (56%, male); 18 (44%, female). 

•  phonological processing:  

     – CAS = 85.55 (mean)

     – nonCAS SSD = 101.44 (mean)

•  receptive vocabulary:

     – CAS = 103.15 (mean)

     – nonCAS SSD =  113.56 (mean)

• Syllable Repetition Task- Percent Consonants Correct (PCC):  

     – CAS = 85% (mean)

     – nonCAS SSD = 92% (mean)

• Syllable Repetition Task- Additions:  

     – CAS =  3.37  (mean)

     – nonCAS SSD = 0.75 (mean)

•  articulation skill:

     – CAS = standard score (SS) was 53.5 (mean)

     – nonCAS SSD =  SS  was 72.2  (mean)

•  Maximum Performance Task- Dysarthria Score:

     – CAS =  0.26 (mean)

     – nonCAS SSD =  0.05 (mean)

•  Maximum Performance Task- Apraxia Score:

     – CAS =  1.58 0.26 (mean)

     – nonCAS SSD = 0.73 0.26 (mean)

–  Were the groups similar? No  

–  Were the communication problems adequately described? No  

     •  disorder types:  Childhood Apraxia of Speech; Speech Sound Disorder without diagnosis of Childhood Apraxia of Speech

5.  What were the different conditions for this research?

•  Subject (Classification) Groups? Yes :

     – CAS

     – nonCAS SSD

•  Experimental Task? Yes 

     – Ps imitated recordings of 20 words consisting of 3 to 5 syllables

•  Criterion/Descriptive Conditions? Yes

Articulatory movements impacting segments

     – voicing change

     – lengthened vowels 

     – nasal changes

Phonological structure

     – percent structurally correct words

     – percent full syllable deletion 

     – migrations  

     – epenthesis 

     – percent full syllable addition 

     – lenitions  

     – metathesis 

Suprasegmentals

     – percent stress correct  

     – syllable segregation

Overall segmental accuracy

     – percent consonants correct 

     – percent phonemes correct 

     – percent vowels correct 

6.   Were the groups controlled acceptably? Yes 

7.  Were dependent measures appropriate and meaningful? Yes 

     – OUTCOME #1: voicing change 

     – OUTCOME #2: percent structurally correct words

     – OUTCOME #3: percent stress correct  

     – OUTCOME #4: percent full syllable deletion 

     – OUTCOME #5: percent consonants correct

     – OUTCOME #6: migrations 

     – OUTCOME #7: lengthened vowels 

     – OUTCOME #8: percent phonemes correct 

     – OUTCOME #9: percent vowels correct 

     – OUTCOME #10: epenthesis 

     – OUTCOME #11: nasal changes

     – OUTCOME #12: percent full syllable addition

     – OUTCOME #13: lenitions 

     – OUTCOME #14: metathesis 

     – OUTCOME #15: syllable segregation

• All the dependent measures were subjective.

• None of the dependent measures were objective.

8.  Were reliability measures provided?

  Interobserver for analyzers?  Yes. The investigators provided reliability data for transcribing of

          – segment accuracy (.97), 

          – segregated syllables (.83), and 

          – lexical stress deviations (.71).   

•  Intraobserver for analyzers?  No  _

•  Treatment or test administration fidelity for investigators?  NA 

9.  Description of design: 

• The investigation involved 2 questions. The first question involved a review of the literature in which over 190 features were identified as potentially being able to differentiate between children (7-17 years) with CAS and those with SSD but not CAS (nonCAS SSD).

• The investigators systematically reduced the original of list of features to 15 perceptual features. (Only of 2 these features were prosody related.) These 15 features were selected for involvement in question two.

• The purpose of the second question was to determine if children with CAS could be distinguished from children with nonCAS SSD. Using the 15 perceptual features, the investigators analyzed previously recorded productions on a multisyllable word repetition (MSWR) task of 61 children (CAS = 20; nonCAS SSD = 41) 

10.  What were the results of the statistical (inferential) testing?

• Because of multiple statistical comparisons, a correction was applied to the results of the inferential tests. Accordingly, the p values for comparisons that were labelled as significant ranged from .0004 to .0034.

• The following features were judged to be significantly different:

     – OUTCOME #1: voicing change

     – OUTCOME #2: percentage of structurally correct words

     – OUTCOME #3: percent stress correct

     – OUTCOME #4: percent full syllable deletion

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

•  Were effect sizes provided? Yes 

     – OUTCOME #1: voicing change  (derived Cohen’s d = 0.95, large)

     – OUTCOME #2: percentage of structurally correct words (derived Cohen’s d = 0.907, large)

     – OUTCOME #3: percent stress correct (derived Cohen’s d = 0.865, large)

     – OUTCOME #4: percent full syllable deletion (derived Cohen’s d = 0.74, moderate)

•  Were confidence interval (CI) provided?  Yes. For the most part no, but they were provided for reliability data.

11.  Summary of correlational results:   The investigators provided these data but they are not the focus of this review.

12.  Summary of descriptive results:  Qualitative research.  NA

13.  Brief summary of clinically relevant results:  

The investigators determined that the CAS and nonCAS SSD children’s performance on a MSWR task could be distinguished using 4 features: correct lexical stress, prevalence of voicing changes, percentage of structurally correct words, and syllable deletions. With respect to prosody, incorrect stress may continue through childhood for students diagnosed with CAS. 

ASSIGNED GRADE FOR QUALITY OF EXTERNAL EVIDENCE: NA, this is not an intervention study.

============================================================


Diehl et al. (2009)

November 16, 2021

ANALYSIS GUIDELINES

Comparison/Nonintervention Research 

KEY:

ADOS = Autism Diagnostic Observation Schedule

ASD = autism spectrum disorder

eta = partial eta squared

F0 = fundamental frequency 

HFA = high-functioning autism

MLU = mean length of utterance

NA = Not Applicable

P = participant or patient

pmh = Patricia Hargrove, blog developer

SD =standard deviation (SD) 

SLP = speech-language pathologist

WNL = within normal limits 

SOURCE:  Diehl, J. J., Watson, D., Bennetto, L., Mcdonough, J., & Gunlogson, C. (2009). An acoustic analysis of prosody in high-functioning autism. Applied Psycholinguistics, 30, 385-404.

REVIEWER(S): pmh

DATE: November 7, 2021  

ASSIGNED GRADE FOR OVERALL QUALITY:  Not Applicable (NA)—This investigation is not concerned with treatment

TAKE AWAY:  In two studies investigating prosody, participants (Ps) displayed increased fundamental frequency (F0) variability in narratives. This variability is not diagnostic because there was overlap between the high functioning autism (HFA) and the Control groups and not all HFA) Ps produced speech that was highly variable. In addition, the findings for adolescents with HFA (in Study 1) revealed an association between clinical ratings of prosody and the F0 measurements. This association was not noted in Study 2, with younger children.

STUDY 1

1.  What type of evidence was identified? 

• What was the type of design?  Comparison Research

• What was the focus of the research? Clinically Related

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

2.  Group membership determination: 

 If there were groups, were participants randomly assigned to groups? No

•  If there were groups and Ps were not randomly assigned to groups, were members of groups carefully matched? Yes 

3.  Were experimental conditions concealed?

•  from participants? No 

•  from administrators of experimental conditions? No

•  from analyzers/judges? No 

4.  Were the groups adequately described?  Yes 

–   How many participants were involved in the study? 

•  total # of Ps: 42 

•  # of groups: 2

     ∞ Ps with high-functioning autism (HFA) = 21

     ∞ Neurotypical control Ps (C) = 21

•  Did all groups maintain membership throughout the investigation? Yes  

CONTROLLED CHARACTERISTICS                                                      

•  age:  

    ∞ HFA = 10-18 years

     ∞ C = 10-18 years

•  gender:  the number of each gender in the Control group was matched to the number in the HFA group

     ∞ HFA = 19 males; 2 females

     ∞ C = 19 males; 2 females

•  diagnosis:

     ∞ HFA = all Ps met diagnostic criteria for autism spectrum disorder (ASD) but no Ps met diagnostic criteria for Asperger syndrome.

     ∞ C = free from the following diagnoses: ASD, learning disabilities, mental retardation, language disabilities, or other psychiatric conditions

•  diagnoses of first and second degree relatives:

∞ C = free from diagnoses of ASD

DESCRIBED CHARACTERISTICS

•  age:  

     ∞ HFA = mean 13.58

     ∞ C = mean 13.24

•  gender: 

     ∞ HFA = 19 males; 2 females

     ∞ C = 19 males; 2 females

•  cognitive skills:  

     ∞ HFA 

     Full Scale = 118.25 (mean)

     Verbal IQ = 117.0 (mean)

     Performance IQ = 116.05 (mean)

     ∞ C = 

     Full Scale = 116.81 (mean)

     Verbal IQ = 116.62 (mean)

     Performance IQ = 112.76 (mean)

•  receptive language (PPVT- III): 

     ∞ HFA = 115.33 (mean)

     ∞ C = 116.90 (mean)

–  Were the groups similar? Yes. HFA and Control groups were matched on gender, Full scale IQ (FSIQ), Verbal IQ (VIQ), and Peabody Picture Vocabulary Test- III (PPVT III).

–  Were the communication problems adequately described? No

•  disorder type:  (List)  Ps with HFA were described as preforming at or above average on standardized language tests but exhibiting social-communication challenges.

5.  What were the different conditions for this research?

•  Subject (Classification) Groups? Yes 

     – HFA 

     – C

•  Experimental Conditions? NA

•  Criterion/Descriptive Conditions? NA

6.   Were the groups controlled acceptably? Yes

7.  Were dependent measures appropriate and meaningful? Yes 

•  OUTCOME #1: average standard deviation (SD) of the fundamental frequency (F0) for each 250 ms segmnt

•  OUTCOME #2: average F0 across the entire narrative

•  OUTCOME #3: average number of clauses for the entire narrative

– The dependent measure that was subjective

     •  OUTCOME #3: average number of clauses

– The dependent/ outcome measures that were objective

     •  OUTCOME #1: average SD of the F0 

     •  OUTCOME #2: average F0

8.  Were reliability measures provided?

–  Interobserver for analyzers? No  

  Intraobserver for analyzers?  No 

–  Treatment or test administration fidelity for investigators?  No 

9.  Description of design: 

• The Ps individually viewed a cartoon in which, for the most part, the characters were nonverbal. In a few instances, however, characters produced an exclamation.

• Ps viewed one-third of the cartoon and then immediately retold it to a person who reportedly had not viewed the cartoon.

• The samples were recorded, digitalized, and then acoustically analyzed. Each sample was divided into 250 ms portions. The metrics derived across the samples were

     – the average of the SDs of the F0 across each 250 ms P’s sample

     – the average F0 across each P’s 3 samples

     – the average number of clauses 

10.  What were the results of the statistical (inferential) testing?

– Comparisons that are listed as significant achieved p ≤ 0.05):

•  OUTCOME #1: average standard deviation (SD) of the fundamental frequency (F0)  for each 250 ms segment

     – Ps in the HFA group produced significantly larger SDs than the Control group. That is, HFA pitch ranges were significantly wider than Controls. 

•  OUTCOME #2: average F0 across the entire narrative

     – There were no significant differences in the comparisons between the HFA and Control groups. 

•  OUTCOME #3: average number of clauses for the entire narrative

     – The HFA group produced significantly shorter P(i.e., fewer clauses) narratives than the Control group.

–  What was the statistical test used to determine significance?  ANOVA

–  Were effect sizes provided?  Yes. Interpretation Hints for partial eta squared (eta):  .01 small effect, .06 is medium effect, and .14 is large effect.

     •  OUTCOME #1: average standard deviation (SD) of the fundamental frequency (F0)  for each 250 ms segment; Partial Eta squared (Eta) =  0.11 (medium effect)

     •  OUTCOME #2: average F0 across the entire narrative; Eta = 0.05 (small effect)

     •  OUTCOME #3: average number of clauses for the entire narrative; Eta = 0.10 (medium effect)

  Were confidence interval (CI) provided?  No

11.  Summary of correlational results:  

•  OUTCOME #1: average SD of the F0 for each 250 ms segment was correlated with performance on the Autism Diagnostic Observation Schedule (ADOS) Communication factor score. The results indicated that there was a significant (p ≤ 0.05) correlation between the 2 measures (r = 0.43).

12.  Summary of descriptive results:  Qualitative research. NA

13.  Brief summary of clinically relevant results:  

• As a group, the adolescent Ps with HFA produced significantly wider pitch ranges than Controls. The investigators, however, warn that these findings are not conclusive because there was considerable overlap between the SDs of the 2 groups.

• For the HFA group, the SDs of the F0s was correlated with clinical judgments of communication skill (i.e., performance on the ADOS).

ASSIGNED GRADE FOR QUALITY OF EXTERNAL EVIDENCE:  NA

STUDY 2

1.  What type of evidence was identified? 

• What was the type of design?  Comparison Research

• What was the focus of the research? Clinically Related

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

2.  Group membership determination: 

• If there were groups, were participants randomly assigned to groups? 

• If there were groups and Ps were not randomly assigned to groups, were members of groups carefully matched? Yes

3.  Were experimental conditions concealed?

•  from participants? No 

•  from administrators of experimental conditions? No 

•  from analyzers/judges? No

4.  Were the groups adequately described? Yes

–   How many participants were involved in the study? 

•  total # of Ps: 34

•  # of groups: 

     – HFA = 17

     – Control = 17

•  Did all groups maintain membership throughout the investigation? 

CONTROLLED CHARACTERISTICS                                                      

•  age: Ps were younger than Study 1 between the ages of 6 to 14

•  cognitive skills: Although Ps cognitive skills were still within normal limits (WNL) they were lower than Study 1

• diagnosis: ASD or Asperger syndrome

DESCRIBED CHARACTERISTICS

•  age:  

     – HFA = 8.81 (mean)

     – Control = 9.49 (mean)

•  gender: 

     – HFA =  13 males, 4 females

     – Control = 12 males; 5 females

•  cognitive skills:  

     – HFA = Composite IQ = 104 (mean); verbal reasoning = 104.8 (mean)

     – Control = Composite IQ = 107.71 (mean); verbal reasoning = 105 (mean)

•  expressive language:  

     – HFA = 100.47 (mean)

     – Control = 102.35 (mean)

•  receptive language: 

     – HFA = 103.35 (mean)

     – Control = 102.12 (mean)

•  diagnosis: 

     – HFA = 15 Ps diagnosed as ASD; 2 diagnosed as Asperger syndrome

     – Control = neurotypical; no history of mental retardation, learning disability, language delay, psychiatric disorders; no history of ASD in first and second degree family members

– Were the groups similar? Yes Matched HFA and Control groups on age, gender, expressive and receptive language scores, composite and verbal reasoning on cognitive tests.

–  Were the communication problems adequately described? No  

5.  What were the different conditions for this research?

  Subject (Classification) Groups? 

     – HFA

     – Control 

  Experimental Conditions? No 

•  Criterion/Descriptive Conditions? No  

6.   Were the groups controlled acceptably? Yes 

7.  Were dependent measures appropriate and meaningful? Yes           

•  OUTCOME #1: average SD of the F0) for each 250 ms segment

•  OUTCOME #2: average F0 across the entire narrative

•  OUTCOME #3: average number of clauses for the entire narrative

– The dependent measure that was subjective was

•  OUTCOME #3: average number of clauses for the entire narrative

 The dependent/ outcome measures that were objective were

•  OUTCOME #1: average standard deviation (SD) of the fundamental frequency (F0) for each 250 ms segment

•  OUTCOME #2: average F0 across the entire narrative

8.  Were reliability measures provided?

 Interobserver for analyzers? No

• Intraobserver for analyzers? No  

• Treatment or test administration fidelity for investigators? No

9.  Description of design: 

• The Ps individually viewed and listened to a recorded reading of the picture book Frog Where Are You?

• The investigators instructed the Ps to listen to the story while they were out of the room and to be prepared to retell the story when the investigator returned. 

• The samples were recorded, digitalized, and then acoustically analyzed. Each sample was divided into 250 ms portions. The metrics derived across the samples were

     – the average of the standard deviations (SD)s of the fundamental frequencies (F0) across each 250 ms P’s sample

     – the average F0 across each P’s 3 samples

     – the average number of clauses 

10.  What were the results of the statistical (inferential) testing?

– Comparisons listed as significant achieved p ≤ 0.05

     •  OUTCOME #1: average standard deviation (SD) of the fundamental frequency (F0)  for each 250 ms segment—The Ps in the HFA groups produced significantly larger SD than the Control group Ps. That is, the variability of the F0 of the Ps in the HFA group was significantly larger.

     •  OUTCOME #2: average F0 across the entire narrative—There was not a significant difference in the productions of the HFA and Control groups.

     •  OUTCOME #3: average number of clauses for the entire narrative– There was not a significant difference in the productions of the HFA and Control groups.

– What was the statistical test used to determine significance? ANOVA

– Were effect sizes provided?   Yes 

Interpretation Hints: 

–  Cohen’s (1988) guidelines for interpreting partial eta squared (eta):  .01 small, .06  medium, and .14 large.

     •  OUTCOME #1: average SD of the F0 for each 250 ms segment; Eta =  0.18 (large effect)

     •  OUTCOME #2: average F0 across the entire narrative; Eta = 0.004 (negligible effect)

     •  OUTCOME #3: average number of clauses for the entire narrative; Eta = 0.08 (medium effect)

–  Were confidence interval (CI) provided? No

11.  Summary of correlational results:  

•  OUTCOME #1: average SD of the F0 for each 250 ms segment was correlated with performance on the Autism Diagnostic Observation Schedule (ADOS) Communication factor score. The results indicated that there was not a significant correlation between the 2 measures (r = 0.16).

12.  Summary of descriptive results:  Qualitative research. NA

13.  Brief summary of clinically relevant results:  

 The findings of this investigation support previous reports that young children with HFA produce more variation in F0 than neurotypical peers. This variability is not diagnostic because there was overlap between the HFA and the Control groups and not all HFA participants produced speech that was highly variable. 

ASSIGNED GRADE FOR QUALITY OF EXTERNAL EVIDENCE:  NA

ANALYSIS GUIDELINES

Comparison/Nonintervention Research 

KEY:

ADOS = Autism Diagnostic Observation Schedule

ASD = autism spectrum disorder

eta = partial eta squared

F0 = fundamental frequency 

HFA = high-functioning autism

MLU = mean length of utterance

NA = Not Applicable

P = participant or patient

pmh = Patricia Hargrove, blog developer

SD =standard deviation (SD) 

SLP = speech-language pathologist

WNL = within normal limits 

SOURCE:  Diehl, J. J., Watson, D., Bennetto, L., Mcdonough, J., & Gunlogson, C. (2009). An acoustic analysis of prosody in high-functioning autism. Applied Psycholinguistics, 30, 385-404.

REVIEWER(S): pmh

DATE: November 7, 2021  

ASSIGNED GRADE FOR OVERALL QUALITY:  Not Applicable (NA)—This investigation is not concerned with treatment

TAKE AWAY:  In two studies investigating prosody, participants (Ps) displayed increased fundamental frequency (F0) variability in narratives. This variability is not diagnostic because there was overlap between the high functioning autism (HFA) and the Control groups and not all HFA) Ps produced speech that was highly variable. In addition, the findings for adolescents with HFA (in Study 1) revealed an association between clinical ratings of prosody and the F0 measurements. This association was not noted in Study 2, with younger children.

STUDY 1

1.  What type of evidence was identified? 

• What was the type of design?  Comparison Research

• What was the focus of the research? Clinically Related

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

2.  Group membership determination: 

 If there were groups, were participants randomly assigned to groups? No

•  If there were groups and Ps were not randomly assigned to groups, were members of groups carefully matched? Yes 

3.  Were experimental conditions concealed?

•  from participants? No 

•  from administrators of experimental conditions? No

•  from analyzers/judges? No 

4.  Were the groups adequately described?  Yes 

–   How many participants were involved in the study? 

•  total # of Ps: 42 

•  # of groups: 2

     ∞ Ps with high-functioning autism (HFA) = 21

     ∞ Neurotypical control Ps (C) = 21

•  Did all groups maintain membership throughout the investigation? Yes  

CONTROLLED CHARACTERISTICS                                                      

•  age:  

    ∞ HFA = 10-18 years

     ∞ C = 10-18 years

•  gender:  the number of each gender in the Control group was matched to the number in the HFA group

     ∞ HFA = 19 males; 2 females

     ∞ C = 19 males; 2 females

•  diagnosis:

     ∞ HFA = all Ps met diagnostic criteria for autism spectrum disorder (ASD) but no Ps met diagnostic criteria for Asperger syndrome.

     ∞ C = free from the following diagnoses: ASD, learning disabilities, mental retardation, language disabilities, or other psychiatric conditions

•  diagnoses of first and second degree relatives:

∞ C = free from diagnoses of ASD

DESCRIBED CHARACTERISTICS

•  age:  

     ∞ HFA = mean 13.58

     ∞ C = mean 13.24

•  gender: 

     ∞ HFA = 19 males; 2 females

     ∞ C = 19 males; 2 females

•  cognitive skills:  

     ∞ HFA 

     Full Scale = 118.25 (mean)

     Verbal IQ = 117.0 (mean)

     Performance IQ = 116.05 (mean)

     ∞ C = 

     Full Scale = 116.81 (mean)

     Verbal IQ = 116.62 (mean)

     Performance IQ = 112.76 (mean)

•  receptive language (PPVT- III): 

     ∞ HFA = 115.33 (mean)

     ∞ C = 116.90 (mean)

–  Were the groups similar? Yes. HFA and Control groups were matched on gender, Full scale IQ (FSIQ), Verbal IQ (VIQ), and Peabody Picture Vocabulary Test- III (PPVT III).

–  Were the communication problems adequately described? No

•  disorder type:  (List)  Ps with HFA were described as preforming at or above average on standardized language tests but exhibiting social-communication challenges.

5.  What were the different conditions for this research?

•  Subject (Classification) Groups? Yes 

     – HFA 

     – C

•  Experimental Conditions? NA

•  Criterion/Descriptive Conditions? NA

6.   Were the groups controlled acceptably? Yes

7.  Were dependent measures appropriate and meaningful? Yes 

•  OUTCOME #1: average standard deviation (SD) of the fundamental frequency (F0) for each 250 ms segmnt

•  OUTCOME #2: average F0 across the entire narrative

•  OUTCOME #3: average number of clauses for the entire narrative

– The dependent measure that was subjective

     •  OUTCOME #3: average number of clauses

– The dependent/ outcome measures that were objective

     •  OUTCOME #1: average SD of the F0 

     •  OUTCOME #2: average F0

8.  Were reliability measures provided?

–  Interobserver for analyzers? No  

  Intraobserver for analyzers?  No 

–  Treatment or test administration fidelity for investigators?  No 

9.  Description of design: 

• The Ps individually viewed a cartoon in which, for the most part, the characters were nonverbal. In a few instances, however, characters produced an exclamation.

• Ps viewed one-third of the cartoon and then immediately retold it to a person who reportedly had not viewed the cartoon.

• The samples were recorded, digitalized, and then acoustically analyzed. Each sample was divided into 250 ms portions. The metrics derived across the samples were

     – the average of the SDs of the F0 across each 250 ms P’s sample

     – the average F0 across each P’s 3 samples

     – the average number of clauses 

10.  What were the results of the statistical (inferential) testing?

– Comparisons that are listed as significant achieved p ≤ 0.05):

•  OUTCOME #1: average standard deviation (SD) of the fundamental frequency (F0)  for each 250 ms segment

     – Ps in the HFA group produced significantly larger SDs than the Control group. That is, HFA pitch ranges were significantly wider than Controls. 

•  OUTCOME #2: average F0 across the entire narrative

     – There were no significant differences in the comparisons between the HFA and Control groups. 

•  OUTCOME #3: average number of clauses for the entire narrative

     – The HFA group produced significantly shorter P(i.e., fewer clauses) narratives than the Control group.

–  What was the statistical test used to determine significance?  ANOVA

–  Were effect sizes provided?  Yes. Interpretation Hints for partial eta squared (eta):  .01 small effect, .06 is medium effect, and .14 is large effect.

     •  OUTCOME #1: average standard deviation (SD) of the fundamental frequency (F0)  for each 250 ms segment; Partial Eta squared (Eta) =  0.11 (medium effect)

     •  OUTCOME #2: average F0 across the entire narrative; Eta = 0.05 (small effect)

     •  OUTCOME #3: average number of clauses for the entire narrative; Eta = 0.10 (medium effect)

  Were confidence interval (CI) provided?  No

11.  Summary of correlational results:  

•  OUTCOME #1: average SD of the F0 for each 250 ms segment was correlated with performance on the Autism Diagnostic Observation Schedule (ADOS) Communication factor score. The results indicated that there was a significant (p ≤ 0.05) correlation between the 2 measures (r = 0.43).

12.  Summary of descriptive results:  Qualitative research. NA

13.  Brief summary of clinically relevant results:  

• As a group, the adolescent Ps with HFA produced significantly wider pitch ranges than Controls. The investigators, however, warn that these findings are not conclusive because there was considerable overlap between the SDs of the 2 groups.

• For the HFA group, the SDs of the F0s was correlated with clinical judgments of communication skill (i.e., performance on the ADOS).

ASSIGNED GRADE FOR QUALITY OF EXTERNAL EVIDENCE:  NA

STUDY 2

1.  What type of evidence was identified? 

• What was the type of design?  Comparison Research

• What was the focus of the research? Clinically Related

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

2.  Group membership determination: 

• If there were groups, were participants randomly assigned to groups? 

• If there were groups and Ps were not randomly assigned to groups, were members of groups carefully matched? Yes

3.  Were experimental conditions concealed?

•  from participants? No 

•  from administrators of experimental conditions? No 

•  from analyzers/judges? No

4.  Were the groups adequately described? Yes

–   How many participants were involved in the study? 

•  total # of Ps: 34

•  # of groups: 

     – HFA = 17

     – Control = 17

•  Did all groups maintain membership throughout the investigation? 

CONTROLLED CHARACTERISTICS                                                      

•  age: Ps were younger than Study 1 between the ages of 6 to 14

•  cognitive skills: Although Ps cognitive skills were still within normal limits (WNL) they were lower than Study 1

• diagnosis: ASD or Asperger syndrome

DESCRIBED CHARACTERISTICS

•  age:  

     – HFA = 8.81 (mean)

     – Control = 9.49 (mean)

•  gender: 

     – HFA =  13 males, 4 females

     – Control = 12 males; 5 females

•  cognitive skills:  

     – HFA = Composite IQ = 104 (mean); verbal reasoning = 104.8 (mean)

     – Control = Composite IQ = 107.71 (mean); verbal reasoning = 105 (mean)

•  expressive language:  

     – HFA = 100.47 (mean)

     – Control = 102.35 (mean)

•  receptive language: 

     – HFA = 103.35 (mean)

     – Control = 102.12 (mean)

•  diagnosis: 

     – HFA = 15 Ps diagnosed as ASD; 2 diagnosed as Asperger syndrome

     – Control = neurotypical; no history of mental retardation, learning disability, language delay, psychiatric disorders; no history of ASD in first and second degree family members

– Were the groups similar? Yes Matched HFA and Control groups on age, gender, expressive and receptive language scores, composite and verbal reasoning on cognitive tests.

–  Were the communication problems adequately described? No  

5.  What were the different conditions for this research?

  Subject (Classification) Groups? 

     – HFA

     – Control 

  Experimental Conditions? No 

•  Criterion/Descriptive Conditions? No  

6.   Were the groups controlled acceptably? Yes 

7.  Were dependent measures appropriate and meaningful? Yes           

•  OUTCOME #1: average SD of the F0) for each 250 ms segment

•  OUTCOME #2: average F0 across the entire narrative

•  OUTCOME #3: average number of clauses for the entire narrative

– The dependent measure that was subjective was

•  OUTCOME #3: average number of clauses for the entire narrative

 The dependent/ outcome measures that were objective were

•  OUTCOME #1: average standard deviation (SD) of the fundamental frequency (F0) for each 250 ms segment

•  OUTCOME #2: average F0 across the entire narrative

8.  Were reliability measures provided?

 Interobserver for analyzers? No

• Intraobserver for analyzers? No  

• Treatment or test administration fidelity for investigators? No

9.  Description of design: 

• The Ps individually viewed and listened to a recorded reading of the picture book Frog Where Are You?

• The investigators instructed the Ps to listen to the story while they were out of the room and to be prepared to retell the story when the investigator returned. 

• The samples were recorded, digitalized, and then acoustically analyzed. Each sample was divided into 250 ms portions. The metrics derived across the samples were

     – the average of the standard deviations (SD)s of the fundamental frequencies (F0) across each 250 ms P’s sample

     – the average F0 across each P’s 3 samples

     – the average number of clauses 

10.  What were the results of the statistical (inferential) testing?

– Comparisons listed as significant achieved p ≤ 0.05

     •  OUTCOME #1: average standard deviation (SD) of the fundamental frequency (F0)  for each 250 ms segment—The Ps in the HFA groups produced significantly larger SD than the Control group Ps. That is, the variability of the F0 of the Ps in the HFA group was significantly larger.

     •  OUTCOME #2: average F0 across the entire narrative—There was not a significant difference in the productions of the HFA and Control groups.

     •  OUTCOME #3: average number of clauses for the entire narrative– There was not a significant difference in the productions of the HFA and Control groups.

– What was the statistical test used to determine significance? ANOVA

– Were effect sizes provided?   Yes 

Interpretation Hints: 

–  Cohen’s (1988) guidelines for interpreting partial eta squared (eta):  .01 small, .06  medium, and .14 large.

     •  OUTCOME #1: average SD of the F0 for each 250 ms segment; Eta =  0.18 (large effect)

     •  OUTCOME #2: average F0 across the entire narrative; Eta = 0.004 (negligible effect)

     •  OUTCOME #3: average number of clauses for the entire narrative; Eta = 0.08 (medium effect)

–  Were confidence interval (CI) provided? No

1

1.  Summary of correlational results:  

•  OUTCOME #1: average SD of the F0 for each 250 ms segment was correlated with performance on the Autism Diagnostic Observation Schedule (ADOS) Communication factor score. The results indicated that there was not a significant correlation between the 2 measures (r = 0.16).

12.  Summary of descriptive results:  Qualitative research. NA

13.  Brief summary of clinically relevant results:  

 The findings of this investigation support previous reports that young children with HFA produce more variation in F0 than neurotypical peers. This variability is not diagnostic because there was overlap between the HFA and the Control groups and not all HFA participants produced speech that was highly variable. 

ASSIGNED GRADE FOR QUALITY OF EXTERNAL EVIDENCE:  NA


Léard-Schneideer & Lévêque (2020)

October 1, 2020

ANALYSIS GUIDELINES

Comparison/Nonintervention Research 

KEY:

eta =   partial eta squared 

f = female

m = male

MBEA = the Montreal Battery of Evaluation of Amusia

MEC = Montreal Evaluation of Communication

MLU = mean length of utterance

NA = Not Applicable

P = participant or patient

pmh = Patricia Hargrove, blog developer

SLP = speech-language pathologist

TBI = traumatic brain injury 

WNL = within normal limits

SOURCE:  Léard-Schneider, L. & Lévêque , Y (2020). Perception of music and speech prosody after traumatic brain injury, PsyArXiv Preprints  https://psyarxiv.com/w7cbf/

REVIEWER(S):  pmh

DATE:  October 1, 2020

ASSIGNED GRADE FOR OVERALL QUALITY:  This is not an intervention study; therefore, there is no Assigned Grade for Overall Quality.

TAKE AWAY:   This investigation compared the performance of French-speaking participants (Ps) with traumatic brain injury (TBI) to a neurotypical peer group or test norms on music and prosody comprehension tasks. The results suggest that Ps with TBI encounter challenges with musical pitch discrimination, rhythm, affective prosody, and linguistic prosody.  

1.  What type of evidence was identified? 

• What was the type of design?  Comparison Research 

• What was the focus of the research? Clinically Related  

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

2.  Group membership determination: 

•  If there were groups, were participants randomly assigned to groups? No, the groups were TBI and Neurotypical Controls. This cannot be randomized.

 • If there were groups and Ps were not randomly assigned to groups, were members of groups carefully matched?  Yes, the groups reported similar gender distribution, age, and schooling.

3.  Were experimental conditions concealed?

•  from participants? No

•  from administrators of experimental conditions? No 

•  from analyzers/judges? No 

4.  Were the groups adequately described?  Yes 

–  How many participants were involved in the study? 

•  total # of Ps:  62

•  # of groups:  2

     Traumatic Brain Injury (TBI) = 31 (of 36 qualified volunteers, 5 were excluded for failing to meet al criteria)

     Neurotypical (NT) = 31 (of 33 qualified volunteers, 2 were omitted because they exhibited possible amusia)

•  Did all groups maintain membership throughout the investigation? Yes, but data was missing for 2 of the TBI group for the Lin Vowel task.         

CONTROLLED CHARACTERISTICS                                                      

•  age: 18 – 60 years

•  cognitive skills:  

•  native language: French

•  short-term memory: all TBI Ps demonstrated sufficient verbal comprehension on a standardized test

•  receptive language: all TBI Ps demonstrated sufficient verbal comprehension on a standardized test

•  severity of TBI: all Ps were rated as having severe TBI

     ∞ NT = none

•  Living Arrangements: only 1 TBI P lived independently

•  Hearing: all Ps within normal limits (WNL)

•  Amusia in NT Ps:  2 of 33 qualified NT volunteers were excluded because meet criterion on tasks identifying amusia.

DESCRIBED CHARACTERISTICS

•  age:  

     ∞ TBI = 38.1 years

     ∞ NT = 37.29 years

•  gender: 

     ∞ TBI = 32% women

     ∞ NT = 32%. women

•  schooling: 

     ∞ TBI = 48% ≤ 11 years

     ∞ NT = 48% ≤ 11 years

•  time post onset (TBI group only):

     ∞ less than 2 years = 25%

     ∞ 2 to 5 years = 23%

     ∞ more than 5 years = 52%

•  musical training (i.e., 3 or mor years of training)

     ∞ TBI = 4 Ps had prior musical training; all had stopped playing their instrument after their TBI.

•  Amusia in NT Ps: 2 of 33 qualified NT volunteers were excluded for failing the Montreal Battery of Evaluation of Amusia (MBEA)

  Were the groups similar? Yes 

•  Were the communication problems adequately described? No 

•  disorder type: Traumatic Brain Injury 

•  functional level:  severe

5.  What were the different conditions for this research?

–  Subject (Classification) Groups? Yes 

      • TBI

      • NT         

–  Experimental Conditions? No  

–  Criterion/Descriptive Conditions? Yes 

     • Performance on Scale portion of the MBEA

     • Performance on Rhythm portion of the MBEA

     • Performance on the Emotional Prosody Understanding portion of the Montreal Evaluation of Communication (MEC)

     • Performance on the Linguistic Prosody Understanding portion of the MEC

     • Performance on Emo Vowel task (accuracy of identifying emotions and the intensity of the emotions)]

     • Performance on Lin Vowel task [accuracy of identifying the intention (question, order, neutral/statement)]  

6.   Were the groups controlled acceptably? Yes 

7.  Were dependent measures appropriate and meaningful? Yes 

• OUTCOME #1: Performance on Scale portion of the Montreal Battery of Evaluation of Amusia (MBEA)

• OUTCOME #2:  Performance on Rhythm portion of the MBEA 

• OUTCOME #3: Performance on the Emotional Prosody Understanding portion of the Montreal Evaluation of Communication (MEC)

• OUTCOME #4:  Performance on the Linguistic Prosody Understanding portion of the MEC

• OUTCOME #5:  Performance on Emo Vowel task (accuracy of identifying emotions and the intensity of the emotions)

• OUTCOME #6:  Performance on Lin Vowel task [accuracy of identifying the intention (question, order, neutral/statement)  

–  All the dependent measures are subjective.

–  None of the dependent/ outcome measures are objective.

8.  Were reliability measures provided?                                   

•  Interobserver for analyzers?  No 

  Intraobserver for analyzers?  No 

•  Treatment or test administration fidelity for investigators?  No

9.  Description of design:  (briefly describe)

• Two groups of French-speaking adult volunteers (TBI and NT) were administered a battery of tests/tasks including those designed to assess musical recognition of pitch and rhythm as well as the comprehension of prosodic affect and linguistic prosody.

• The groups were similar for age, gender, and education.

• The results of correlational and gender analyses as well as results pertaining attitudes toward musi are not summarized in this review.

10.  What were the results of the statistical (inferential) testing? 

• OUTCOME #1: Performance on Scale (pitch) portion of the MBEA

     ∞ TBI group performed significantly more poorly than the NT

     ∞ 42 % of TBI Ps were classified as pathological

• OUTCOME #2:  Performance on Rhythm portion of the MBEA. 

     ∞ 52 % of TBI Ps were classified as Pathological 

• OUTCOME #3: Performance on the Emotional Prosody Understanding portion of the MEC

     ∞ the TBI and NT groups were not compared because the NT were not administered this task

• OUTCOME #4:  Performance on the Linguistic Prosody Understanding portion of the MEC

     ∞ the TBI and NT groups were not compared because the NT were not administered this task

• OUTCOME #5:  Performance on Emo Vowel task (accuracy of identifying emotions and the intensity of the emotions)

     § accuracy of affective prosody understanding was significantly lower for the TBI group than the NT group. d = 1.11

     § however, the perceived intensity of the emotion in the task was not significantly different for the NT versus the TBI groups

• OUTCOME #6:  Performance on Lin Vowel task [accuracy of identifying the intention (question, order, neutral/statement) 

     § accuracy of linguistic prosody understanding was significantly lower for the TBI group than the NT group. d = 1.11

∞ The descriptive analyses of correct responses for Outcomes 3, 4, 5, and 6 were combined:

     § pathological = equal or below 2 standard deviations below the performance of the NT groups or below cut-off on MBEA or MEC

     § 84% of the TBI groups had one or more of the above 4 Outcomes categorized as impaired/pathological.

     § 42% of the TBI groups had impaired affective and linguistic prosody understanding.

     § Approximately equal proportions of TBI Ps experienced problems with only affective (19%) or linguistic (23%) prosody.

     § Vowel based outcome tasks (i.e., Outcomes 5 and 6) were more of challenge than the sentence based, or MEC, outcome tasks (i.e., Outcomes 3 and 5).

          • for affective prosody, 55% of the Ps had a problem with the Vowel task (Outcome 5) compared to 35% for the sentences (Outcome 3).

          • for linguistic prosody, , 55% of the Ps had a problem with the Vowel task (Outcome 6) compared to 35% for the sentences (Outcome 4).

  What was the statistical test used to determine significance?

• Mann-Whitney U

•  Spearman

∞  Were effect sizes provided?   Yes

• OUTCOME #1: Performance on Scale (pitch) portion of the MBEA

     ∞ d = 1.04 (large effect)

• OUTCOME #5:  Performance on Emo Vowel task (accuracy of identifying emotions and the intensity of the emotions)

     ∞ d = 1.11 (large effect)

• OUTCOME #6:  Performance on Lin Vowel task [accuracy of identifying the intention (question, order, neutral/statement) 

     ∞ d = 1.11 (large effect)

∞  Were confidence interval (CI) provided?  No

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

12.  Summary of descriptive results:  Qualitative research. NA

13.  Brief summary of clinically relevant results:  

• Ps with TBI performed significantly more poorly on tasks measuring amusia as well as comprehension of affective and linguistic prosody.

• Ps with TBI were more likely to exhibit problems understanding affective and/or linguistic prosody than they were to exhibit amusia. That is, prosodic comprehension is more vulnerable than music processing following a TBI.

• Although not all Ps with TBI exhibited pathological music, affective prosody, and linguistic prosody, a large percentage of them did.

• Clinicians should consider assessing affective prosody, linguistic prosody, and music processing in Ps with TBI.

ASSIGNED GRADE FOR QUALITY OF EXTERNAL EVIDENCE:  NA

============================================================


Gravelin & Whitfield (2019)

August 11, 2020

ANALYSIS GUIDELINES

Comparison/Nonintervention Research

KEY:

eta =   partial eta squared

f = female

m = male

MLU = mean length of utterance

NA = Not Applicable

P = participant or patient

PD = Parkinson disease

pmh = Patricia Hargrove, blog developer

SLP = speech-language pathologist

sps syllables per second

WNL = within normal limits

 

SOURCE: Gravlin, A. C., & Whitfield, J. A. (2019). Effect of Clear Speech on the duration of silent intervals at syntactic and phonemic boundaries in the speech of individuals with Parkinson disease. American Journal of Speech-Language Pathology, 28, 793-806.

 

REVIEWER(S): pmh

 

DATE:  August 10, 2020

 

ASSIGNED GRADE FOR OVERALL QUALITY: no grade assigned; this is not an intervention investigation

 

TAKE AWAY: Comparisons of silent durations in speakers with Parkinson disease (PD) and neurotypical controls in habitual and Clear Speech speaking conditions revealed some similarities. The findings suggest that PD speakers do change their speech production patterns when attempting to use Clear Speech. This may provide guidance to clinicians considering targeting Clear Speech when working with individuals with PD.

 

  1. What type of evidence was identified?

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

What was the focus of the research? Clinically Related

– What was the level of support associated with the type of evidence? B+

                                                                                                           

  1. Group membership determination:

– If there were groups, were participants randomly assigned to groups? No

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

                                                                    

  1. Were experimental conditions concealed?

– from participants? No                                                                     

– from administrators of experimental conditions? No

– from analyzers/judges? No

 

  1. Were the groups adequately described? Yes

– How many participants were involved in the study?

  • total # of participants (Ps): 20
  • # of groups: 2
  • List names of groups and the number of Ps in each group:

     – speakers with PD (PD group) = 10

– control group (C group) = 10

  • Did all groups maintain membership throughout the investigation? Yes

CONTROLLED CHARACTERISTICS                                                     

  • gender: each group m = 5; f = 5
  • cognitive skills: “all” Ps within normal limits (WNL) on dementia screener (unclear whether is all PD and C Ps or just PD)
  • first language language: English
  • residence: USA Midwest
  • Hearing: all Ps WNL

DESCRIBED CHARACTERISTICS

  • age:

     PD = average 67 years (64-77 years)

     C = average 69 years (64-76 years)

  • educational level of clients:
  • medications: 9 of 10 Ps in PD group were taking carbidopa levodopa; 1 P in the PD group was taking Requipt; Ps in PD group were also taking other medications; all Ps from the PD groups were on medications at the time of testing
  • Diagnosis:

PD = idiopathic PD

     C = neurotypical

  • previous speech therapy: No P had received speech or voice therapy for 2 years
  • time since diagnosis: timing of PD diagnosis ranged from 2 to 11 years prior 

–  Were the groups similar? Unclear

  Were the communication problems adequately described? Yes

  • disorder type: hypokinetic dysarthria all 12 PD group 3 Ps also were hyperkinetic
  • functional level: severity of dysarthria ranged from mild to severe

 

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

     – Parkinsons disease (P)

     – Control (C)

  • Experimental Conditions? Yes

     – Reading aloud using comfortable rate and loudness (habitual)

     – Reading aloud as clearly as possible (Clear Speech)

  • Criterion/Descriptive Conditions? No

 

  1. Were the groups controlled acceptably? Yes

 

  1. Were dependent measures appropriate and meaningful? Yes
  • OUTCOME #1: mean speaking rate in syllables per second (sps)
  • OUTCOME #2: inter-sentence silent duration
  • OUTCOME #3: intra-sentence silent duration
  • OUTCOME #4: between-word silent duration
  • OUTCOME #5: within-word silent duration
  • OUTCOME #6: combined between- and within-word silent durations preceded by fricatives
  • OUTCOME #7: combined between- and within-word silent durations preceded by sonorants
  • OUTCOME #8: combined between- and within-word silent durations preceded by stops

 

– The dependent measures were subjective were

  • OUTCOME #2: inter-sentence silent duration
  • OUTCOME #3: intra-sentence silent duration
  • OUTCOME #4: between-word silent duration
  • OUTCOME #5: within-word silent duration
  • OUTCOME #6: combined between- and within- word silent durations preceded by fricatives
  • OUTCOME #7: combined between- and within- word silent durations preceded by sonorants
  • OUTCOME #8: combined between- and within- word silent durations preceded by stops

–  The dependent/ outcome measure that was objective was

  • OUTCOME #1: mean speaking rate in sps

 

  1. Were reliability measures provided?
  • Interobserver for analyzers? Yes. For overall syntactic boundary judgments inter-observer reliability was 90%.
  • Intraobserver for analyzers? Yes. For overall syntactic boundary judgments intra-observer reliability was 93%.
  • Treatment or test administration fidelity for investigators? No

 

  1. Description of design:

– Ten Ps with PD and 10 neurotypical age-matched peers  \(C) participated in the investigation.

– The Ps read aloud a passage in 2 conditions:

∞ habitual speech and

∞ Clear Speech

– The investigators measured overall speech rate and silent durations. The silent durations were measured in several contexts:

∞ between sentence boundaries,

∞ within sentence boundaries,

∞ between words, and

∞ within words.

– The investigators also analyzed the silent duration with respect to the manner of articulation of the speech sound that followed the silence:

∞ stop,

∞ fricative, and

∞ sonorant.

– The investigators compared performance in the Habitual and Clear Speech conditions as well as the performance of the PD and C groups.

 

  1. What were the results of the statistical (inferential) testing?

Only the comparisons that are significant  (e.g.,  p ≤ 0.05) are listed

RATE

  • OUTCOME #1: mean speaking rate in syllables per second (sps)

– No significant difference overall speaking rate for PD versus C groups.

– C Ps reduce speaking rate significantly between habitual and Clear Speech (Clear Speech was slower) but PD Ps rate for the 2 contexts was not significantly different.

LINGUISTIC BOUNDARIES

  • OUTCOME #2: inter-sentence silent duration

     – For Control Ps

∞ in the habitual condition duration of inter-sentence silences was significantly longer than

  • intra-sentence silences,
  • between word silences, and
  • within word silences.

– For PD Ps, although the pattern for habitual condition was similar to the Control Ps, none of the differences were significant.

– For C Ps, the comparison of habitual to Clear Speech silences revealed

∞ there was a significant increase in duration of silences at the inter-sentence boundary.

∞ the silent duration increases for all other boundaries (intra-sentence, word, intra-word) were significantly smaller than the increase for the inter-sentence boundary,

– The comparison of PD versus C speakers in the habitual and Clear Speech conditions indicated

∞ the PD speakers produced significantly smaller increases at the inter-sentence boundary than the Cs when comparing habitual and Clear Speech conditions.

– For PD Ps, the comparison of habitual to Clear Speech silences revealed

∞ there was a significant increase in duration of silences at the inter-sentence boundary.

∞ PD speakers’ increase in silence duration related to the habitual versus Clear Speech condition was significantly smaller for the inter-sentence boundaries.

 

  • OUTCOME #3: intra-sentence silent duration

– For C Ps, the comparison of habitual to Clear Speech silences revealed

∞ there was a significant increase in duration of silences at the intra-sentence boundary for Clear Speech.

– For PD Ps, the comparison of habitual to Clear Speech silences revealed

∞ there was a significant increase in duration of silences at the intra-sentence boundary.

 

  • OUTCOME #4: between-word silent duration

– For C Ps, the comparison of habitual to Clear Speech silences revealed

∞ there was a significant increase in duration of silences at the between-word boundary for Clear Speech.

– For PD Ps, the comparison of habitual to Clear Speech silences revealed

∞ there was a not significant increase in duration of silences at the between-word boundary.

– The comparison of PD versus C speakers in the habitual and Clear Speech conditions indicated

∞ PD speakers’ increase in silence duration related to the habitual versus Clear Speech condition was significantly smaller than the C speakers..

 

  • OUTCOME #5: within-word silent duration

– For C Ps, the comparison of habitual to Clear Speech silences revealed

∞ there was a significant increase in duration of silences at the within-word boundary for Clear Speech.

– For PD Ps, the comparison of habitual to Clear Speech silences revealed

∞ there was a significant increase in duration of silences at the within-word boundary.

      – The comparison of PD versus C speakers in the habitual and Clear Speech conditions indicated

∞ PD speakers’ increase in silence duration related to the habitual versus Clear Speech condition was significantly smaller than the C speakers.

 

PHONEMIC BOUNDARIES

  • OUTCOME #6: combined between and within words silent durations preceded by fricatives

∞ For both groups (PD and C), in the habitual condition when a stop consonant preceded a silence associated with between or within word pauses, it was significantly long than if the pause was preceded by a fricative or a sonorant.

∞ Overall, C Ps produced significantly longer silences in the Clear Speech condition compared to the habitual condition. For the comparison of Clear Speech productions,

  • silences preceded by stops were significantly longer than silences preceded by fricatives or sonorants.

 

  • OUTCOME #7: combined between and within words silent durations preceded by sonorants

∞ For both groups (PD and C), in the habitual condition when a stop consonant preceded a silence associated with between or within word pauses, it was significantly long than if the pause was preceded by a fricative or a sonorant.

∞ Overall, C Ps produced significantly longer silences in the Clear Speech condition compared to the habitual condition. For the comparison of Clear Speech productions,

  • silences preceded by stops were significantly longer than silences preceded by fricatives or sonorants.

∞ PD Ps produced significantly larger increases in silences from habitual to Clear Speech conditions for pauses that were preceded by sonorants compared to stops or fricatives.

 

  • OUTCOME #8: combined between and within words silent durations preceded by stops

∞ For both groups (PD and C), in the habitual condition when a stop consonant preceded a silence associated with between or within word pauses, it was significantly long than if the pause was preceded by a fricative or a sonorant.

∞ Overall, C Ps produced significantly longer silences in the Clear Speech condition compared to the habitual condition but

  • silences preceded by stops were significantly longer than silences preceded by fricatives or sonorants.

∞ Comparing C and PD groups, PD Ps produced significantly shorter silences for pauses preceded by stops in the Clear Speech condition.

– What were the statistical tests used to determine significance? t-test, ANOVA, Linear-mixed model analysis

– Were effect sizes provided? No 

– Were confidence interval (CI) provided? No

 

  1. Summary of correlational results: NA

 

  1. Summary of descriptive results: Qualitative research. —NA

 

  1. Brief summary of clinically relevant results:
  • The purpose of this investigation was to explore the duration of silences at selected linguistic and phonemic boundaries of participants (Ps) with PD and their neurotypical controls (C) when speaking in habitual and Clear Speech conditions.
  • Both groups of speakers increased the duration of silences at linguistic boundaries in the Clear Speech condition compared to the habitual condition.
  • There were differences between the PD and C groups with respect to the changes at the linguistic boundaries with the PD group tending to produce fewer and shorter increases than the C group.
  • While the C group routinely showed changes at the phonemic boundaries, PD speakers’ changes were less robust.
  • Clinicians may consider using Clear Speech to facilitate the use of pauses (particularly inter-sentence pauses) in the speech of speakers with P.
  • When measuring progress or change in speakers with PD, clinicians should temper the use of metrics such as speaking rate because

– there was not a significant difference between PD and C speakers overall speaking rate and

– PD speakers did not regularly modulate rate in the habitual as opposed to Clear Speech conditions.

 

ASSIGNED GRADE FOR QUALITY OF EXTERNAL EVIDENCE: B+

 


Patel et al. (2020)

March 28, 2020

 

ANALYSIS

Comparison Research

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

KEY:

ADOS = Autism Diagnostic Observation Scale

BAP = Broad Autism Phenotype

eta = partial eta squared

f = female

F0 = fundamental frequency

m = male

MLU = mean length of utterance

MPAS = Modified Personality Assessment Schedule (MPAS)

NA = Not Applicable

P = participant or patient

pmh = Patricia Hargrove, blog developer

PSA = Pragmatic Rating Scale

PSA-SA = Pragmatic Rating Scale-School Age

SD = standard deviation

SLP = speech-language pathologist

 

SOURCE:  Patel, S. P., Nayer, K., Martin, G. E., Franich, K., Crawford, S., Diehl, J. J., & Losh, M. (2020). An acoustic characterization of prosodic differences in autism spectrum disorder and first-degree relatives. Journal of Autism and Developmental Disorders https://doi.org/10.1007/s10803-020-04392-9

REVIEWER(S):  pmh

 

DATE:  March 19, 2020

 

ASSIGNED GRADE FOR OVERALL QUALITY:  Not Applicable (NA). No grade was assigned because this investigation did not deal with intervention.

 

TAKE AWAY:  This investigation explored the acoustic characteristics of communication of children with autism spectrum disorders (ASD) and their parents by comparing them to neurotypical peers and their parents. Significantly slower speaking rate was observed in both the participants with ASD and their parents.

 

  1. What type of evidence was identified?
  • What was the type of design?Comparison Research
  • What was the focus of the research? Clinically Related
  • What was the level of support associated with the type of evidence? Level = C+

                                                                                                           

  1. Group membership determination:
  • . If there were groups, were participants randomly assigned to groups? No
  • If there were groups and Ps were not randomly assigned to groups, were members of groups carefully matched?  Unclear

     –  The chronological age of the children with ASD and their neurotypical peers was not significantly different. However, there were significant difference for the following measures

∞ Full scale IQ

∞ Verbal IQ

∞ Performance IQ

∞ male to female ratio

–  The ASD parent group and the Parent control group differed significantly on the following measures

∞ Chronological age (the ASD parent group was older)

∞ Verbal IQ

                                                                    

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

                                                                    

  1. Were the groups adequately described? Yes

   How many participants were involved in the study?

  • total # of Ps: 238
  • # of groups: 4
  • List names of groups and the number of Ps in each group:

     – ASD Group = 55

– ASD Control Group (neurotypical) = 39

– ASD Parent Group = 96

– Parent Control Group = 48

  • Did all groups maintain membership throughout the investigation? Yes, but data from one adolescent and one parent were discarded due to poor quality of the recordings.

 

CONTROLLED CHARACTERISTICS                                                     

  • Diagnosis:

     – ASD Group = all diagnosed with ASD and confirmed

     – ASD Control Group and Parent Control Group = ASD ruled out for all Ps and no family history (1stand 2nd degree relatives) of ASD or related genetic disorders, dyslexia,

  • Other Diagnoses:

     – All Ps = no history of brain injury, major psychiatric disorders, genetic disorders, neurotypical development

 

DESCRIBED CHARACTERISTICS

  • age:

     – ASD Group:  mean = 16.6

     – ASD Control Group:  mean = 19

     – ASD Parent Group:  mean = 46.7

     – Control Parent Group:  mean = 43

  • gender:

    – ASD Group:  45m; 10f

     – ASD Control Group: 19m; 20f

     – ASD Parent Group:  38m; 58f

     – Control Parent Group: 20m; 28f

  • cognitive skills:

     – ASD Group:

∞ mean Full scale IQ = 104.2

∞ mean Verbal IQ = 105.1

∞ mean Performance IQ =  102.9

     – ASD Control Group:

∞ mean Full scale IQ = 115.5

∞ mean Verbal IQ = 117.5

∞ mean Performance IQ = 111.1

     – ASD Parent Group:

∞ mean Full scale IQ = 111.1

∞ mean Verbal IQ = 109.4

∞ mean Performance IQ = 110.4

     – Control Parent Group:

∞ mean Full scale IQ = 114.8

∞ mean Verbal IQ = 111.2

∞ mean Performance IQ = 115.1

 

  • Were the groups similar?Unclear  
  • Were the communication problems adequately described?No 
  • disorder type: Autism Spectrum Disorder (ASD)

 

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

     – ASD Group:

     – ASD Control Group:

     – ASD Parent Group:

     – Control Parent Group:

  • Experimental Conditions? No  x_____     Unclear ____, there was only one condition in which the speech samples were elicited– Narratives
  • Criterion/Descriptive Conditions?Yes

Acoustic Measures: mean, standard deviation (SD), and range of the fundamental frequency (F0) for each utterance, utterance final F0 excursion size (F0 range of the final word0 of each utterance; rate (syllables per second including within utterance pauses); Normalized Pairwise Variability Index (nPVI, for rhythm)

     –  Clinical Behaviors (for Correlations):

–  Broad Autism Phenotype (BAP) Characteristics—Modified Personality Assessment Schedule (MPAS)

–  Pragmatic Language Ability — Pragmatic Rating Scale (PSA) Pragmatic Rating Scale-School Age (PSA-SA)

–  Perceptual Judgments: rating on a 11-point Likert Scale for each of the following

–  Intonation

–  Rate

–  Rhythm

–  Likelihood the speaker had ASD

 

  1. Were the groups controlled acceptably?  Yes

 

  1. Were dependent measures appropriate and meaningful? Yes

 

ACOUSTIC MEASURES

  • OUTCOME #1: Mean F0 for each utterance selected from a narrative sample
  • OUTCOME #2: Mean utterance final F0 excursion size for each utterance selected from a narrative sample
  • OUTCOME #3: SD of the F0 for each utterance selected from a narrative sample
  • OUTCOME #4: Range of the F0 for each utterance selected from a narrative sample
  • OUTCOME #5: Speech rate from a narrative sample
  • OUTCOME #6: nPVI from a narrative sample

 

CLINICAL BEHAVIORAL MEASURES

  • OUTCOME #7: Rating as BAP+ or BAP- on the basis of P performance on the MPAS scales of Social, Rigid, or Untactful Traits
  • OUTCOME #8: Performance on the Autism Diagnostic Observation Scale (ADOS)
  • OUTCOME #9: Performance on the Pragmatic Rating Scale (PSA) or the Pragmatic Rating Scale-School Age (PSA-SA)

 

PERCEPTUAL MEASURES

  • OUTCOME #10: Rating of intonation of utterances selected from the narrative
  • OUTCOME #11: Rating of rhythm of utterances selected from the narrative
  • OUTCOME #12: Rating of rate of utterances selected from the narrative
  • OUTCOME #13: Rating of likelihood the speaker had been diagnosed with ASD

 

LANGUAGE MEASURE

  • OUTCOME #14: Utterance length (number of syllables per utterance)

 

—  The following outcomes measures are subjective:

CLINICAL BEHAVIORAL MEASURES

  • OUTCOME #7: Rating as BAP+ or BAP- on the basis of P performance on the MPAS scales of Social, Rigid, or Untactful Traits
  • OUTCOME #8: Performance on the Autism Diagnostic Observation Scale (ADOS)
  • OUTCOME #9: Performance on the Pragmatic Rating Scale (PSA) or the Pragmatic Rating Scale-School Age (PSA-SA)

 

PERCEPTUAL MEASURES

  • OUTCOME #10: Rating of intonation of utterances selected from the narrative
  • OUTCOME #11: Rating of rhythm of utterances selected from the narrative
  • OUTCOME #12: Rating of rate of utterances selected from the narrative
  • OUTCOME #13: Rating of likelihood the speaker had been diagnosed with ASD

 

LANGUAGE MEASURES

  • OUTCOME #14: Utterance length (number of syllables per utterance)

 

–  The following outcomes are objective measures:

ACOUSTIC MEASURES

  • OUTCOME #1: Mean F0 for each utterance selected from a narrative sample
  • OUTCOME #2: Mean utterance final F0 excursion size for each utterance selected from a narrative sample
  • OUTCOME #3: SD of the F0 for each utterance selected from a narrative sample
  • OUTCOME #4: Range of the F0 for each utterance selected from a narrative sample
  • OUTCOME #5: Speech rate from a narrative sample
  • OUTCOME #6: nPVI from a narrative sample

 

  1. Were reliability measures provided?

   Interobserver for analyzers?  Yes _x__     No  ___      Unclear  ____

CLINICAL BEHAVIORAL MEASURES

  • OUTCOME #7:Rating as BAP+ or BAP- on the basis of P performance on the MPAS scales of Social, Rigid, or Untactful Traits—Inter-rater reliability 81%
  • OUTCOME #8:Performance on the Autism Diagnostic Observation Scale (ADOS)
  • OUTCOME #9: Performance on the Pragmatic Rating Scale (PSA) or the Pragmatic Rating Scale-School Age (PSA-SA) —Inter-rater reliability 86% and 76%, respectively

 

–  Intraobserver for analyzers?

–  Treatment or test administration fidelity for investigators?  No

 

  1. Description of design:
  • A total of 238 Ps representing the following groups the ASD Group, ASD Control Group, ASD Parent Group, and Control Parent Group participated in the investigation.
  • The investigators administered the MPAS and the PRS or the PRS-SA to all the Ps. In addition, the investigator elicited narrative language samples from which they measured selected utterances acoustically and perceptually.
  • The data were analyzed using inferential and correlational statistics including regression analysis.

 

 

 

 

  1. What were the results of the statistical (inferential, regression analysis) testing?

 

10a  List comparisons that are significant  (e.g.,  p ≤ 0.05).  For each outcome, list any significant difference among comparisons or in the case of the use of descriptive statistics only, list any notable differences or trends. Note if you do not use ≤ 0.05 as your criterion.

 

Start on page BAP GROUP DIFFERENCES. Id bap in description of design

 

 

ACOUSTIC MEASURES

  • OUTCOME #1: Mean F0 for each utterance selected from a narrative sample—ASD Parent Group was significantly lower than Parent Control Group; mothers in the Parent ASD group were significantly lower than mothers in Parent Control Group
  • OUTCOME #2: Mean utterance final F0 excursion size for each utterance selected from a narrative sample—overall ASD Group produced a larger change; male ASD Ps produced a larger change than male ASD Controls
  • OUTCOME #3: SD of the F0 for each utterance selected from a narrative sample
  • OUTCOME #4: Range of the F0 for each utterance selected from a narrative sample—ASD Parent Group was significantly higher than Parent Control Group; mother in ASD Parent Group had significantly larger range than mother in the Parent Control Group
  • OUTCOME #5: Speech rate from a narrative sample —Overall ASD Group produced slower; male ASD Ps produced slower rate than ASD Controls; ASD Parent group showed more slowing as the utterance length increasd (Outcome 14)
  • OUTCOME #6:nPVI from a narrative sample

 

CLINICAL BEHAVIORAL MEASURES

  • OUTCOME #7:Rating as BAP+ or BAP- on the basis of P performance on the MPAS scales of Social, Rigid, or Untactful Traits
  • OUTCOME #8:Performance on the Autism Diagnostic Observation Scale (ADOS)
  • OUTCOME #9: Performance on the Pragmatic Rating Scale (PSA) or the Pragmatic Rating Scale-School Age (PSA-SA)

 

PERCEPTUAL MEASURES

  • OUTCOME #10:Rating of intonation of utterances selected from the narrative—ASD Ps were rated significantly more poorly than the ASD Control Ps;
  • OUTCOME #11:Rating of rhythm of utterances selected from the narrative
  • OUTCOME #12:Rating of rate of utterances selected from the narrative—rate and the likelihood the P had ASD (Outcome 13) most significantly predicted the diagnosis of ASD

 

  • OUTCOME #13:Rating of likelihood the speaker had been diagnosed with ASD—Expert listeners were more likely to accurately identify Ps from the ASD Group as having ASD; nonexpert listeners did not do this; this outcome and rate perception (Outcome 12 ) most significantly predicted the diagnosis of ASD

 

LANGUAGE MEASURES

  • OUTCOME #14:Utterance length (number of syllables per utterance). ASD Parent group showed more slowing (Outcome 5)  as the utterance length increased

 

 

 

 

 

 

  • OUTCOME #1:
  • OUTCOME #2:
  • OUTCOME #3:

 

(add additional outcomes as appropriate)

 

10b  What was the statistical test used to determine significance?  Place xxx after any inferential statistical test used in the investigation.

  • t-test:
  • ANOVA:
  • MANOVA:
  • Tukey: xxxx
  • Mann-Whitney U:
  • Wilcoxan:
  • Regression Analysis xxxx
  • . Kappa Values xxxx

 

10c  Were effect sizes provided?

Yes ____  No__x__

If yes, provide data and interpretation for any outcome with effect size results.

Interpretation Hints:

–  Cohen’s (1988) guidelines for interpreting standardized mean difference: d =  .20 small treatment effect; d = .50 moderate treatment effect; d =  .80 large treatment effect

–  for partial eta squared (eta):  .01 small, .06 is medium, and .14 is large.

 

  • OUTCOME #1:
  • OUTCOME #2:
  • OUTCOME #3:

 

(add additional outcomes as appropriate)

 

10d  Were confidence interval (CI) provided?  Yes ___          No __x__

 

10e  If the answer to 10d was yes, list the dependent measure (from item 7a) associated with the reported confidence interval (CI):

  • 98% CI:
  • 95% CI:
  • 90%
  • Other (List CI%):

 

 

  1. Summary of correlational results: for the most part these appeared to be the Pearson correlations. xxx

  –  For any outcomes associated with correlational statistics, list the following:

  • The name of the correlational test
  • The correlational data
  • The interpretation of the correlation

 

  • The following associations were significantly correlated:

  –  F0 variability [SD of F0 (Outcome 3) and FO utterance final excursion (Outcome 2)] with

     ∞  perceived intonation (Outcome 10)

     ∞  perceived rhythm (Outcome 11)

     ∞  perceived rate (Outcome 12)

  –  range of F0 (Outcome 4) with perceived intonation (Outcome 10)

  –  rate of speech (Outcome 5) with perceived rate (Outcome 12) and perceived

rhythm (Outcome 11)

  –  A subgroup of ASD Parents, labeled BAP+, presented with a significant interaction between speaking rate and utterance length. The BAP+ subgroup of ASD Parents differed significantly from the Parent Control Group. (BAP+ , or Broad Autism Phenotype, was determined by parents’ performance on subtests of the MPAS indicating the presence of the following traits: socially reticent, rigid and untactful.)

 

  –  The following associations between acoustic measures, severity of ASD, and pragmatics were found to be significant:

        ∞  in the ASD Group

  • decreased rate of speech with (1) overall severity, (2) severity of social symptom, (3) greater impairment on the Theory of Mind on the PSA-SA
  • greater impairment on the Theory of Mind on the PSA-SA with (1)  decreased rate of speech, (2) increased F0 range

 

        ∞  in the ASD Control Group

  •   increased F0 ranges with (1) greater impairment on the Theory of Mind on the PSA-SA, (2) greater impairment on suprasegmental on the PSA-SA
  • decreased rate of speech with increased score on the ADOS
  • F0 excursion with (1)  the severity of restrictive and repetitive behaviors, especially in males, (2) increased language impairment as measured by the PSA-SA

 

        ∞  in the ASD Parent Group

  • increased  nPVI was correlated with overall pragmatic violations on the PSA (such as overly detailed, tangential)
  • decreased F0 ranges was correlated with pragmatic violations on the PSA (such as lack of reciprocity, vaguness), especially in mothers

 

 

START WITH ASD PARENTS AND PARENT CONTROL

  1. Summary of descriptive results: Qualitative research.  NA

 

 

DIRECTIONS:

–  Complete this item only if the investigation was solely or primarily Qualitative in nature.

–  List the finding associated with each of the outcomes listed in item 7a.

 

  • OUTCOME #1:
  • OUTCOME #2:
  • OUTCOME #3:

 

(add other outcomes as appropriate)

 

 

  1. Brief summary of clinically relevant results:

 

  • The following acoustic measure may differentiate individuals with ASD and neurotypical peers as well as the subgroup of BAP from the Parent Control Group: the rate of speech (slower).

 

  • Mother of children with ASD who were labelled as BAP displayed mean and range differences in F0:

–  decreased F0 mean

–  wider F0 range

 

 

ASSIGNED GRADE FOR QUALITY OF EXTERNAL EVIDENCE: ___NA__

 

============================================================

 


Morgan & Ferguson (2017)

December 24, 2019

ANALYSIS GUIDELINES

Comparison/Nonintervention Research

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

KEY:

eta =   partial eta squared

HI =  hearing impairment

MLU = mean length of utterance

NA = Not Applicable

P = participant or patient

pmh = Patricia Hargrove, blog developer

SLP = speech-language pathologist

WNL =  within normal limits

YNH = Young Adults with Normal Hearing

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

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

 

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

 

REVIEWER(S): pmh

 

DATE:December 17, 2019

 

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

 

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

 

 

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

                                                                                                           

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

                                                                                                           

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

                                                                    

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

 

  1. Were the groups adequately described? Yes

–   How many participants were involved in the study?

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

     –  YNH total =  28

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

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

–  OHI =  20

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

 

CONTROLLED CHARACTERISTICS                                                   

  • age:

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

     –  OHI =  greater than 65 years

 

  • cognitive skills:

     –  YNH =  within normal limits (WNL

     –  OHI = 

  • native language:

     –  YNH =  all native speakers of American English

     –  OHI =  all native speakers of American English

  • Socio-economic status:

     –  YNH

     –  OHI

  • educational level of clients:

     –  YNH

     –  OHI =  students in a University Psychology Participant Pool

  • speech or language disorders:

     –  YNH = no history

     –  OHI = no history

  • speech or language therapy:

     –  YNH = no history

     –  OHI = no history

  • Word recognition skills:

     –  OHI =  greater than 80% 

  • Hearing:

     –  YNH =   WNL by self report

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

 

–  DESCRIBED CHARACTERISTICS

  • age:

     –  YNH1  = 18 to 33 years

     –  YNH2  = 18 to 30 years

     –  OHI =  65 – 78 years

  • Word recognition skills:

     –  YNH  =  average was 93%

 

–  Were the groups similar?  No

                                                         

–  Were the communication problems adequately described?

Yes ___      No  _x__      Unclear ____   NA ____x___

 

  • disorder type: Hearing Impaired  

 

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

–  YNH listeners

–  OHI listeners

 

  • Conditions?Yes

–  Sentences (14)

–  Speaking Style (Conversation, Clear Speech)

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

 

*  Criterion/Descriptive Conditions?  No 

 

  1. Were the groups controlled acceptably?  Yes

 

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

 

 

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

 

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

 

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

 

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

 

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

 

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

–  anger,

–  fear,

–  disgust,

–  sadness,

–  happiness, or

–  neutral.

 

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

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

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

∞ anger

∞  fear

∞  sadness

∞  happiness

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

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

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

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

(add additional outcomes as appropriate)

 

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

 

  • Were effect sizes provided?No____

 

  • Were confidence interval (CI) provided?No

 

  1. Summary of correlational results:  NA

 

  1. Summary of descriptive results: Qualitative research  NA

 

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

 

ASSIGNED GRADE FOR QUALITY OF EXTERNAL EVIDENCE: Not graded


McWhirter et al. (2019)

November 20, 2019

ANALYSIS GUIDELINES

Comparison/Nonintervention Research

KEY: 

eta =   partial eta squared

HADS =  portion of the survey focusing on depression and anxiety characteristics

MLU = mean length of utterance

modified IPQ-R =  portion of the survey that focused on perceptions of illness

NA = Not Applicable

P = participant or patient

PHQ-15 =  portion of the survey focusing on somatic characteristics (PHQ-15),

pmh = Patricia Hargrove, blog developer

SLP = speech-language pathologist

WSAS =  portion of the survey focusing on depression and anxiety characteristics (HADS),

 

SOURCE:  McWhirter, L., Miller, N., Campbell, C., Hoeritzaur, I., Lawton, A., Carson, A., & Stone, J. (2019). Understanding foreign accent syndrome. Journal of Neurology, Neurosurgery & Psychiatry, pp. jnnp-2018-319842.   DOI: 10.1136/jnnp-2018-319842

REVIEWER(S): pmh

DATE:  November 17, 2019

ASSIGNED GRADE FOR OVERALL QUALITY:  Not Applicable (NA, this is not an intervention study.) 

TAKE AWAY: This investigation into the nature Foreign Accent Syndrome (FAS) primarily focuses on the characteristics of functional and structural FAS in participants (P) who self-reported as having FAS. The results indicated that investigators were able to identify participants with functional FAS with 85% accuracy  from audiorecordings. In addition, the investigators identified some P characteristics that were more often observed in Ps one or the other subtype of FAS.

  1. What type of evidence was identified?
  • What was the type of design? Comparison Research
  • What was the focus of the research? Clinically
  • What was the level of support associated with the type of evidence? Level = not graded because this is not intervention research.

                                                                                                           

  1. Group membership determination:
  • If there were groups, were participants randomly assigned to groups? Not Applicable (NA), there was only one group.

 

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

                                                                    

  1. Was the group adequately described?  Yes 

  How many participants were involved in the study?

  • total # of Ps: 49
  • # of groups: 1

          ∞ Initial Group:  n =  49

          ∞  Subgroup (of Ps who submitted audiorecordings):  n = 13

  • Did all groups maintain membership throughout the investigation? NA

 

CONTROLLED CHARACTERISTICS:                                        

  • age: over 18 years of age
  • diagnosis:answered “Yes” when Ps asked if they believed they had FAS.

– DESCRIBED CHARACTERISTICS

  • age:49 (mean); 24-72 (range)
  • gender:female:male ratio = 6:1
  • Onset:Sudden (67%); Gradual (33%) 
  • Median symptom duration:3.25 years; .2 to 18 years range)

–  Were the groups similar?  NA                                                         

–  Were the communication problems adequately described?  Yes

  • disorder type: Foreign Accent Syndrome (FAS)—functional or structural

 

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

–  Probably functional FAS (n= 35)

–  Possibly structural FAS (n = 4)

–  Probably structural FAS (n = 10)

  • Criterion/Descriptive Conditions?Yes

– Responses to survey

– Investigators reviews of audiotapes

 

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

 

  1. Were measures appropriate and meaningful? Yes
  • MEASURE #1:Responses to survey questions (number of Ps = 49)
  • MEASURE #2:Investigators review of audiotapes (number of Ps = 13)

 

–  Bothmeasures were subjective.

–  Neither of the measures were objective.

 

  1. Were reliability measures provided?

   Interobserver for analyzers?  Yes _x__, for Measure 2

  • MEASURE #1:  no reliability data but judgments were made by consensus
  • MEASURE #2: 100% agreement

–  Intraobserver for analyzers?  No 

–  Treatment or test administration fidelity for investigators? NA 

 

  1. Description ofdesign:
  • The investigators recruited participants (Ps) from online support groups for FAS.
  • They administered a survey to the 49 volunteers/Ps. The survey focused on the following:

–  clinical features of FAS

–  co-morbidities

–  somatic characteristics (PHQ-15),

– depression and anxiety characteristics (HADS),

–  social/occupational characteristics (WSAS), and

–  perceptions of illness (modified (IPQ-R).

  • The investigators also requested audiorecordings of the Ps reading the Rainbow Passage and spontaneously describing the Cookie Theft Picture. Thirteen Ps complied with this request.
  • The investigators reviewed the survey results by having 3 of the investigators discuss and classify by consensus each of the Ps into one of the following categories:

–  probably functional FAS,

–  possibly structural FAS, or

–  probably functional FAS.

  • Two of the investigators reviewed the audiorecordings and classified by consensus each of the audiorecordings as

–  probably functional FAS,

–  possibly structural FAS, or

–  probably functional FAS.

  • The results were analyzed descriptively.

 

  1. What were the results of the statistical (inferential) testing? NA (not provided)

 

  1. Summary of correlational results: NA (not provided)

 

  1. Summary of descriptive results: Qualitative research

 

  • MEASURE #1:Responses to survey questions (number of Ps = 49)

–  Regarding the categorization:

∞  71% (35) of the Ps were classified as probably functional,

∞  8% (4) of the Ps were classified as possibly structural, and

∞  20% (10) of the Ps were classified as probably structural.

–  Although 43 of the Ps underwent some form of brain imaging, only 5 (all Probably Structural) reported site of lesion was identified.

–  Accents from many different languages were self-reported as well as immature speech patterns, stuttering, and paraphasia.

–  Overall, almost half of the Ps reported some remission of the FAS.

–  About 1/3 of the Ps reported syntax/grammatical changes (50% of the Probably Structural category reported this).

 

  • MEASURE #2:Investigators review of audiotapes (number of Ps = 13)

–  Two judges who were blinded to the categorization of the Ps reviewed the audiotapes. Their judgments were in agreement with one another and these judgments agreed with the categorizations for 11 (85%( of the 13 audiorecordings.

–  The investigators identified speech behaviors that appeared to be associated with functional FAS:

∞ Speech characteristics that were not associated with a structural abnormality (e.g., the P presented with a problem producing tongue-tip sounds but the tongue tip elevated normally  and there was no apraxia, dysarthria, or incoordination.

∞  There was inconsistency of speech sound production but the inconsistencies were not linked to issues such as syllable complexity or the phonotactic probability.

∞  Changes in speech patterns not typically associated with neurological conditions (e.g.,  immature prosody, substituting foreign words while speaking in the core language) were observed.

∞  The investigators provided a table (Table 3) that described the speech characteristics associated with functional FAS and structural FAS.

∞  According to the investigators, the following prosodic features differentiate structural and functional FAS:

FUNCTIONAL FAS

  • Pitch/Intonations changes are excessive. These changes can be on a stressed word or can be perceived to be inconsistent.
  • Pauses occur in inappropriate syntactical, articulatory, or respiratory

 

  1. Brief summary of clinically relevant results:
  • Those who consider themselves as having FAS may fall into one of 3 categories:

–  Probably functional

–  Possible structural

–  Probably structural

  • However, structural FAS can occur with some features of functional FAS.
  • Although prosody disturbance is a characteristic of FAS it is not the sole characteristic. That is, FAS speakers present with an array of segmental and suprasegmental characteristics; prosody is only one of them.

 

ASSIGNED GRADE FOR QUALITY OF EXTERNAL EVIDENCE:  Not graded

 

============================================================

 


Fairbanks (1960, Ch. 11., Pitch Variability)

October 16, 2019

CRITIQUE OF UNSUPPORTED PROCEDURAL DESCRIPTIONS

(also known as Expert Opinion)

KEY
C =  clinician

NA = not applicable

P =  patient or participant

pmh =  Patricia Hargrove, blog developer

SLP = speech-language pathologist

 

Source:  Fairbanks, G. (1960, Ch. 11, Pitch Variability)  Voice and articulation drillbook.  New York: Harper & Row.  (pp. 129-132)

 

Reviewer(s):  pmh

 

Date:  October 9, 2019

 

Overall Assigned Grade:  Not Graded.  The Assigned Overall Grade reflects the quality of the evidence supporting the intervention and does not represent a judgment regarding the quality of the intervention.

 

Level of Evidence:  F = Expert Opinion, no supporting evidence for the effectiveness of the intervention although the author may provide secondary evidence supporting components of the intervention.

 

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

 

 

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

 

  1. Were the specific procedures/components of the intervention tied to the reviewed literature? Not Applicable (NA)

 

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

 

  1. Did the authors provide a rationale for components of the intervention? Variable

 

  1. Description of outcome measures:

 Are outcome measures suggested? Yes

 

  • Outcome #1: Producing speech with the best pitch level and variability
  • Outcome #2: Producing speech with the pitch level and variability that is appropriate to the emotion of the speaker

 

  1. Was generalization addressed? No

 

  1. Was maintenance addressed? No

 

SUMMARY OF INTERVENTION

 

PURPOSE: To produce speech using appropriate pitch variability

 

POPULATION:  Adults

 

MODALITY TARGETED: production

 

ELEMENTS/FUNCTIONS OF PROSODY TARGETED:  pitch variability, affective prosody

 

ELEMENTS OF PROSODY USED AS INTERVENTION:  rate, pitch level, pitch range

 

DOSAGE: NA

 

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

 

MAJOR COMPONENTS:

 

  • Fairbanks (1960, Ch. 11, Pitch Variability, pp. 129-132) defines several terms used in this section of the chapter. He also notes that there is not a sharp dividing line between male and female speakers. That is, the high pitches for men and low pitches for women often overlap. In treatment, speakers should target producing

–  a difference of about 2 octaves between the highest and lowest pitches,

–  the number of the pitches above and below the most frequent (modal) pitch gradually decrease as the pitch level moves from modal to above/below modal, and

–  more productions below modal than above.

 

  • Fairbanks notes that if the Participant/Patient (P) has a limited ability to produce a typical total pitch range, attention should be directed to improving the typical total pitch range. However, pitch variability can improve even for Ps with limited total pitch ranges.

 

TREATMENT IDEAS

 

  • The clinician (C) directs P to read aloud the first passage on page 130 four different ways using the best pitch level:

– chanting using a monotone,

–  a narrow range,

– an average range, and

–  a wide range.

The P should be careful to have more than just a few productions of high or low pitches when trying to produce variable pitches.

 

  • P rereads the first passage on page 130 four different ways using the a high pitch level:

– chanting using a monotone,

–  a narrow range,

– an average range, and

–  a wide range.

 

  • P rereads the first passage on page 130 four different ways using the a low pitch level:

– chanting using a monotone,

–  a narrow range,

– an average range, and

–  a wide range.

 

  • P reads the first passage on page 131 at the best pitch level and then increases the pitch variability until P produces a very wide pitch range.

 

  • P rereads the first passage on page 131 at the best pitch level and increasing the pitch variability until P or C judges it to be optimal.

 

  • P rereads the first passage on page 131 at the best pitch level and with very wide variability then decreases pitch variability until P or C judges it to be optimal.

 

  • C provides a passage of factual prose for P to read aloud. The target is

–  best pitch level and

–  optimal variability.

 

  • P gives a short impromptu speech. The target is

–  best pitch level and

–  optimal variability.

 

  • C directs P to read aloud the second passage on page 131 (at the bottom of the page) expressing different emotions using variations of rate, pitch level, and pitch variation:

–  Anger (fast rate, high pitch level, wide range for variability)

–  Fear (fast rate, high pitch level, medium range for variability)

–  Indifference (fast rate, low pitch level, narrow range for variability)

–  Grief (slow rate, low pitch level, narrow range for variability)

–  Contempt (slow rate, low pitch level, wide range for variability)

 

———————————————————————

 


Connaghan & Patel (2013)

September 20, 2019

 

ANALYSIS GUIDELINES

Comparison Research

 KEY:

eta =  partial eta squared

f =  female

GFTA-2 =  Goldman-Fristoe Test of Articulation-2

HC =  healthy controls

m =  male

MLU =  mean length of utterance

MSI =  motor speech impairment

NA =  Not Applicable

P =  participant or patient

pmh =  Patricia Hargrove, blog developer

SLP =  speech-language pathologist

WNL =  within normal limits

  

SOURCE:   Connaghan, K. P., &  Patel, R. (2013).  Impact of prosodic strategies on vowel intelligibility in childhood motor speech impairment.  Journal of Medical Speech-Language Pathology, 20 , 133-139.

 

REVIEWER(S): pmh

 

DATE:September 20, 2019

 

ASSIGNED GRADE FOR OVERALL QUALITY:   No grade assigned. This investigation compared performance of children on 4 tasks and is not considered to be interventional research. However, its findings have implications for intervention.

 

TAKE AWAY: This preliminary investigation explored the vowel production of children with motor speech impairment (MSI) and healthy controls in 4 conditions. Two of the 3 members of the MSI group were perceived to improve vowel intelligibility in at least one of the conditions. In addition, acoustic analysis revealed that participants (Ps) with MSI displayed significantly more F2 variance than the Healthy Control (HC) group.

 

  1. What type of evidence was identified?

                                                                                                             

  • What was the type of design? Comparison Research and Prospective, Nonrandomized Group Design with Controls
  • What was the focus of the research? Clinically Related

           

  1. Group membership determination:

                                                                                                           

  • If there were groups, were Ps randomly assigned to groups? No, the groups were children with motor speech impairment (MSI) and healthy controls (HC); therefore, assignment cannot be random.

 

  • If there were groups and Ps were not randomly assigned to groups, were members of groups carefully matched?Not Applicable (NA)

 

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

 

  1. Were the groups adequately described? Yes

–   How many participants were involved in the study?

  • total # of Ps: 6
  • # of groups:  2
  • List names of groups and the number of Ps in each group:

–  motor speech impairment (MSI) =  3

–  healthy controls (HC) =  3

  • Did all groups maintain membership throughout the investigation? Yes

 

–  CONTROLLED CHARACTERISTICS                                                  

  • age:

     –  HC within 6 months of age of an MSI participant (P)

  • diagnosis:

     –  MSI:  childhood apraxia of speech

     –  HC: free from reported or suspected communication or developmental impairments

 

–  DESCRIBED CHARACTERISTICS

  • age:

     –  MSI:  3;6 to 8;5

     –  HC: 4;1 to 8;10

  • gender:

     –  MSI:   3m

     –  HC:  1m, 2f

  • cognitive skills:

     –  MSI:  developmental delay (1P)

     –  HC:  all within normal limits (WNL)

  • expressive language:

     –  MSI:  expressive language delay (1P)

     –  HC:  all WNL

  • receptive language:

     –  MSI:  receptive language delay (1P)

     –  HC:  all WNL

  • phonology:

     –  MSI:  phonological disorder (1P)

     –  HC:  all WNL

  • Motor skills

     –  MSI:  generalized motor planning impairment (2P)

     –  HC:  all WNL

  • Hearing:

 

–  Were the groups similar?  Yes

                                                         

–  Were the communication problems adequately described?  Yes

  • disorder type: motor speech impairment; CAS
  • Other characteristics (Table 1; p. 134)

–  MSI#1:

∞  vowel and Consonant Inventory: Limited

∞  vowel distortions

∞  sequencing difficulties (verbal)

∞  inconsistent errors

∞  below 1%ile on the Goldman-Fristoe Test of Articulation-2 (GFTA-2)

∞  oral structure/function WNL

–  MSI #2:

∞  speech sound distortions

∞  idiosyncratic speech sound substitutions

∞  sequencing difficulties (verbal and nonverbal)

∞  phonological impairment

∞  10th%ile on the GFTA

–  MSI #3:

∞  slow speech rate

∞  inconsistent speech sound errors

∞  speech sound distortions

∞  sequencing difficulties (verbal and nonverbal)

∞  18th% on the GFTA

 

  1. What were the different conditions for this research?
  • Subject (Classification) Groups? No 
  • Experimental Conditions? Yes

–  Habitual speech

–  Increased loudness

–  Slowed rate

–  Empathic stress

  • Criterion/Descriptive Conditions?No 

 

  1. Were the groups controlled acceptably?  NA

 

  1. Were dependent measures appropriate and meaningful? Yes
  • OUTCOME #1:Vowel acoustics (F1 and F2 on the vowel nucleus)
  • OUTCOME #2:Intelligibility

 

–  The dependent measure that is subjective is OUTCOME #2:  Intelligibility

–  The dependent measures that is objective is OUTCOME #1:  Vowel acoustics (F1 and F2 on the vowel nucleus)

 

  1. Were reliability measures provided?

–  Interobserver for analyzers?  Yes

  • OUTCOME #1:  Vowel acoustics (r = 0.92)

  Intraobserver for analyzers?  No 

 Treatment or test administration fidelity for investigators?  No 

 

  1. Description ofdesign:
  • Three children with CAS (MSI group) and 3 typically developing peers (HC group) participated.

 

  • The stimuli were 6 sentences that were modeled for the Ps in 4 conditions:

–  Habitual speech

–  Increased loudness

–  Slowed rate

–  Empathic stress

Therefore, there were a total of 24 stimuli.

 

  • Following a training procedure, each P imitated the 24 sentences (6 sentences, 4 times each) after hearing and viewing a visual representation of each sentence (i.e., the audio-visualization techniques).

 

  • The investigators recorded the Ps productions. To measure vowel accuracy, the investigators plotted F1 and F2 for the vowels /i/, /a/, and /u/ from each of the 24 sentences for a target of 48 vowels productions per P.(NOTE:  2 of the Ps, one from each group, failed to meet the criterion for increased loudness and that data could not be analyzed statistically.)

 

  • To measure intelligibility and stress placement, the investigators enlisted 16 SLP students to serve as listeners.

 

  1. What were the results of the statistical (inferential) testing?

 

  • OUTCOME #1:Vowel acoustics (F1 and F2 on the vowel nucleus)

∞  the coefficient of variation (COV) for F1 was significantly higher for the MSI group

 

  • OUTCOME #2:Intelligibility

∞  2 of the 3 MSI Ps increased in intelligibility relative to the habitual condition using at least one of the 3 strategies (loud, slow, emphatic stress.)  NOTE: this analysis was descriptive only.

 

–  What was the statistical test used to determine significance ANOVA

–  Were effect sizes provided?  No

  Were confidence interval (CI) provided?  No

 

  1. Summary of correlational results:  NA

 

  1. Summary of descriptive results: Qualitative research  NA

 

  1. Brief summary of clinically relevant results:
  • The performance of the 3 MSI Ps varied with intelligibility and production of vowel.
  • Ps with MSI exhibited more variability in F2 than HC peers.

 

ASSIGNED GRADE FOR QUALITY OF EXTERNAL EVIDENCE:  No Grade

 

============================================================

 


Dalhberg et al. (2018)

August 20, 2019

ANALYSIS GUIDELINES

Comparison Research

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

KEY:

ADD =  attention deficit disorder

ADHD =  attention deficit/hyperactivity disorder

ASD = autism spectrum disorder(s)

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

eta =  partial eta squared

fo = fundamental frequency

Hz =  Hertz

MLU = mean length of utterance

NA = Not Applicable

NAP =  Narrative Assessment Profile

P = participant or patient

pmh = Patricia Hargrove, blog developer

SLP = speech-language pathologist

WLN = within normal limits

 

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

 

REVIEWER(S): pmh

 

DATE:  August 12, 2019

 

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

 

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

 

  1. What type of evidence was identified?

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

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

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

 

                                                                                                           

  1. Group membership determination:
  • If there were groups, were participants randomly assigned to groups? No
  • If there were groups and Ps were not randomly assigned to groups, were members of groups carefully matched? Yes

                                                                    

 

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

                                                                    

 

  1. Were the groups adequately described? Yes

   How many participants were involved in the study?

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

     –  Autism Spectrum Disorders (ASD)  = 11

–  Typically Developing Children (TDC) = 11

  • Did all groups maintain membership throughout the investigation? Yes

 

–  CONTROLLED CHARACTERISTICS                                                  

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

     – ASD group = diagnosis of ASD

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

 

DESCRIBED CHARACTERISTICS  (* = a significant difference between groups)

  • age:

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

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

  • gender:

     – ASD group =  10 males; 1 female

     – TDC group =  6 males; 1 female

  • receptive vocabulary*:

     – ASD group =  4.8 scaled score

     – TDC group =  9.6 scaled score

  • receptive linguistic age*:

     – ASD group =  10.4 years

     – TDC group =  14.7 years

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

     – ASD group =  14.9

     – TDC group =   16.1

  • additional diagnoses:

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

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

          –  1 P = attention deficit disorder (ADD)

     – TDC group =  no diagnoses

 

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

                                                         

–  Were the communication problems adequately described?  Unclear

  • disorder type: High Functioning ASD

 

 

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

     – ASD

     – TDC       

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

 

 

  1. Were the groups controlled acceptably? Yes

 

 

  1. Were dependent measures appropriate and meaningful? Yes

 

ACOUSTIC MEASURES

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

 

PERCEPTUAL MEASURES

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

 

POST HOC ANALYSES MEASURES

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

 

–  The perceptual measures were subjective.

–  The acoustic measures were objective.

 

 

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

 

 

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

 

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

 

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

 

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

 

 

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

–  OUTCOME #5: utterance length orwords per utterance

 

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

–  The 3 Ps identified as ASD

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

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

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

 

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

 

  • Were effect sizes provided?Yes, for one Outcome

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

 

  • Were confidence interval (CI) provided?No

 

 

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

 

 

  1. Summary of descriptive results: Qualitative research  NA

 

 

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

 

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

 

  • The Ps who were correctly identified as having ASD had

– significantly poorer narrative skills

–  significantly more atypical fluency

– significantly more atypical speaking rate

 

ASSIGNED GRADE FOR QUALITY OF EXTERNAL EVIDENCE:  B-