Horley et al. (2010)

January 9, 2017

 

 

ANALYSIS 

Comparison Research

NOTE: The focus of the investigation is on the nature of prosodic disorders. Accordingly, no summary of intervention is included in the review.

 KEY: 

DAT = Dementia of the Alzheimer’s Type

eta = partial eta squared

F0 = fundamental frequency

MLU = mean length of utterance

NA = Not Applicable

P = participant or patient

pmh = Patricia Hargrove, blog developer

SD = standard deviation

SLP = speech-language pathologist

 

 

SOURCE: Horley, K., Reid, A., & Burnham, D. (2010). Emotional prosody perception in Dementia of the Alzheimer’s Type. Journal of Speech, Language, and Hearing Research, 53, 1132-1146.

 

 

REVIEWER(S): pmh

 

DATE: January 8, 2017

 

ASSIGNED GRADE FOR OVERALL QUALITY: The overall quality of the evidence for intervention is not graded because the investigation is concerned with impairment.

 

TAKE AWAY: Speakers with moderate Dementia of the Alzheimer’s Type (DAT) when compared to typically aging (TA) participants (Ps) produced similar average fundamental frequencies (F0) for affective prosody tasks. TA Ps, however, produced significantly more pitch variation (i.e., F0 standard deviations) than did their DAT peers. For rate, the DAT and TA Ps did not differ during a modeling task but Ps with DAT produced significantly slower sentences during a reading task. The ordering of difficultly of producing the targeted emotions was similar for the DAT and TA groups. With respect to perception, Ps with DAT consistently underperformed compared to TA peers.

  

  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 = B+

 

                                                                                                           

  1. Group membership determination:

                                                                                                           

  • If there were groups, were participants randomly assigned to groups? No. There could not be random assignment to groups because the groups consisted of TA Ps and Ps who had been diagnosed with DAT.

 

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

                                                                    

 

  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: 40
  • # of groups:  2
  • List names of groups and the number of Ps in each group:

     – Dementia of the Alzheimer’s Type (DAT) = 20

– Typically Aging (TA) = 20

 

– Did all groups maintain membership throughout the investigation? Yes

                                                                                

–  CONTROLLED CHARACTERISTICS

                                                                                                                       

  • age:

     – DAT = 71- 92 years, mean = 80 years

     – TA = 70- 84 years, mean = 78 years

  • gender: both groups 10m, 10f
  • expressive language:

– DAT – those with diagnosis of aphasia excluded

     – TA – no noted communication disorders

  • mood disorder: excluded from both groups
  • Socio-economic status: “generally matched” (p. 1135)
  • educational level of participants: “generally matched” (p. 1135)
  • neurological status:

– TA – no known neurological impairment

  • age at referral

 

– DESCRIBED CHARACTERISTICS

  • cognitive skills:

– DAT – diagnosed as DAT

  • language skills:

– DAT – diagnosed as DAT

  • memory:

– DAT – diagnosed as DAT

  • diagnosis:

DAT = Alzheimer’s with Late Onset; majority attended services for people with moderate to severe dementia

  • reading level of participants (Ps): all Ps read at least at the first and second grade level

 

– Were the groups similar? Yes ______  

                                                         

– Were the communication problems adequately described? No

  • disorder type: DAT
  • functional level: moderate DAT

 

 

  1. What were the different conditions for this research?

                                                                                                             

  • Subject (Classification) Groups? Yes

Cognitive Status:

– DAT       

     – TA

                                                               

  • Experimental Conditions? Yes

     – Tasks:

  • Production

               ∞ Modeling

               ∞ Reading

  • Comprehension/Perception

              ∞ Affect Identification (prosody and semantic content)

             ∞ Neutral Content Affect Identification

Emotions:

             ∞ Anger

             ∞ Sadness

             ∞ Surprise

             ∞ Happiness

 

  • Criterion/Descriptive Conditions?

 

 

  1. Were the groups controlled acceptably? Yes

 

 

  1. Were dependent measures appropriate and meaningful? Yes

                                                                                                             

– Dependent measures:

 

  • PRODUCTION TASKS (Modeling and Reading Aloud)
  • OUTCOME #1: Average pitch (i.e., mean fundamental frequency of F0 )of each utterance
  • OUTCOME #2: Pitch modulation (i.e., F0 standard deviation, SD) of each utterance
  • OUTCOME #3: Speaking rate (i.e., syllables per second) of each utterance

 

  • PERCEPTION TASKS (Affect Identification using Prosody and Linguistic Content and Neutral Content Affect Identification)
  • OUTCOME #4: Percentage of correct identification of target emotion

 

OUTCOME #4 (Percentage of correct identification of target emotion) was  subjective.

 

– The outcomes that were objective are

  • OUTCOME #1 [Average pitch (i.e., mean fundamental frequency of F0 )of each utterance]
  • OUTCOME #2 [Pitch modulation (i.e., F0 standard deviation, SD) of each utterance]
  • OUTCOME #3 [Speaking rate (i.e., syllables per second) of each utterance]

 

 

  1. Were reliability measures provided?

                                                                                                            

  • Interobserver for analyzers?

 

  • Intraobserver for analyzers?

 

  • Task administration fidelity for investigators? No

 

 

  1. Description of design:
  • Ps with moderate DAT were matched to TA peers.
  • The investigators administered tasks individually to all Ps. Testing times for the Ps were:

– DAT = 15 to 20 minutes

– TA = 5 to 10 minutes.

  • Although the tasks were presented in a prescribed order (Production Tasks: Modeling, Reading; Perception Tasks: Using Prosody and Linguistic Content for Affect Identification, Neutral Context Affect Identification), the order of sentences within each task as well as order of emotions were counterbalanced across Ps.
  • Each of the tasks explored happiness, anger, surprise, and sadness. The sentence stimuli are provided in the appendixes.
  • Statistical analyses explored differences between genders, Subject Groups (DAT, TA), Emotions (Happiness, Anger, Surprise, Sadness.) Because there were no Group x Gender interactions, gender data were collapsed.

 

 

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

 

  • PRODUCTION TASKS (Modeling and Reading Aloud)

 

  • OUTCOME #1: Average pitch (i.e., mean fundamental frequency of F0 )of each utterance
  • No significant difference for DAT vs TA Groups in reading or modeling production tasks.
  • Both Groups (DAT, TA) produced significantly higher mean F0 for

∞ surprise vs happiness emotions

∞ combined surprise and happiness vs combined anger and sadness emotions

∞ anger vs sadness emotion

 

  • OUTCOME #2: Pitch modulation (i.e., F0 standard deviation, SD) of each utterance
  • Significantly greater for TA compared to DAT. (The investigators noted that for reading p = 0. 502
  • Patterns of pitch modulation were similar for DAT and TA groups.

∞ During the modeling task both groups produced more pitch modulation for anger vs sadness

∞ During the reading task both groups produced more pitch modulation

– for surprise vs happiness

– for combined surprise and happiness vs anger and sadness

 

  • OUTCOME #3: Speaking rate (i.e., syllables per second) of each utterance
  • Ps with DAT spoke at a significantly higher rate during the reading task but not during the modeling task.
  • Overall, for modeling, but not for reading,

∞ happiness was slower than surprise

  • Overall, for both modeling and reading,

∞ combined anger and sadness were slower than combined happiness and surprise

∞ sadness was slower than anger

 

  • PERCEPTION TASKS (Affect Identification using Prosody and Linguistic Content and Neutral Content Affect Identification)

 

  • OUTCOME #4: Percentage of correct identification of target emotion
  • For each of the targeted emotions, Ps with DAT scored significantly more poorly on the task that provided semantic and prosodic cues than did the TA group.
  • On the task that provided only prosodic cues, Ps with DAT scored significantly more poorly on 3 of the 4 targeted emotions than did TA peers.
  • Both groups performed more poorly on the prosody only task than on the prosody plus semantic content task

– What statistical tests were used to determine significance?

  • ANOVA: 2 (Group: DAT, TA) x 4 (EMOTION: happiness, anger, surprise, sadness)
  • Chi Square

 

– Were effect sizes provided? Yes

 

  • OUTCOME #1: Average pitch (i.e., mean fundamental frequency of F0 )of each utterance
  • Both Groups (DAT, TA) produced significantly higher mean F0 for

∞ surprise vs happiness emotions (modeling eta = 0.11, medium effect; reading eta = 0.19, large effect)

∞ combined surprise and happiness vs combined anger and sadness emotions modeling (eta = 0.22, large effect; reading eta = 0.42, large effect)

∞ anger vs sadness emotion modeling (eta = 0.24, large effect; reading eta = 0.18, large effect)

 

  • OUTCOME #2: Pitch modulation (i.e., F0 standard deviation, SD) of each    utterance
  • Significantly greater for TA compared to DAT (modeling eta = 0.16, large effect; reading eta = 0.10, medium effect)
  • Patterns of pitch modulation were similar for DAT and TA groups.

∞ During the modeling task both groups produced more pitch modulation for anger vs sadness (eta = 0.28, large effect)

∞ During the reading task both groups produced more pitch modulation

– for surprise vs happiness (eta = 0.13, medium effect)

– for combined surprise and happiness vs anger and sadness (eta = 0.56, large effect)

 

  • OUTCOME #3: Speaking rate (i.e., syllables per second) of each utterance
  • Ps with DAT spoke at a significantly higher rate during the reading task (eta = 0.39, large effect).
  • Overall, for modeling, but not for reading,

∞ happiness was slower than surprise (eta = 0.39, large effect)

  • Overall, for both modeling and reading,

∞ combined anger and sadness were slower than combined happiness and surprise [eta = 0.13, medium effect (modeling); eta = 0.43, large effect (reading)]

∞ sadness was slower than anger [eta = 0.47, large effect (modeling); eta = 0.46, large effect (reading)]

 

– 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:
  • Speakers with moderate DAT when compared to TA peers produced similar average fundamental frequencies (F0) for affective prosody tasks.

 

  • TA Ps, however, produced significantly more pitch variation (i.e., F0 standard deviations) than did their DAT peers.

 

  • For rate, the productions of DAT and TA Ps did not differ during a modeling task but Ps with DAT produced significantly slower sentences during a reading task.

 

  • The ordering of difficultly of producing the targeted emotions was similar for the DAT and TA groups.

 

  • With respect to perception, Ps with DAT consistently underperformed compared to TA peers.

 

 

ASSIGNED GRADE FOR QUALITY OF EXTERNAL EVIDENCE:   B

 


Grossman et al. (2010)

December 15, 2016

 

ANALYSIS

Comparison Research  

NOTES:

  • A summary of an intervention is not included in the review because this in not an investigation about intervention. 

KEY: 

ASD = autism spectrum disorders

eta =   partial eta squared

HFA = high-functioning autism

MLU = mean length of utterance

NA = Not Applicable

P = participant or patient

pmh = Patricia Hargrove, blog developer

SLP = speech-language pathologist

TD = typically developing

  

SOURCE: Grossman, R. B., Bemis, R. H., Skwerer, D. P., & Tager-Flusberg, H. (2010.) Lexical and affective prosody in children with high-functioning autism. Journal of Speech, Language, and Hearing Research, 53, 778- 793.

 

REVIEWER(S): pmh

 

DATE: December 7, 2016

 

ASSIGNED GRADE FOR OVERALL QUALITY:  Not graded, this is an investigation of the nature of prosody within a clinical population; it is not an intervention study.

 

TAKE AWAY: This investigation of lexical and affective prosody in children and adolescents with high functioning autism (HFA) comprises 3 experiments: perception of affective prosody, perception of lexical prosody, and production of lexical prosody. The results indicate that children and adolescents with HFA are similar to TD peers with respect to their perception of affective prosody and lexical stress as well in their ability to mark correctly the stressed syllable in compound words (e.g., greenhouse) and noun phrases (green house.) However, the Ps with HFA differed from their TD peers with respect to how they marked the stressed syllable. Specially, the productions of Ps with HFA were of longer duration which was perceived be slower, more labored, containing longer pauses than TD peers.

 

 

  1. What type of evidence was identified?

                                                                                                           

  • What was the type of design? Comparison; 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? Yes
  • If there were groups and Ps were not randomly assigned to groups, were members of groups carefully matched? Yes

                                                                    

 

  1. Were experimental conditions concealed?

                                                                                                           

  • from participants? No

                                                                    

  • from administrators of experimental conditions? No

                                                                    

  • from analyzers/judges? Unclear

                                                                    

 

  1. Were the groups adequately described? Yes

 

–    How many participants (Ps) were involved in the study?

 

NOTE: The same Ps were involved in all 3 experiments

  • total # of Ps: 31
  • # of groups: 2
  • List names of groups and the number of Ps in each group:

– High-Functioning Autism (HFA) = 16 (except Experiment #3, N = 11 for pitch and intensity analyses

– Typically Developing (TD) = 15 (except Experiment #3, N = 9 for pitch and intensity analyses

 

  • Did all groups maintain membership throughout the investigation? Yes, but data from some Ps were discarded from the pitch and intensity analysis for Experiment #3 due to excessive static on the recordings. This resulted in the following Ns for the 2 groups”

– TD = 9

– HFA = 11

                                                                                

–   CONTROLLED CHARACTERISTICS

                                                                                                                       

  • cognitive skills:

     – HFA = within normal range

     – TD = within normal range

 

  • receptive language:  (performance on the Peabody Picture Vocabulary Test)

     – HFA = within normal range

     – TD = within normal range

 

  • presence of identified genetic disorders: excluded from experiments

 

  • diagnosis of HFA =

     – met criteria in the Diagnostic and Statistical Manual of Mental Disorders; Autism Diagnostic Interview—Revised; Autism Diagnostic Observation Schedule

     – diagnosis noted that the P was in classified as “full range” autism

     – verbal IQ and receive vocabulary were within 2 standard deviations (SD) of the mean but the following challenges still resulted in diagnosis of ASD:

  • social skills
  • communication skills
  • pragmatic skills

     – excluded the following diagnoses:

  • Asperger syndrome
  • Autism, Pervasive Developmental Disorder, not otherwise specified

 

–   DESCRIBED CHARACTERISTICS (* = no significant differences between TD and HFA groups)

 

  • age*:

     HFA = mean – 12;4, range 7;6-17

     TD = mean 12;7, range 7;-18

 

  • gender: Not reported
  • cognitive skills:

HFA =

  • Full range IQ = 106.7 ( mean); 87-123 (range)
  • Verbal IQ* = 101.2 (mean); 83-127 (range)
  • Nonverbal IQ* = 109.6 (mean); 94-127 (range)

     TD =

  • Full range IQ = 108.9 (mean); 87-123 (range)
  • Verbal IQ* = 108.1 (mean); 81-127 (range)
  • Nonverbal IQ* = 106.7 (mean); range 85-116 (range)

 

  • receptive language*: (performance on the Peabody Picture Vocabulary Test)

     HFA = 107.0 (mean); 79-138 (range)

     TD =  111.3 (mean); 79-139 (range)

  • Hearing: Not reported

 

– Were the groups similar? Yes

                                                         

– Were the communication problems adequately described? Unclear.

 

  • disorder type: Ps in the HFA group were described as having social, pragmatic, and communication problems but they were not described. In addition, Ps with HFA were described as “did not at this time exhibit measureable language impairment” (p. 783’)

 

 

NOTE: This study investigated 3 experiments that used the same Ps described in item #4. Items #5 through #13 are presented separately for each of the experiments.

 

EXPERIMENT 1:

Investigation of the perception of affective prosody

 

 

  1. What were the different conditions for this research?

                                                                                                             

  • Subject (Classification) Groups? Yes

HFA

     – TD          

 

  • Experimental Conditions? Yes

 

CONTENT OF STIMULI

– Unfiltered Condition: 6 Sentences produced for each of 3 forms of affective prosody (happy, sad, neutral.) In each case, the content of the sentence and the prosody of the sentence matched the targeted content. For example, happy affective prosody was paired with the following sentence: “When Mike pets the puppy, it’s wagging its tail” (p.792)

– Filtered Condition: The 18 unfiltered sentences were passed through a low-pass filter deleting speech frequencies that resulted in the removal of semantic content but the retention of prosody.

 

EMOTION REPRESENTED ON STIMULI: (p. 781)

– Sad = lower pitch, slower rate, low tone ending

Happy = higher pitch, faster rate, complex tone ending

Neutral = midrange pitch, accent on the main topic, less complex final tone

 

  • Criterion/Descriptive Conditions? No

 

 

  1. Were the groups controlled acceptably? Yes

 

 

  1. Were dependent measures appropriate and meaningful? Yes

 

– OUTCOMES:

 

  • OUTCOME #1: Percentage of correct identifications of depicted affects in unfiltered and filtered sentence stimuli.

 

–   The outcome was subjective.

 

The outcome measures was not objective.

 

 

  1. Were reliability measures provided?

                                                                                                            

  • Interobserver for analyzers? No

 

  • Intraobserver for analyzers? No

 

  • Treatment or test administration fidelity for investigators?

 

 

  1. Description of design:
  • Following a training session that involved only unfiltered sentences, Ps listened to sentences and classified the emotions/affect as happy, sad, or neutral.
  • The validity of prerecorded sentence stimuli wasa ascertained by the independent rating of affect by 10 listeners who were not Ps in the investigation.
  • There were 18 sentences each for the unfiltered and filtered sentences. There were 3 versions of each of the sentence types which difference with respect to the order of sentence. The order of sentences was pseudorandomized and counterbalanced.
  • The verbal stimuli are included in an appendix.
  • Sentences were presented on acomputer via speakers. The filtered sentences were administered first; then the unfiltered sentences were administered.
  • Ps signified their choices by selecting the appropriated button.

 

 

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

 

– Results:

 

  • OUTCOME #1: Percentage of correct identifications of depicted affects in unfiltered and filtered sentence stimuli.
  • performance above chance for
  • filtered task: both TD and HFA
  • unfiltered task: both TD and HFA
  • performance was better on unfiltered than filtered for both TD and HFA
  • performance on neutral sentences was significantly poorer for neutral sentences for both TD and HFA
  • there was not an overall significant difference between TD and HFA groups

 

– The statistical tests used to determine significance included t-test; ANOVA: repeated measure 2 (Group—TD, HFA) x 2 (Task—filtered, unfiltered) x 3 (Emotion—happy, sad, neutral); repeated measure 2 (Group) x 3 (Emotion) for each task

 

– Were effect sizes provided? Yes

 

  • OUTCOME #1: Percentage of correct identifications of depicted affects in unfiltered and filtered sentence stimuli.
  • performance was better on unfiltered than filtered for both TD and HFA;
  • HFA – Cohen’s d = 1.04 (large effect)
  • TD – Cohen’s d = 0.76 (moderate 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:

 

  • TD and HFA Ps exhibited similar skills in interpreting affective prosody.
  • Both groups had significantly more difficulty on the filtered task than the unfiltered task. However, they still were able to label emotions above chance in the filtered condition. Therefore, both groups make use of semantic information to interpret affect (in addition to prosody.)
  • Both groups found the neutral affect sentences to be more difficult to interpret.

 

 

ASSIGNED GRADE FOR QUALITY OF EXTERNAL EVIDENCE: B

 

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

 

EXPERIMENT 2

Investigate the perception of lexical stress for differentiating noun phrases from compound nouns

 

  1. What were the different conditions for this research?

                                                                                                             

  • Subject (Classification) Groups? Yes

– HFA

     – TD

                                                               

  • Experimental Conditions? Yes

     – Noun Phrases (e.g. green house, wet suit, p. 792)

     – Compound Words (e.g., greenhouse, wetsuit, )

     – Foils (e.g., tree house, headphones, p. 792)

 

  • Criterion/Descriptive Conditions? No

 

 

  1. Were the groups controlled acceptably? Yes

 

 

  1. Were dependent measures appropriate and meaningful? Yes

 

–OUTCOMES:

  • OUTCOME #1: Percentage accuracy of responses to the experimental task

 

– The outcome measure was subjective.

 

 The outcome measure was not objective.

 

 

  1. Were reliability measures provided?

                                                                                                            

  • Interobserver for analyzers? No

 

  • Intraobserver for analyzers? No _

 

  • Treatment or test administration fidelity for investigators? No

 

  • Validity of the stimuli was supported by

AUDITORY STIMULI:

  • The investigators analyzed the experimental auditory stimuli using Praat to insure that the first syllable was stressed in the compound word (e.g., HOTdog) and the second syllable was stressed in the noun phrase (e.g., hot DOG.)
  • The acoustic criteria the investigators used to identify stressing were

         ¶ longer duration

         ¶ higher pitch

         ¶ greater intensity

  • For the foil items (i.e., stimuli produced with equal stress), acoustic analysis of the 3 above features did not reveal differences between the first and second syllable.
  • Ten judges listened to the auditory stimuli to determine which words could be properly identified as noun phrases or compound words.

 

VISUAL STIMULI:

  • The investigators insured that judges could properly link the auditory stimuli with pictures of the targeted words.

 

 

  1. Description of design:
  • The experimental stimuli included auditory and visual stimuli.

– Every experimental word (compound word or noun phrase) was paired with a picture presenting the target word and the opposite stress pattern. For example, for the target “wetsuit,” the investigator presented a picture of a “wet suit” and a picture of a suit that was wet.

–  Eleven foil words (i.e., compound words without corresponding noun phrases) were also presented auditorily and visually throughout the testing. For example, ne picture presented the target word (e.g., rainbow) and one picture presented the picture of a hair bow.

– The verbal stimuli are included in an appendix.

 

  • Prior to the experimental task, investigators administered a brief training task insuring that the Ps were able to press a button signifying their picture choice. Investigators provided corrective feedback to the Ps.

 

  • The Ps listened to prerecorded auditory stimuli of the compound words or noun phrases in isolation (i.e., not in a contextualizing sentence.)

 

 

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

 

– RESULTS:

 

  • OUTCOME #1: Percentage accuracy of responses to the experimental task
  • All Ps from both groups (TD, HFA) performed at the 80% accuracy level on foil stimuli.
  • All Ps from both groups (TD, HFA) performed at the 80% accuracy level for compound word and noun phrase stimuli.
  • Both groups were significantly more accurate on compound word/first syllable stress targets than noun phrase/second syllable stress target.
  • There was no significant differenceS between TD and HFA groups.

 

– The statistical tests used to determine significance included t-test; ANOVA: 2 (Groups: TD, HFA) x 2 (Stress: compound word/first syllable targets, noun phrase/ second syllable targets)

 

–   Were effect sizes provided? Yes

  • OUTCOME #1: Percentage accuracy of responses to the experimental task
  •  Both groups (TD, HFA) were significantly more accurate on compound word/first syllable stress targets than noun phrase/second syllable stress target.

∞ TD Cohen’s d = 0.80 (moderate effect)

∞ HFA Cohen’s d = 1.2 (large effect)

 

 

  1. Summary of correlational results: NA

 

 

  1. Summary of descriptive results: Qualitative research NA

 

 

  1. Brief summary of clinically relevant results:

 

  • HFA and TD groups performed similarly on the task requiring Ps to demonstrate comprehension of compound words (e.g., Yellowstone) compared to noun phrases (yellow stone.) Thus, Ps with HFA and their TD peers are equally competent on this task.

 

 

ASSIGNED GRADE FOR QUALITY OF EXTERNAL EVIDENCE:   B

 

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

 

EXPERIMENT 3

Investigate the production of lexical prosody

 

 

  1. What were the different conditions for this research?

                                                                                                             

  • Subject (Classification) Groups? Yes

HFA

     – TD

                                                               

  • Experimental Conditions? Yes

 

    – Lexical type (compound words/first syllable stress; noun phrases/second syllable stress)

 

  • Criterion/Descriptive Conditions? Yes

 

 

  1. Were the groups controlled acceptably? Yes

 

 

  1. Were dependent measures appropriate and meaningful? Yes

                                                                                                             

–  Outcome measures:

 

  • OUTCOME #1: Mean pitch of productions

 

  • OUTCOME #2: Mean intensity of productions

 

  • OUTCOME #3: Mean whole word duration

 

– The Outcome measures are not subjective.

 

All of the outcome measures are objective.

 

 

  1. Were reliability measures provided?

                                                                                                            

– Interobserver for analyzers? Yes

 

  • OUTCOME #3: Mean whole word duration—The investigators calculated the mean difference in overall duration length for the original analyzer and a second judge using 15% of the samples. The difference was 4 ms which met the investigators 5 ms or less criterion.

 

– Intraobserver for analyzers? No

 

– Treatment or test administration fidelity for investigators? No

 

 

  1. Description of design:

 

  • Experiment 3 was administered after a break following the administration of Experiments 1 and 2.
  • The investigators used the same picture stimuli as Experiment #2 with Experiment #2 always preceding Experiment #3.
  • In this investigation, there were 27 targets: 11 compound word/first syllable stress, 11 noun phrases/second syllable stress, 5 foils.
  • Scripts of the verbal stimuli are included in an appendix.
  • The investigators taught the procedures of Experiment 3 during a brief training session insuring that P clearly understood the procedures.
  • Investigators read a brief narrative designed to elicit the target word while a picture of that word was displayed.
  • Discarded data due to static on the recordings from the 2 groups resulted in reduced Ns for the intensity and pitch analyses to

– TD = 9

– HFA = 11

 

 

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

 

– RESULTS

 

  • OUTCOME #1: Mean pitch of productions

– No significant difference between groups (TD, HFA) on the production of

  • compound word/first syllable stressed targets
  • noun phrase/second syllable stressed targets

 

  • OUTCOME #2: Mean intensity of productions

– No significant difference between groups (TD, HFA) on the production of

  • compound word/first syllable stressed targets
  • noun phrase/second syllable stressed targets

 

  • OUTCOME #3: Mean whole word duration

     Compound words/first syllable stressed words were significantly shorter than noun phases/second syllable stressed word

– HFA group produced significantly longer utterances than the TD group

 

– What were the statistical tests used to determine significance? t-test; ANOVA: one way ANOVA; 2 (Group: HFA, TD) x 2 (Stress: compound word/first syllable stressed, noun phrase/second syllable stressed)

  • Other: (List the test and the associated outcomes)

 

– Were effect sizes provided? Yes.

 

  • OUTCOME #3: Mean whole word duration

     Compound words/first syllable stressed words were significantly shorter than noun phases/second syllable stressed word– eta = 0.53 (large effect)

  • for HFA the effect size was — Cohen’s d = 0.90 (large effect)
  • for TD the effect size was—Cohen’s d = 0.80 (large effect)

 

– HFA group produced significantly longer utterances than the TD group eta = 0.16 (large effect)

  • for compound words/first syllable stressed targets the effect size was –Cohen’s d = 0.82 (large effect)
  • for noun phrases/second syllable stressed targets the effect size was –Cohen’s d = 0.75 (moderate effect)

 

– 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:

 

  • Ps with HFA were able to differentiate compound words/first syllable stress (e.g., highlight) from noun phrases/second syllable stress (e.g., high light) using duration.

 

  • However, their productions of both types of target words were significantly longer than their TD peers.

 

  • The investigators described their perceptions of Ps with HFA longer productions as being labored and slow with exaggerated pauses between syllables. The TD Ps productions, on the other hand, were perceived to be shorter, not labored, with smoother transitions between syllables.

 

 

ASSIGNED GRADE FOR QUALITY OF EXTERNAL EVIDENCE: __B-___

 


Hoque (2008)

September 8, 2016

ANALYSIS GUIDELINES

Comparison Research

 

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

 

KEY:

 

ASD = Autism Spectrum Disorder

DS = Down syndrome

EI = early intervention

NA = Not Applicable

P = participant or patient

pmh = Patricia Hargrove, blog developer

SLP = speech-language pathologist

 

 

SOURCE: Hoque, M. E. (2008). Analysis of speech properties of neurotypicals and individuals diagnosed with autism and Down syndrome. Proceedings of the 10th International ACM SIGACCESS Conference on Computers and Accessibility (Assets ’08). ACM, New York, NY, USA, 311-312. ARTICLE: DOI=http://dx.doi.org/10.1145/1414471.1414554

 

REVIEWER(S): pmh

 

DATE: August 28, 2016

 

ASSIGNED GRADE FOR OVERALL QUALITY: Not graded; this investigation was concerned with the nature of prosodic impairments in individuals diagnosed with Autism Spectrum Disorder (ASD) or Down syndrome (DS.)

 

TAKE AWAY: This brief report in conference proceedings of an investigation involving a small number of participants provides preliminary support for differential use of prosody among NT Ps, ASD Ps, and DS Ps. NT Ps exhibited longer speaking turns than ASD and DS peers and they were most likely to produce pause features that corresponded to typical pause strategies. DS Ps produced speech with higher energy values than DS or NT peers. In addition, ASD (but not DS Ps) and NT Ps produced the same number of rising and falling edges in conversation. However, both the ASD and DS Ps differed from the NT peers in their execution of rising and falling edges with NT Ps producing higher maximum. Interestingly, the DS Ps productions of edges also were higher than the ASD Ps.

 

 

  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

 

                                                                                                           

  1. Group membership determination:

                                                                                                           

  • If there were groups, were participants randomly assigned to groups? Not Applicable (NA)

 

 

  1. Were experimental conditions concealed?

                                                                                                           

  • from participants (Ps)? NA

                                                                    

  • from administrators of experimental conditions? NA

                                                                    

  • from analyzers/judges? NA

                                                                    

 

  1. Were the groups adequately described? No

 

–   How many participants were involved in the study?

  • total # of Ps: 6
  • # of groups: 3
  • List names of groups and the number of Ps in each group:

     – Autism Spectrum Disorder (ASD) = 3

– Down syndrome (DS) = 1

– Neurotypical (NT) = 2

 

  • Did all groups maintain membership throughout the investigation? Yes, there was only one session.

                                                                                

– CONTROLLED CHARACTERISTICS—none described                 

 

– DESCRIBED CHARACTERISTICS

  • education of Ps: All ASD and DS Ps attended a nonprofit school that provided early intervention (EI) services to children with disabilities
  • severity of ASD: mild or moderate

 

– Were the groups similar? Unclear

                                                         

– Were the communication problems adequately described?

 

 

  1. What were the different conditions for this research?

                                                                                                             

– Subject (Classification) Groups? Yes

  • ASD
  • DS
  • NT

                                                               

– Experimental Conditions? No

 

–  Criterion/Descriptive Conditions? No

 

 

  1. Were the groups controlled acceptably?

 

 

  1. Were dependent measures appropriate and meaningful? Yes

                                                                                                             

– DEPENDENT MEASURES:

 

NOTE: The investigator noted that more than 50 features associated with segmental and suprasegmental aspects of speech were analyzed but only the following prosody related features are listed here

 

PITCH FEATURES

  • OUTCOME #1: Minimum pitch
  • OUTCOME #2: Maximum pitch
  • OUTCOME #3: Mean pitch
  • OUTCOME #4: Pitch standard deviation
  • OUTCOME #5: Absolute value of pitch
  • OUTCOME #6: Quantiles (pitch)
  • OUTCOME #7: Ratio between voiced and unvoiced frames

 

INTENSITY FEATURES

  • OUTCOME #8: Minimum intensity
  • OUTCOME #9: Maximum intensity
  • OUTCOME #10: Mean intensity
  • OUTCOME #11: Intensity standard deviation
  • OUTCOME #12: Quantiles (intensity)

 

RATE FEATURE

  • OUTCOME #13: Speaking rate

 

PAUSE FEATURES

  • OUTCOME #14: Number of pauses in an utterance
  • OUTCOME #15: Percent of Unvoiced Frames
  • OUTCOME #16: Number of voice breaks
  • OUTCOME #17: Maximum duration of pauses
  • OUTCOME #18: Average duration of pauses
  • OUTCOME #19: Total duration of pauses

 

DURATION FEATURE

  • OUTCOME #20: Average duration per turn

 

None of the dependent measures were subjective.

 

– All of the dependent measures were objective.

 

 

  1. Were reliability measures provided?

                                                                                                            

  • Interobserver for analyzers?  No

 

  • Intraobserver for analyzers? No

 

  • Treatment or administration fidelity for investigators? No

 

 

  1. Description of design:

 

  • Pairs of Ps engaged in a conversation while seated across from one another a table. Each conversational pair comprised one NT P and either one P with ASD or one P with DS. Each member of the pair was recorded separately.

 

  • The NT P selected a topic and each P’s speech was recorded onto its own channel.

 

  • More than 50 segmental and suprasegmental features were calculated from each of the recorded samples.

 

  • The investigator analyzed the data using feature mining algorithms. These algorithms were used to identify similarities and differences among the three P groups (ASD, DS, NT.)

 

  1. What were the results of the statistical testing?

 

– OUTCOMES (For the most part, the results are reported in feature grouping. The outcomes associated with each feature group are provided to assist in comprehensibility.)

 

PITCH FEATURES—Ps with ASD exhibited lower maximum falling and rising edges than the P with DS or the NT Ps.

  • OUTCOME #1: Minimum pitch
  • OUTCOME #2: Maximum pitch
  • OUTCOME #3: Mean pitch
  • OUTCOME #4: Pitch standard deviation
  • OUTCOME #5: Absolute value of pitch
  • OUTCOME #6: Quantiles (pitch)
  • OUTCOME #7: Ratio between voiced and unvoiced frames

 

INTENSITY FEATURES— Ps with DS exhibited higher intensity features than Ps with ASD or NT Ps.

  • OUTCOME #8: Minimum intensity
  • OUTCOME #9: Maximum intensity
  • OUTCOME #10: Mean intensity
  • OUTCOME #11: Intensity standard deviation
  • OUTCOME #12: Quantiles (intensity)

 

RATE FEATURE

  • OUTCOME #13: Speaking rate

 

PAUSE FEATURES—NT Ps used pauses more appropriately than Ps with either ASD or DS but ASD Ps produced a similar number of pauses as NT peers.

  • OUTCOME #14: Number of pauses in an utterance
  • OUTCOME #15: Percent of Unvoiced Frames
  • OUTCOME #16: Number of voice breaks
  • OUTCOME #17: Maximum duration of pauses
  • OUTCOME #18: Average duration of pauses
  • OUTCOME #19: Total duration of pauses

 

DURATION FEATURE

  • OUTCOME #20: Average duration per turn—The utterance durations of Ps with NT were longer than the durations of Ps with either ASD or DS.

 

PROSODIC FEATURES THAT WERE SIMILAR ACROSS THE GROUPS:

  • Speaking rate
  • Number of pauses per turn
  • Maximum duration of pauses

 

PROSODIC FEATURES THAT WERE DISSIMILAR ACROSS THE GROUPS:

  • Minimum pitch
  • Mean pitch
  • Maximum pitch
  • Mean intensity
  • Maximum intensity
  • Minimum intensity
  • Energy

 

(add additional outcomes as appropriate)

 

– What was the statistical test used to determine significance? Feature Mining Algorithm—Waikato Environment for Knowledge Analysis (WEKA)

 

– 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:
  • On average in conversations, NT Ps exhibited longer speaking turns than ASD and DS peers. The investigator noted that is supports the view that NT speakers tend to dominate conversations with ASD and DS partners.

 

  • NT speakers were most likely to produce pause features that corresponded to typical pause strategies.

 

  • On average in conversations, DS Ps produced speech with higher energy values than DS or NT peers. The investigators posited that this supports characterizations of DS speakers as being easily excited.

 

  • On average in conversations, ASD (but not DS Ps) and NT Ps produced the same number of rising and falling edges in conversation.

 

  • However, both the ASD and DS Ps differed from the NT peers in their execution of rising and falling edges with NT Ps producing higher maximum edges. Interestingly, the DS Ps also were higher than the ASD Ps. This corresponds with previous characterizations of ASD Ps.

 


Lenden & Flipsen (2007)

August 26, 2015

NATURE OF PROSODIC DISORDERS

ANALYSIS FORM

 

Key:

 

CA = chronological age

CI = Cochlear Implant

HA = Hearing Age

HI = hearing impaired

NA = not applicable

P = participant

PIA = Post-Implantation Age

pmh = Patricia Hargrove, blog developer

PVSP = Prosody-Voice Screening Profile

 

SOURCE: Lenden, J. M., & Flipsen Jr., P. (2007). Prosody and voice characteristics of children with cochlear implants. Journal of Communication Disorders, 40, 66-81.

 

REVIEWER(S): pmh

 

DATE: August 24, 2015

ASSIGNED GRADE FOR OVERALL QUALITY: C+ (The highest grade for this type of design is C+.)

 

POPULATION: Cochlear Implants, Hearing Impairment; Children

 

PURPOSE: To identify aspects of prosody and voice that are problematic for children with cochlear implants (CI) and developmental trends relevant to prosody and voice.

 

INSIGHTS ABOUT PROSODY:

  • In this longitudinal investigation, the children with CI did not display problems with phrasing and pitch noted in children with hearing impairment (HI). Children with CIs and problems with Phrasing and Pitch might warrant special attention in therapy.
  • Resonance and stress continued to be problematic for most children with CI and did not improve with age. Accordingly, they may be aspects of voice/prosody that clinicians focus attention on in intervention.
  • The investigators noted that the number of participants (Ps) was small and that further research is needed.
  • The investigators recommended that the Prosody-Voice Screening Profile (PVSP) be considered in long-term monitoring of the prosody and voice of children with HI.

 

 

  1. What type of evidence was identified? Longitudinal Research
  1. Group membership determination:
  • If there were groups of participants were members of groups matched? Not applicable (NA.) There was only one group.
  1. Was participants’ communication status concealed?
  • from participants? No

                                                                    

  • from assessment administrators? No

                                                                    

  • from data analyzers? Yes, raters were presented with samples in random order to avoid bias (relative to change over time.)

                                                                    

 

  1. Were the participants adequately described? Yes

How many participants were involved in the study? 6

  • total # of participants: 6
  • was group membership maintained throughout the experiment? Yes
  • # of groups: 1
  • # of participants in the group: 6

 

– The following variables were controlled:

  • hearing status: Prelingually deaf (mean age of identification = 8 months; range 0 to 15 months)
  • time since CI: at least 18 months
  • language modality: spoken language only as primary mode of communication
  • receptive language: Receptive Vocabulary is within 2 standard deviations of the mean for P’s chronological age (CA); Peabody Picture Vocabulary Test III—mean standard score 82.3 months; range 72 months to 99 months

 

– The following variables were controlled described:

  • age at beginning of investigation: mean 5 years; range 3 years, 9 months to 6 years, 2 months
  • gender: 1m; 5f
  • cognitive skills: no known disability
  • mean time (hearing aid use + CI) amplified at the beginning of the investigation: mean 4 years, 4 months; range 2 years, 10 months to 5 years, 3 months
  • age of implantation: mean 28 months; range 20 months to 3 years
  • cause of hearing impairment (HI): unknown (5); partial agenesis of the cochlea (1)
  • physical skills: no known disability
  • emotional status: no known disability
  • implant type: Clarion (2); Nucleus 24 (2); Nucleus 22 (1)
  • intervention: all received prior intervention; oral mode was the focus of the interventions; interventions continued for all participants (Ps) throughout the investigation
  • educational level of clients: all in regular classrooms

 

– Were the communication problems adequately described? No. The investigators were vague about the general level of expressive and receptive language of the Ps but the Ps were capable of some conversational speech.  

 

  1. What were the different conditions for this research?

– Subject (Classification) Groups? Yes. All the Ps all were prelingually deaf.

                                                               

– Experimental Conditions? No

 

– Criterion/Descriptive Conditions? Yes– Ratings of conversational samples on the Prosody-Voice Screening Profile (PVSP).

 

  1. Were the groups controlled acceptably? NA

 

 

  1. Were dependent measures appropriate and meaningful? Yes

– The dependent measures were

  • Dependent Measure #1: Ratings on the Phrasing section of the PVSP
  • Dependent Measure #2: Ratings on the Rate section of the PVSP
  • Dependent Measure #3: Ratings on the Stress section of the PVSP
  • Dependent Measure #4: Ratings on the Loudness section of the PVSP
  • Dependent Measure #5: Ratings on the Pitch section of the PVSP
  • Dependent Measure #6: Ratings on the Laryngeal Quality section of the PVSP
  • Dependent Measure #7: Ratings on the Resonance Quality section of the PVSP
  • Dependent Measure #8: Relationship between measures of the PVSP and 3 age variables: Chronological Ages (CA), Hearing Age (HA), and Post-Implantation Age (PIA)
  • Dependent Measure #9: Changes with age on ratings on the PVSP

All of the dependent measures were subjective.

None of the dependent/ outcome measures were objective.

                                         

 

  1. Were reliability measures provided?

Interobserver for analyzers? No

 

– Intraobserver for analyzer?   Yes

  • Dependent Measure #1: Ratings on the Phrasing section of the PVSP = 100%
  • Dependent Measure #2: Ratings on the Rate section of the PVSP = 92%
  • Dependent Measure #3: Ratings on the Stress section of the PVSP = 83%
  • Dependent Measure #4: Ratings on the Loudness section of the PVSP = 95%
  • Dependent Measure #5: Ratings on the Pitch section of the PVSP = 94%
  • Dependent Measure #6: Ratings on the Laryngeal Quality section of the PVSP = 92%
  • Dependent Measure #7: Ratings on the Resonance Quality section of the PVSP = 85%
  • Overall PVSP score: 92%

Treatment/Procedural fidelity for investigators? No

 

  1. Description of design:
  • This longitudinal investigation involved 6 children with CIs.
  • Spontaneous samples of conversational speech were elicited every 3 months for time ranges varying from 12 to 21 months.
  • The prosody and voice characteristics of the Ps’ speech was determined from the samples that were analyzed using the PVSP.
  • The results were presented primarily using descriptive and correlational statistics as well as descriptions of developmental trends.

 

  1. What were the results of the inferential statistical testing? The only inferential testing mentioned in the manuscript was when correlations were reported for correlations. Those results will be presented in the correlational statistical testing section of this review.

 

 

  1. What were the results of the correlational statistical testing?

 

  • The relationships between measures of the PVSP and 3 age variables (CA, HA, PIA) were explored in 2 ways: (1) by correlating the combined PVSP and age scores of all 6 Ps and (2) ) by correlating the combined PVSP and age scores of only 5 Ps. (One set of P data were omitted because of the possibility of the child being a high performing outlier.)
  • The significant correlations ( p ≤ 0.05) were

–Ratings on the Stress section of the PVSP

  • stress ratings and HA for the 5 member set of Ps: r = 0.354
  • stress ratings and PIA for the 5 member set of Ps: r = 0.341

 

Rating of the Laryngeal Quality section of the PVSP

  • laryngeal quality ratings and CA for all 5 and 6 member sets: for 5 member set r = 0.554 and for 6 member set r = 0.421
  • laryngeal quality ratings and HA for all 5 and 6 member sets: :   for 5 member set r = 0.562 and for 6 member set r = 0.528
  • laryngeal quality ratings and PIA for all 5 and 6 member sets: :   for 5 member set r = 0.571 and for 6 member set r = 0.382

Rating of the Resonance Quality section of the PVSP

  • resonance quality and PIA: for the 5 member set r= 0.335
  • The investigators interpreted the correlations to indicate that at least for Stress, Laryngeal Quality, and Resonance Quality performance tended to improve with age.
  • What was the statistical test used to determine correlation? Not provided

 

  1. What were the results of the descriptive analysis
  • The investigators provided pooled data representing correct scores on the PVSP.
  • In line with the PVSP protocol, they also provided data describing the number of samples (remember each P is represented by multiple samples) in which P’s performance was classified as passed, borderline, or failed.

Dependent Measure #1: Ratings on the Phrasing section of the PVSP: 97% appropriate; 36 Ps passed; 4 borderline; 0 failed

 

Dependent Measure #2: Ratings on the Rate section of the PVSP: 88% appropriate; 22 Ps passed; 13borderline; 5 failed

Dependent Measure #3: Ratings on the Stress section of the PVSP: 48% appropriate; 2 Ps passed; 5 borderline; 33 failed

Dependent Measure #4: Ratings on the Loudness section of the PVSP: 92% appropriate; 32 Ps passed; 2 borderline; 6 failed

Dependent Measure #5: Ratings on the Pitch section of the PVSP: 98% appropriate; 38 Ps passed; 2 borderline; 0 failed

Dependent Measure #6: Ratings on the Laryngeal Quality section of the PVSP: 87% appropriate; 24 Ps passed; 7 borderline; 9 failed

Dependent Measure #7: Ratings on the Resonance Quality section of the PVSP: 10% appropriate; 0 Ps passed; 1 borderline; 39 failed

  • The investigators also described the changes in performance of individuals over time.

Dependent Measure #9: Changes with age on ratings on the PVSP

–   All Ps performed appropriately for the Phrasing and Pitch Sections of the PVSP.

– 4 of the 6 Ps did not improve on the Stress Section of the PVSP with performance remaining unacceptable throughout the investigation. However, 2 of the Ps appeared to improve.

– 5 of the 6 Ps did not evidence problems Loudness and their performance level remained stable. The remaining P did have a reduced score and did improve. The improvement seemed to be more related to the comfort level of the P and it was suspected that the initial poor score was not a problem.

–3 of the 6 Ps produced stable and relatively appropriate Laryngeal Quality during the investigation. One P was unstable at the beginning of the investigation and the other 2 Ps showed a tendency to improve

– 4 of the 6 Ps produced stable but inappropriate Resonance Quality throughout the investigation. One P showed improvement during the investigation. The remaining P started to improve and then performance regressed.


Diehl & Paul (2013)

July 18, 2015

NATURE OF PROSODIC DISORDERS

ANALYSIS FORM

 

Key:

 

ASD = Autism spectrum disorders

CA = chronological age

LD = Learning disability

NA = not applicable

P = participant(s)

PEPS-C = Profiling Elements of Prosodic Systems in Children

pmh = Patricia Hargrove, blog developer

SD = standard deviation

SS = Standard Score

TD = typically developing

 

 

SOURCE: Diehl, J. J., & Paul, R. (2013). Acoustic and perceptual measurements of prosody production on the Profiling Elements of Prosodic Systems in Children by children with autism spectrum disorders. Applied Psycholinguistics, 34, 135-161.

 

REVIEWER(S): pmh

 

DATE: July 11, 2015

ASSIGNED GRADE FOR OVERALL QUALITY: B+ (The highest possible grade, based on the design of the investigation, was B+.)

 

POPULATION: Autism spectrum disorders (ASD); Learning disability (LD)

 

PURPOSE: To investigate the prosody production (and to a lesser extent comprehension) of children with ASD, children with LD, and typically developing (TD) children using acoustic and perceptual measures of prosody.

 

INSIGHTS ABOUT PROSODY:

  • Comparisons of participant (P) groups on the subtests of the Profiling Elements of Prosodic Systems in Children (PEPS-C) revealed that the Ps with ASD and LD struggled with prosodic comprehension of affect, turn ends/terminal contour, and focus/stress but not chunking/phrasing. In addition, Ps with LD struggled with the production of accurate chunking/phrasing. The specific results are listed below:

– For the comprehension of affect subtest, the TD Ps performed significantly better than Ps with ASD or LD.

– For the production of affect subtest, the scores did not differ significantly for the 3 groups (ASD, LD, TD.)

– For the comprehension of turn ends/terminal contour subtest, TD Ps performed significantly better than Ps with ASD or LD.

– For the production of turn ends/terminal contour subtest, the scores did not differ significantly for the 3 groups.

– For the comprehension of chunking/phrasing subtest, the scores did not differ significantly for the 3 groups.

– For the production of chunking/phrasing subtest, the Ps with LD performed significantly more poorly than the Ps with ASD and the TD peers.

– For the comprehension of focus/stress subtest, the TD Ps performed significantly better than Ps with ASD or LD.

– For the production of focus/stress subtest, the scores did not differ significantly for the 3 groups (ASD, LD, TD.)

  • The prosodic productions of the Ps also were measured acoustically.

– As a group, the Ps with ASD displayed significant differences from the TD on the following:

  • longer duration of utterances for affect (conveying dislike) and turn-end/terminal contour tasks.
  • louder intensity for stress/focus task.
  • wider average f0 range for focus/stress task
  • larger SD of f0 during focus/stress task
  • On several expressive prosodic tasks, the Ps with LD produced prosody that differed significantly from the TD peers:
  • lower average f0 for turn ends/terminal contour, chunking/phrasing, and focus/stress tasks.
  • longer duration for turn-end/terminal contour
  • Because the intent of Ps and ASD were regularly interpreted by judges as correct, the findings may be interpreted as indicating that most Ps with ASD or LD can convey meaning using prosody. However, at times their productions are atypical.

 

 

  1. What type of evidence was identified? Prospective, Nonrandomized Group Comparison Design
  1. Group membership determination:

 

  • If there were groups of participants were members of groups matched? Yes

                                                                    

  • The matching strategy involved

The TD group and ASD and LD groups were matched on chronological age (CA).

–  The participants (Ps) with LD and ASD were matched on CA, nonverbal IQ, CELF-4 core, and receptive language scores,

  1. Was participants’ communication status concealed?
  • from participants? No
  • from assessment administrators? No
  • from data analyzers? Unclear

                                                                    

 

  1. Were the groups adequately described? Yes

How many participants were involved in the study?

  • total # of participants: 62
  • was group membership maintained throughout the experiment? Yes
  • # of groups: 3
  • List names of groups:

– TD (Typically developing)

– LD (Learning disability)

– ASD (Autism spectrum disorder)

  • # of participants in each group:

– TD = 22

– LD = 16

– ASD = 24

 

The following variables were CONTROLLED

 

  • neurological status: neurological problems excluded
  • vision: visual loss excluded, if uncorrected
  • hearing: hearing loss excluded
  • diagnosis:

All ASD Ps had been diagnosed with ASD (autism, Asperger’s syndrome, or PPD-NOS);

     – All LD Ps showed no sign of ASD and there were no reports of first degree family members with ASD;

     – For the TD group, the parents reported typical development; there were no reports of first degree family members with ASD or no previous diagnoses of development disability; and TD Ps were in the appropriate grade in school

– The following variables were DESCRIBED

  • age: mean age ASD group = 12.31; mean age LD group = 12.99; mean age TD group = 12.21
  • gender: ASD = 16m, 8f; LD = 12m, 4f; TD = 15m, 7f
  • nonverbal IQ: ASD = 103.61; LD = 96.85 (difference was not significant); TD—not reported
  • core language on CELF-4: ASD = 97.21; LD = 88.94: TD—not reported
  • expressive language on CELF-4: ASD = 100.54; LD = 90.00 (difference was significant); TD not reported
  • receptive language: ASD = 93.67; LD = 88.73; (difference was significant); TD not reported
  • learning disability: based on parent report of the LD group—5 Ps with reading disability, 11 Ps with language-based learning disability
  • Were the communication problems adequately described? Yes

– Communication disorder descriptions:

 

ASD

     – The Standard Score (SS) for the Core CELF-4 for the ASD group

  • ranged from 67-132
  • mean was 97.21

     – The SS for the Receptive Language CELF-4 for the ASD group

  • ranged from 58-121
  • mean was 93.67

– The SS for the Expressive Language CELF-4 for the ASD group

  • ranged from 75-126
  • mean was 100.54
  • This was significantly higher than the LD group.

LD

     – The SS for the Core CELF-4 for the LD group

  • ranged from 60-117
  • mean was 88.94

     – The Standard SS for the Receptive Language CELF-4 for the LD group

  • ranged from 58-119
  • mean was 88.73

– The SS for the Expressive Language CELF-4 for the LD group

  • ranged from 65-114
  • mean was 90.00
  • This was significantly lower than the ASD group.

 

  1. What were the different conditions for this research?

                                                                                                             

– Subject (Classification) Groups? Yes

  • There were 3 subject groups:

     – ASD

     – LD

     – TD

                                                               

– Experimental Conditions? No

 Criterion/Descriptive Conditions? Yes. Performance on the Profiling Elements of Prosodic Systems in Children (PEPS-C)

 

  1. Were the groups controlled acceptably? Yes

 

 

  1. Were dependent measures appropriate and meaningful? Yes

 

The dependent measures were

  • Dependent Measure #1: To comprehend affect signaled by prosody (number correct)

 

  • Dependent Measure #2: To express correctly affect using prosody (number correct perceptually)

 

  • Dependent Measure #3: Expression of prosodic affect of all liking food items as measured by

– average f0

– f0 standard deviation

– f0 variability/range

– intensity of utterance

– duration of utterance

 

  • Dependent Measure #4: Expression of prosodic affect of all not liking food items as measured by

– average f0

– f0 standard deviation

– f0 variability/range

– intensity of utterance

– duration of utterance

 

  • Dependent Measure #5: Expression of prosodic affect of all and correct only liking food items as measured by

– average f0

– f0 standard deviation

– f0 variability/range

– intensity of utterance

– duration of utterance

  • Dependent Measure #6: Expression of prosodic affect of correct not liking food items as measured by

– average f0

– f0 standard deviation

– f0 variability/range

– intensity of utterance

– duration of utterance

 

  • Dependent Measure #7: To comprehend when sentences contained prosody signifying question asking (correct responses)

 

  • Dependent Measure #8: To express statements and questions using prosody (perceptually measured)

 

  • Dependent Measure #9: Prosodic expression of all questions as measured by

– average f0

– f0 standard deviation

– f0 variability/range

– intensity of utterance

– duration of utterance

 

  • Dependent Measure #10: Prosodic expression of correct questions as measured by

– average f0

– f0 standard deviation

– f0 variability/range

– intensity of utterance

– duration of utterance

 

  • Dependent Measure #11: Prosodic expression of all statements as measured by

– average f0

– f0 standard deviation

– f0 variability/range

– intensity of utterance

– duration of utterance

 

  • Dependent Measure #12: Prosodic expression of correct statements as measured by

– average f0

– f0 standard deviation

– f0 variability/range

– intensity of utterance

– duration of utterance

  • Dependent Measure #13: To comprehend prosodic chunking (correct responses)

 

  • Dependent Measure #14: To produce accurate prosodic chunking (correct responses)

 

  • Dependent Measure #15: Prosodic expression of chunking of all subtest items as measured by

– average f0

– f0 standard deviation

– f0 variability/range

– intensity of utterance

– duration of utterance

 

  • Dependent Measure #16: Prosodic expression of chunking of correct subtest items as measured by

– average f0

– f0 standard deviation

– f0 variability/range

– intensity of utterance

– duration of utterance

 

  • Dependent Measure #17: To comprehend prosodic stress/focus (correct responses)

 

  • Dependent Measure #18: To express stress/focus prosodically (correct responses)
  • Dependent Measure #19: Prosodic expression of stress/focus of all subtest items as measured by

– average f0

– f0 standard deviation

– f0 variability/range

– intensity of utterance

– duration of utterance

 

  • Dependent Measure #20: Prosodic expression of stress/focus of correct subtest items as measured by

– average f0

– f0 standard deviation

– f0 variability/range

– intensity of utterance

– duration of utterance

The dependent measures that were subjective were

  • Dependent Measure #1: To comprehend samples of prosodic affect (number correct)
  • Dependent Measure #2: To express correctly affect using prosody (number correct perceptually)
  • Dependent Measure #7: To comprehend when sentences contained prosody signifying question asking (correct responses)
  • Dependent Measure #8: To express statements and questions using prosody (perceptually measured)
  • Dependent Measure #13: To comprehend prosodic chunking (correct responses)
  • Dependent Measure #14: To produce accurate prosodic chunking (correct responses)
  • Dependent Measure #17: To comprehend prosodic stress/focus (correct responses)
  • Dependent Measure #18: To express stress/focus prosodically (correct responses)

–   The dependent/ outcome measures that were objective are

 

  • Dependent Measure #3: Expression of prosodic affect of all liking food items as measured by

– average f0

– f0 standard deviation

– f0 variability/range

– intensity of utterance

– duration of utterance

  • Dependent Measure #4: Expression of prosodic affect of all not liking food items as measured by

– average f0

– f0 standard deviation

– f0 variability/range

– intensity of utterance

– duration of utterance

  • Dependent Measure #5: Expression of prosodic affect of all and correct only liking food items as measured by

– average f0

– f0 standard deviation

– f0 variability/range

– intensity of utterance

– duration of utterance

  • Dependent Measure #6: Expression of prosodic affect of correct not liking food items as measured by

– average f0

– f0 standard deviation

– f0 variability/range

– intensity of utterance

– duration of utterance

  • Dependent Measure #9: Prosodic expression of all questions as measured by

– average f0

– f0 standard deviation

– f0 variability/range

– intensity of utterance

– duration of utterance

  • Dependent Measure #10: Prosodic expression of correct questions as measured by

– average f0

– f0 standard deviation

– f0 variability/range

– intensity of utterance

– duration of utterance

  • Dependent Measure #11: Prosodic expression of all statements as measured by

– average f0

– f0 standard deviation

– f0 variability/range

– intensity of utterance

– duration of utterance

  • Dependent Measure #12: Prosodic expression of correct statements as measured by

– average f0

– f0 standard deviation

– f0 variability/range

– intensity of utterance

– duration of utterance

  • Dependent Measure #15: Prosodic expression of chunking of all subtest items as measured by

– average f0

– f0 standard deviation

– f0 variability/range

– intensity of utterance

– duration of utterance

  • Dependent Measure #16: Prosodic expression of chunking of correct subtest items as measured by

– average f0

– f0 standard deviation

– f0 variability/range

– intensity of utterance

– duration of utterance

  • Dependent Measure #19: Prosodic expression of stress/focus of all subtest items as measured by

– average f0

– f0 variability/range

– f0 standard deviation

– intensity of utterance

– duration of utterance

  • Dependent Measure #20: Prosodic expression of stress/focus of correct subtest items as measured by

– average f0

– f0 standard deviation

– f0 variability/range

– intensity of utterance

– duration of utterance

                                         

 

  1. Were reliability measures provided?

                                                                                                            

– Interobserver for analyzers? Yes

  • Average overall interrater reliability for combined combined Dependent Measures #2 was 0.88. (As a reminder, Dependent Measures #2 is listed below.)

– Dependent Measure #2: To express correctly affect using prosody (number correct perceptually)

 Intraobserver for analyzers? No

 

– Treatment/Procedural fidelity for investigators? No

 

 

  1. Description of design:
  • This investigation involved a prospective, nonrandom comparison design.
  • There were 3 groups of Ps:

– ASD

– LD

– TD

  • All 3 groups were administered the PEPS-C.
  • The dependent measures involved

– perceptual judgments of correction on and production subtests of the PEPS-C

– acoustic analysis of the production subtests.

  • The acoustic analyses comprised:

– average f0

– standard deviation of f0

– f0 range

– utterance duration

– utterance intensity

 

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

– The comparisons are significant presented with p ≤ 0.05.

  • Dependent Measure #1: To comprehend affect using prosody (number correct): TD was significantly better than ASD and LD
  • Dependent Measure #2: To express correctly affect using prosody (number correct perceptually): No significant differences
  • Dependent Measure #3: Expression of prosodic affect of all liking food items as measured by the 5 variables: No significant differences
  • Dependent Measure #4: Expression of prosodic affect of all not liking food items as measured by the 5 variables: No significant differences
  • Dependent Measure #5: Expression of prosodic affect of all and correct liking food items as measured by the 5 variables: No significant differences
  • Dependent Measure #6: Expression of prosodic affect of correct not liking food items as measured by

– average f0

– f0 standard deviation:

– f0 variability/range

– intensity of utterance

– duration of utterance: The ASD group produced significantly longer utterances than the LD group and the TD group.

  • Dependent Measure #7: To comprehend when sentences contained prosody signifying question asking (correct responses): TD was significantly better than ASD and LD
  • Dependent Measure #8: To express statements and questions using prosody (perceptually measured): No significant differences:
  • Dependent Measure #9: Prosodic expression of all questions as measured by

– average f0: The LD group produced significantly lower average f0 and the TD group

– f0 standard deviation:

– f0 variability/range:

– intensity of utterance

– duration of utterance: The Ps with ASD produced significantly longer utterances than the TD peers.

  • Dependent Measure #10: Prosodic expression of correct questions as measured by

– average f0: : The LD group produced significantly lower average f0 and the TD group

– f0 standard deviation:

– f0 variability/range

– intensity of utterance

– duration of utterance

  • Dependent Measure #11: Prosodic expression of all statements as measured by

– average f0

– f0 standard deviation:

– f0 variability/range

– intensity of utterance

– duration of utterance: Ps with ASD produced significantly longer utterances than Ps with LD and those with TD. The Ps with LD produced significantly longer utterances than TD peers.

  • Dependent Measure #12: Prosodic expression of correct statements as measured by

– average f0: The LD group produced significantly lower average f0 and the TD group

– f0 standard deviation:

– f0 variability/range

– intensity of utterance

– duration of utterance: Ps with ASD produced significantly longer utterances than Ps with LD and those with TD. The Ps with LD produced significantly longer utterances than TD peers.

  • Dependent Measure #13: To comprehend prosodic chunking/phrasing (correct responses) No significant differences
  • Dependent Measure #14: To produce accurate prosodic chunking/phasing (correct responses): The Ps with LD displayed significantly lower scores than Ps with ASD and the TD peers.
  • Dependent Measure #15: Prosodic expression of chunking of all subtest items as measured by

– average f0: Ps with LD produced significantly lower f0 than TD peers and Ps with ASD.

– f0 standard deviation

– f0 variability/range

– intensity of utterance

– duration of utterance

  • Dependent Measure #16: Prosodic expression of chunking of correct subtest items as measured by

– average f0: Ps with LD produced significantly lower f0 than TD peers and Ps with ASD.

– f0 standard deviation

– f0 variability/range

– intensity of utterance

– duration of utterance

  • Dependent Measure #17: To comprehend prosodic stress/focus (correct responses): The TD group exhibited significantly higher scores than the ASD and LD groups.
  • Dependent Measure #18: To express stress/focus prosodically (correct responses): No significant differences
  • Dependent Measure #19: Prosodic expression of stress/focus of all subtest items as measured by

– average f0: The LD group was significantly lower than the TD and ASD groups

– f0 standard deviation: The ASD and LD groups were significantly larger than the TF group

– f0 variability/range: Ps with ASD used a significantly wider range than TD.

– intensity of utterance

– duration of utterance

  • Dependent Measure #20: Prosodic expression of stress/focus of correct subtest items as measured by

– average f0: The LD group was significantly lower than the TD and ASD groups

– f0 standard deviation: The f0 SD was significantly smaller for the TD group than for the ASD group.

– f0 variability/range: The range of the ASD group was significantly larger range than the TD group.

– intensity of utterance: The Ps with ASD were significantly louder than the Ps with LD.

– duration of utterance

 

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

–   Were effect sizes provided? Yes. The effect sizes for significant comparisons ranged from 0.05 (small) to 0.25 (large).

– Were confidence intervals (CI) provided? No

 

 

  1. What were the results of the correlational statistical testing? There was no correlational analysis.

 

  1. What were the results of the descriptive analysis? The descriptive analysis was secondary to the inferential analysis.

 


Russo et al. (2008)

June 30, 2015

NATURE OF PROSODIC DISORDERS

ANALYSIS FORM

 

Key:

 

ASD = Autism spectrum disorders

fo = fundamental frequency

H2 = second harmonic

NA = not applicable

P = participant or patient

pmh = Patricia Hargrove, blog developer

TD = typically developing

WNL = within normal limits

 

 

SOURCE:  Russo. N. M., E. Skoe, E., Trommer, B., Nicol, T., Zecker, S., Bradlow, N., Kraus, N. (2008). Deficient brainstem encoding of pitch in children with Autism Spectrum Disorders. Clinical Neurophysiology, 119, 1730-1731.

 

REVIEWER(S): pmh

 

DATE: June 21, 2015

ASSIGNED GRADE FOR OVERALL QUALITY: B+ (The highest grade for this investigation, based on its design, is B+.)

 

POPULATION: Autism Spectrum Disorders (ASD)

 

PURPOSE: To investigate the subcortical responsiveness to prosody in children with ASD.

 

INSIGHTS ABOUT PROSODY:

  • The ability of children with ASD to encode pitch less was accurate/preserved and less robust than typically developing (TD) peers.
  • However, subgroup analysis of the ASD group revealed that a small group of children with ASD (i.e., ASD OUT) accounted for the poor pitch encoding scores.
  • The ASD OUT group included 5 Ps (about 20% of the overall ASD group) and they exhibited more Frequency and Slope errors as well as reduced pitch locking.

 

 

  1. What type of evidence was identified? Prospective, Nonrandomized Group Comparison Design
  1. Group membership determination:

 

  • If there were groups of participants were members of groups matched? Yes

                                                                    

  • The participants (Ps) were matched by age.
  1. Was participants’ communication status concealed?

                                                                                                           

  • from participants? No
  • from assessment administrators? No
  • from data analyzers? Unclear

                                                                    

 

  1. Were the groups adequately described? Yes

– How many participants were involved in the study?

  • total # of participants: originally there were 48 Ps but 6 Ps with ASD were eliminated due to abnormal brainstem responses (click evoked brainstem responses –atypical Wave V latency), noncompliance, parental choice, and/or relocation; the working total of Ps was 42
  • was group membership maintained throughout the experiment? 6 Ps withdrew/were eliminated from the investigation, as noted above
  • # of groups: 2
  • List names of groups: Autism Spectrum Disorders (ASD), typically developing (TD)
  • # of participants in each group: ASD = 21; TD = 21

                                                                                

– Characteristics of Ps:

CONTROLLED                                                                                           

  • age: 7 to 13 years
  • cognitive skills: Full scale IQ In which with the confidence intervals, the value is >80
  • hearing: within normal limits (WNL)
  • diagnosis: for the Ps with ASD, diagnosis by neurologist/psychologist and actively followed
  • neurological problems: lack of confounding neurological problems

 

DESCRIBED

  • age: mean age ASD = 9.9; mean age TD = 9.95 (no significant difference)
  • gender: ASD = 19m, 2f; TD = 13m, 8f
  • cognitive skills: for both groups the mean was WNL, although TD Ps scored significantly higher
  • expressive language: mean scores on the core portion of the Clinical Evaluation of Language Fundamentals were WNL, although TD Ps scored significantly higher
  • receptive language: mean scores on the receptive portion of the Clinical Evaluation of Language Fundamentals were WNL, although TD Ps scored significantly higher
  • overall language skills: mean scores of the core Clinical Evaluation of Language Fundamentals were WNL, although TD Ps scored significantly higher
  • diagnoses of Ps with ASD: parent reported the following specific diagnoses– autism, Asperger Disorder, PDD-NOS, combined diagnoses
  • supplemental observations by investigators of Ps with ASD: Ps displayed some or all of the following

   – limited eye contact

   – limited reciprocity

   – restricting range of topics in conversation

   – use of restricted or idiosyncratic language

   – abnormal prosody

   – echolalia or scripted speech

   – stereotyped movements

 

Were the communication problems adequately described? Yes, but I would have liked to see a description of the communication scores of ASD OUT versus ASD IN Ps.

  • disorder type: ASD
  • functional level: observations by investigators of Ps with ASD revealed that Ps displayed some or all of the following:

– limited eye contact

– limited reciprocity

– restricting range of topics in conversation

– use of restricted or idiosyncratic language

– abnormal prosody

– echolalia or scripted speech

 

  1. What were the different conditions for this research?
  • Subject (Classification) Groups? Yes: ASD, TD
  • Experimental Conditions? No
  • Criterion/Descriptive Conditions? Yes: passively evoked brainstem responses to

     – click evoked brainstem responses

     – speech evoked brainstem responses– speech syllables with descending and ascending pitch contours

  1. Were the groups controlled acceptably? Yes

 

 

  1. Were dependent measures appropriate and meaningful? Yes

– The dependent measures were

  • Dependent Measure #1: Wave V latency within the normal range (this was actually an exclusionary criterion; 2 Ps with ASD were excluded from the original 48 Ps)
  • Dependent Measure #2: Rate of frequency errors (an accuracy measure of encoding) for fo (fundamental frequency) and H2 (second harmonic)
  • Dependent Measure #3: Rate of slope error (a measure of preservation of the pitch contour) for fo (fundamental frequency) and H2 (second harmonic)
  • Dependent Measure #4: Rate of pitch strength (a measure of periodicity) for fo (fundamental frequency)
  • Dependent Measure #5: Composite score of overall pitch tracking (frequency errors of fo plus frequency errors and pitch strength of H2)
  • Dependent Measure #6: Relationship of age, sex, and intelligence on brainstem responses

None of the dependent measures that were subjective.

 

– All of the dependent/ outcome measures were objective.

                                         

 

  1. Were reliability measures provided?

                                                                                                            

  • Interobserver for analyzers? No
  • Intraobserver for analyzers? No
  • Treatment/Procedural fidelity for investigators? No
  • Test/Retest Reliability? Yes. Six Ps with ASD were retested. There were no significant differences in the first and second administrations of the protocol using nonparametric statistical analysis. Accordingly, the Ps responses were judged to be stable and reliable.

 

 

  1. Brief description of design:
  • The investigators compared Ps with ASD and TD peers on series of measures representing the subcortical processing of prosody using passively evoked brainstem responses.
  • Ps watched a video of their choice as the experimental stimuli were delivered to the right ear. The investigators instructed the Ps to ignore the sounds in their right ear.
  • Two sets of stimuli were presented:

– clicks (these were part of the exclusion criteria. Ps with abnormal Wave V latency were excluded from the investigation)

– speech (a single syllable [ya] with ascending and descending pitch contours)

  • The investigators compared the TD and ASD groups on the dependent measures using parametric statistics.
  • They then performed follow up with an statistical analysis of the ASD group (using nonparametrics) in which they identified two subgroups: ASD OUT and ASD IN.

 

 

  1. What were the results of the inferential statistical testing

 

– The comparisons that are significant are p ≤ 0.05.

NOTE: For several of the dependent measure, there were 2 sets of comparisons:

  • ASD vs TD and
  • a subgroup analysis for the ASD Ps — ASD OUT (n = 5) vs ASD IN (n = 16.)

The subgroups of ASD were classified on the basis of performance on the composite score (Dependent measure #5.) The ASD OUT group (i.e., deficient pitch trackers) had composite scores that were <1.65 standard deviations from the overall ASD mean composite score. The ASD OUT group comprised

– 3 Ps with Asperger Disorder

– 1 P with PDD-NOS

– 1 P with ASD with Sensory Integration Disorder

  • Dependent Measure #1: Wave V latency within the normal range (this was actually an exclusionary criterion)— no significant differences between ASD and TD groups, although 2 Ps with were eliminated from the investigation;

 

  • Dependent Measure #2: Rate of frequency errors (an accuracy measure of encoding) for fo (fundamental frequency) and H2 (second harmonic)

For fo, the overall ASD group was significantly less accurate than the TD group.

     — For H2, the overall ASD group was significantly less accurate than the TD group.

   — Reanalysis of the data with the ASD subgroups revealed that for fo and for H2, the ASD IN performed similarly to the TD group but that the ASD OUT group differed significantly more poorly than the TD group and the ASD IN subgroup.

 

  • Dependent Measure #3: Rate of slope error (a measure of preservation of the pitch contour) for fo (fundamental frequency) and H2 (second harmonic)

— For fo, no significant differences between ASD and TD groups.

   — For H2, no significant differences between ASD and TD groups.

  • Dependent Measure #4: Rate of pitch strength (a measure of periodicity) for fo (fundamental frequency)

For fo, the ASD group yielded significantly higher scores than the TD group.

   — Reanalysis of the data with the ASD subgroups revealed that for fo, the ASD IN performed similarly to the TD group but that the ASD OUT group differed significantly from TD and the ASD IN subgroup.

  • Dependent Measure #5: Composite score of overall pitch tracking (frequency errors of fo plus frequency errors and pitch strength of H2)

— Overall, the TD group was significantly better than the ASD group.

 

  • Dependent Measure #6: Relationship of age, sex, and intelligence on brainstem responses

— Overall, Ps in the ASD group had significantly poorer scores than the TD group on measures of language skills (CELF) and most measures of intelligence with the exception of performance mental skills.

     — For the ASD subgroups, there were no significant differences on the measures of language and intelligence.

– What were the statistical tests used to determine significance? MANOVA, Mann-Whitney U, Kruskal-Wallis, and Chi square.

– Were effect sizes provided? Yes, but only for some of the measures. If an effect size is not listed for a dependent measure, it was not provided in the paper.

  • Dependent Measure #2: Rate of frequency errors (an accuracy measure of encoding) for fo (fundamental frequency) and H2 (second harmonic)

— For fo, the effect size for ASD vs TD scores was d = 0.61 (moderate)

     — For H2, the effect size for ASD vs TD scores was d = 0.73 (moderate)

  • Dependent Measure #4: Rate of pitch strength (a measure of periodicity) for fo (fundamental frequency)

— For fo, the effect size for ASD vs TD scores was d = 0.56 (moderate)

  • Dependent Measure #5: Composite score of overall pitch tracking (frequency errors of fo plus frequency errors and pitch strength of H2)

– Were confidence interval (CI) provided? No

 

 

  1. What were the results of the correlational statistical testing?
  • Dependent Measure #6: Relationship of age, sex, and intelligence on brainstem responses

– For the overall ASD group and the ASD IN subgroup, significant differences were not noted for the following

  • pitch tracking and measures of intelligence
  • pitch tracking and language measures (CELF)

     – Correlational analysis could not be performed with the data for the ASD OUT subgroup due to the small n.

  • What was the statistical test used to determine correlation? Pearson Product

Tosto et al. (2011)

June 18, 2015

NATURE OF PROSODIC DISORDERS

ANALYSIS FORM

 

Key:

 

AD = Altzheimer’s disease

NA = not applicable

NT = neurotypical

P = participant

pmh = Patricia Hargrove, blog developer

WNL = within normal limits

 

 

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

Journal Address: http://neuro.psychiatryonline.org

REVIEWER(S): pmh

 

DATE: June 13, 2015

ASSIGNED GRADE FOR OVERALL QUALITY: D (Based on the case study design, the highest possible grade was D+.)

 

POPULATION: Altzheimer’s disease (AD); Adult

 

PURPOSE: To describe comprehension and production of emotional prosody in an Italian male with mild, early onset AD.

 

INSIGHTS ABOUT PROSODY:

  • This case study diverges from the clinical literature on prosody in dementia in which the expectation is that

– problems with the comprehension of emotional prosody appear in the early stages of AD and then remain stable throughout the mild and moderate stages and

– problems with the production and imitation of emotional prosody are minimal during the early stages of AD but during the moderate stage of AD, significant problems with the production and imitation of emotional prosody begin to emerge.

  • In this case study of an adult Italian speaking male diagnosed being in the early stages of early onset AD, the participant (P) displayed significant impairment in the production and comprehension of emotional prosody.
  • The investigators recommend that clinicians (C) should carefully monitor the emotional prosody skills of Ps with AD and consider emotional prosody skills when working with AD individuals and their families.

 

 

  1. What type of evidence was identified? Case Study
  1. Group membership determination:
  • If there were groups of participants were members of groups matched? Not Applicable (NA), there was only one P.
  1. Was participant’s communication status concealed?
  • from participant? No
  • from assessment administrators? No
  • from data analyzers? No

                                                                    

 

  1. Was the participant adequately described? Yes. I would have liked more information but to be fair to the investigators I rated this question as “yes” because this was a letter to the Editor and was only 3 pages long.

 

How many participants were involved in the study? 1

The following variables were described:

  • age: 55 years
  • gender: male
  • cognitive skills: 29/30 on the Mini-Mental State Exam; within normal limits (WNL)
  • neurological exam: WNL
  • diagnosis: early onset AD
  • MRI results: cortical/subcortical atrophy of fronto-parietal areas
  • PET scan results: hypometabolism in the right frontal-temporal-parietal areas, left posterior parietal areas, and basal ganglia
  • results of neuropsychological testing:

– widespread, mild cognitive impairment,

     – more impaired on tasks sensitive for both right-hemisphere and executive function

  • educational level of P: may be 14 years

 

– Were the communication problems adequately described? No

  • disorder type: AD

 

 

  1. What were the different conditions for this research?

                                                                                                             

– Subject (Classification) Groups? No. There was only 1 P. ____

If yes, list:

Experimental Conditions? No

 

– Criterion/Descriptive Conditions? Yes

  • Experimental Protocol –Melodic Alternation [previously administered to a group of neurotypical (NT) adults: 10 Ps; same gender; mean age = 54.5; mean education: 14 years]

– Task 1: Auditory Verbal Task: P listened and identified the same neutral sentence produced with sad, happy, angry, surprised, and neutral prosody

– Task 2: Visual Task: P viewed facial expressions depicting sad, happy, angry, surprised, and neutral emotions and identified each

– Task 3: Repetition Task: using the sentences from Task 1, P imitated the same sentence using the emotional prosody modeled in the sentence. Independent judges listened to the models and the imitation to judge accuracy.

– Task 4: Production Task: The investigators presented P with a sentence and directed him/her to produce the sentence with sad, happy, angry, surprised, and neutral intonations.

 

  1. Were the groups controlled acceptably? NA

 

 

  1. Were dependent measures appropriate and meaningful? Yes

 

–   The dependent measures were

  • Dependent Measure #1: Performance on Task 1: Auditory Verbal Task
  • Dependent Measure #2: Performance on Task 1: Visual Task
  • Dependent Measure #3: Performance on Task 1: Repetition Task
  • Dependent Measure #4: Performance on Task 1: Production Task

 

All the dependent measures were subjective.

 

None of the dependent/ outcome measures were objective.

                                         

 

  1. Were reliability measures provided?

                                                                                                            

– Interobserver for analyzers? Yes

  • Dependent Measure #3: Performance on Task 1: Repetition Task—K index = 0.86
  • Dependent Measure #4: Performance on Task 1: Production Task—-K index = 0.93

 

Intraobserver for analyzers? No

 

– Treatment/Procedural fidelity for investigators? No

 

  1. Description of design:
  • In this case study, a 55-year-old Italian male, who had been diagnosed as being in the early stages of early-onset AD, was administered 4 tasks to assess his emotional prosody skills.
  • The 4 tasks were

– Task 1: Auditory Verbal Task: P listened to and identified the same neutral sentence produced with sad, happy, angry, surprised, and neutral prosody

– Task 2: Visual Task: P viewed facial expressions depicting sad, happy, angry, surprised, and neutral emotions and identified each

– Task 3: Repetition Task: using the sentences from Task 1, P imitated the same sentence using the emotional prosody modeled in the sentence. Independent judges listened to the models and the imitation to judge accuracy.

– Task 4: Production Task: The investigators presented P with a sentence and directed him to produce the sentence with sad, happy, angry, surprised, and neutral intonations. Independent judges listened to the production to judge accuracy.

  • The 4 tasks, Melodic Alternation, had previously been administered to a group of neurotypical (NT) adults: 10 Ps; same gender; mean age = 54.5; mean education: 14 years. This provided comparison data.

 

 

  1. What were the results of the inferential statistical testing? NA

 

  1. What were the results of the correlational statistical testing? Correlational statistics were presented only of the reliability data for measures #3 and #4. (See item #8.)

 

  1. What were the results of the descriptive analysis?
  • Dependent Measure #1: Performance on Task 1: Auditory Verbal Task—P correctly identified 31 of 60 trials (NT control group identified 58/60.) The emotional states that exhibited most errors were neutral, happy, and sad. The P also frequently confused these 3 states.

 

  • Dependent Measure #2: Performance on Task 1: Visual Task—P correctly identified 73% of the trials (NT control group identified correctly 92%. The emotional states that exhibited most problems were neutral and sad.

 

  • Dependent Measure #3: Performance on Task 1: Repetition Task—Overall, P incorrectly imitated prosody 33% of the time. The poorest imitation rate was for happiness (83% errors); the best imitation rates were for surprise (no errors) and neutral.

 

  • Dependent Measure #4: Performance on Task 1: Production Task—All the production trails were associated with some failure. Happy (100% error rate) and angry (83% error rate) were the most challenging emotions to produce acceptably.