Reviews About Treating Prosody

Most recent update:  May 28,  2017

 

REVIEWS ABOUT TREATING PROSODY

 

  • This table can be used to locate reviews about different prosodic interventions.
  • Scroll down to the aspect of prosody that you are interested in treating.
  • The table is organized by prosodic outcomes which include

Affect Outcomes

Duration Outcomes

Fluency Outcomes

General Prosodic Outcomes

Intonation Outcomes

Intonation –Overall Contour Outcomes

Intonation – Terminal Contour Outcomes

Linguistic Prosody Outcomes

Loudness Outcomes

Pause Outcomes

Phrasing Outcomes

Pitch Outcomes

Pitch Level Outcomes

Pitch Variability/Range Outcomes

Rate Outcomes

Rhythm Outcomes

Rhythm — Stress Sequences Outcomes

Stress Outcomes

Stress- Emphatic Outcomes

Stress—Lexical Outcomes

Stress – Sentence Outcomes

 

NOTE:  Full reviews can be accessed by clicking on (or cutting and pasting) the address at the end of each summary.

 

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AFFECT OUTCOMES

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Strong Evidence, minus

  • These single subject experimental design investigations provide strong support for two approaches to increasing the percentage of correctly read sentences using a targeted affect (Leon et al., 2005.) Right Hemisphere Damage, Aprosodia; Adult https://clinicalprosody.wordpress.com/?s=Leon

 

  • Recognition of affective prosody did not improve following inventions that targeted other aspects of affect (facial recognition, ability to infer from the context.) The findings suggest that affective prosody needs to be directly treated (Radice-Neumann et al, 2009.) Traumatic Brain Injury; Adults https://clinicalprosody.wordpress.com/2016/02/13/radice-neumann-et-al-2009/

 

 

  • Fourteen single subject experimental design studies support the effectiveness of 6 step Imitative or Cognitive-Linguistic continuum for increasing the number of sentences produced with the targeted affective prosody (Rosenbek et al., 2006.) Aprosodia; Adult   https://clinicalprosody.wordpress.com/?s=Rosenbek

 

  • The results of single subject experimental design studies indicated that both cognitive-linguistic and imitative intervention approaches were effective in improving the rate of correct productions of 3 affects/emotions: happy, sad, angry. The investigators provided thorough descriptions of both intervention procedures as well as the participant characteristics (Rosenbek et al., 2007). Expressive Aprosodia, Right Hemisphere Brain Damage; Adults https://clinicalprosody.wordpress.com/2015/01/21/rosenbek-et-al-2004/

 

Moderate Evidence

  

  • Using single-subject experimental design studies explored, the effectiveness of across-modal matching to sample intervention to improve the comprehension of affective prosody of Japanese children diagnosed was confirmed (Matsuda & Yamamoto, 2013.) Autism Spectrum Disorders; Children https://clinicalprosody.wordpress.com/2015/01/29/matsuda-yamamote-2013/

 

  • Single subject experimental design investigations revealed that a computer based intervention administered by a “tutor” was associated with moderate improvements on formal tests of prosodic affect recognition. There only was limited support for generalization to social interaction with peers (Lacava et al., 2010.)  Autism Spectrum Disorders; Children https://clinicalprosody.wordpress.com/2015/02/28/lacava-et-al-2010/

 

 

  • The systematic review summarized and analyzed the literature pertaining to the use of computer-based interventions to treat social and emotional outcomes. All the direct treatments of recognition of prosodic emotion employed “Mind Reading” software. Gains generally were moderate to large (Ramdoss et al., 2012).  Autism Spectrum Disorders; Children, Adolescents, Adults https://clinicalprosody.wordpress.com/2015/05/03/ramdoss-et-al-2012/ 

 

Moderate Evidence, minus

  • Computer-assisted technologies have potential to improve comprehension of prosodic affect and sarcasm/metaphors in individuals with autism spectrum disorders (ASD) but it is not clear that it is more effective than conventional interventions (Ploog et al., 2013.) Autism Spectrum Disorders, Asperger’s Syndrome; Children https://clinicalprosody.wordpress.com/2016/03/28/ploog-et-al-2013/

 

 

Fair Evidence

  • Using pre- and post-tests scores of a single group the investigators determined that a self-administered computer based program (Mind Reading software) has potential for improving the recognition of prosodic affect (Lacava et al., 2007.) Aspergers Syndrome; Children https://clinicalprosody.wordpress.com/2015/02/17/lacava-et-al-2007/

 

 

Fair Evidence, minus

  • Support for an intervention procedure for improving matching of facial expression and affective prosody, discrimination of affective and grammatical functions of prosody, and production of selected affective prosody (Scott & Caird,1984.) Parkinson’s Disease; Adulthttps://clinicalprosody.wordpress.com/?s=Scott+%26+Caird+%281984%29

 

 

  • Single subject experimental design investigation provides acoustic evidence (fo mean, fo variability, Intensity mean, Intensity variability) supporting change in emotional prosody using either of Rosenbek’s 6 step continuum programs (Jones et al., 2009.) Expressive Aprosodia; Adults https://clinicalprosody.wordpress.com/?s=Jones

 

Limited Evidence

 

 

  • This case study provides limited support for a procedure involving modeling and biofeedback to improve prosodic imitation and production on an author designed test and production of facial gestures (Stringer, 1996.) Aprosodia; Adults https://clinicalprosody.wordpress.com/?s=Stringer

 

  • The authors provide treatment recommendations for receptive and expressive goals associated with affective prosody. The recommendations are accompanied by 3 illustrative case studies in which real and/or potential treatment plans are presented (Robin et al., 1991). Brain Damage; Neurogenic Conditions; Adults https://clinicalprosody.wordpress.com/2014/09/30/robin-et-al-1991/

 

  • The author summarizes research indicating that while people with ASD may experience difficulty interpreting emotional prosody, their (musical) tonal pitch tends to be intact and suggests that MT interventions may use this intact skill to improve emotional prosody comprehension. No specific procedures were recommended but the author encouraged additional research (Khetrapal, 2009.) Autism Spectrum Disorders https://clinicalprosody.wordpress.com/2015/06/02/khetrapal-2009/

  

No Evidence Provided Concerning Treatment of Impaired Learners

 

  • This retrospective investigation of typically developing Canadian children revealed that groups that had received for keyboard and drama instruction exhibited superior skills in distinguishing fearful and angry affective prosody to Ps who had received no treatment or singing instruction (Thompson, et al., 2004) Typically Developing; Children https://clinicalprosody.wordpress.com/2016/05/05/thompson-et-al-2004/ 

 

 

 

Evidence contraindicates the use of the intervention for the specific outcome(s)

 

  • Recognition of affective prosody did not improve following inventions that targeted other aspects of affect (facial recognition, ability to infer from the context.) The findings suggest that affective prosody needs to be directly treated (Radice-Neumann et al, 2009.) Traumatic Brain Injury; Adults https://clinicalprosody.wordpress.com/2016/02/13/radice-neumann-et-al-2009/

 

  • This single-subject experimental design investigation revealed that there was no improvement in the percentage of correct production of targeted affective prosody as the result of the drug Bromocriptine (Raymer et al., 2001.)   Aphasia, Crossed Nonfluent Aphasia; Adults https://clinicalprosody.wordpress.com/2015/09/09/raymer-et-al-2001/

 

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DURATION OUTCOMES

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Strong Evidence, minus

  • This prospective, randomized group design with controls investigation supports the effectiveness of Lee Silverman Voice Treatment (LSVT) as well as respiration-based (R) therapy in improving utterance duration (Ramig et al., 1995.) Parkinson’s Disease; Adult  https://clinicalprosody.wordpress.com/2014/02/04/ramig-et-al-1995/

 

 

Moderate Evidence, plus

 

  • This single-subject experimental design investigation provides moderate support for an intervention involving auditory and visual feedback to modify duration/speaking rate (Le Dorze et al., 1992.) Parkinson’s Disease; Adult  https://clinicalprosody.wordpress.com/?s=Le+Dorze

 

Moderate Evidence

  • Duration based pairwise variability index differences between 2 adjacent syllables (stressing) yielded strong change (Ballard et al., 2010.) Childhood Apraxia of Speech; Child  https://clinicalprosody.wordpress.com/?s=Ball

  

 

Moderate Evidence, minus

  • This Systematic Review (SR) with broad criteria is concerned with a variety of treatments and outcomes. The authors of the SR rated sources for quality of certainty of results. The source that targeted duration was rated as Preponderant (Murray et al., 2014.) Childhood Apraxia of Speech; Children https://wordpress.com/post/clinicalprosody.wordpress.com/1329

 

 

Fair Evidence, plus

 

Fair Evidence

  • This case study provides limited support for a treatment approach that combines explicit and interactive components to resolve lengthening and pausing (Bellon-Harn et al., 2007.) Childhood Apraxia of Speech, Child  https://clinicalprosody.wordpress.com/?s=Bellon

 

 

 

  • Overall results of 2 Experiments involved French children diagnosed with reading impairments treated with Cognitive-Musical Training (CMT) indicated at improvement in some measures of syllable duration perception (Habib et al., 2016.) Literacy Problems; Children  https://clinicalprosody.wordpress.com/2017/03/12/habib-et-al-2016/

 

 

Fair Evidence, minus

 

 

 

Limited Evidence, plus

 

Limited Evidence

 

 

  • Use of visual (oscilloscope and intraoral pressure) feedback shows promise for increasing normalcy ratings of some (but not all) Ps’ duration for marking stress (Caligiuri & Murry, 1983.) Dysarthria; Adult  https://clinicalprosody.wordpress.com/?s=Caligiuri

 

 

Limited Evidence, minus

 

 

  • This traditional narrative reviews provides a guide to incorporating Lee Silverman Voice Treatment (LVST-Loud) into telepractice and reviews research documenting its effectiveness as well as its costs and P satisfaction (Theodoros & Ramig, 2011) Parkinson’s Disease; Adults https://clinicalprosody.wordpress.com/2014/05/23/theodoros-ramig-2011

 

  • Based on the critique of 2 investigations of children with childhood apraxia of speech this narrative review contends that Rapid Syllable Transition Treatment (ReST) has potential for success with adults with apraxia of speech (Ballard et al., 2010b). Apraxia of Speech; Adult  https://clinicalprosody.wordpress.com/2014/06/13/ballard-et-al-2010/

 

No Intervention  Evidence Provided

 

 

Evidence contraindicates the use of the intervention for the specific outcome(s)

  • The results from this case study indicate that this computer-based intervention was not effective in reducing scanning speech by increasing the temporal variability (duration) of adjacent syllables (Tjaden, 2000). Expressive Aphasia, Scanning Speech; Adult  https://clinicalprosody.wordpress.com/2013/05/24/tjaden-2000/

 

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FLUENCY OUTCOMES

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Fair Evidence

 

 

Limited Evidence

 

 

Limited Evidence, minus

  • This single group investigation revealed that a comprehension-based Readers Theatre intervention for 2nd graders who are English Language Learners can improve timing (phrasing), intonation, and stress (i.e., fluency) of oral reading (Daly, 2009). Literacy (fluency), ELL; Child https://clinicalprosody.wordpress.com/2014/06/02/daly-2009/

 

 

 

No Evidence Provided

  • This expert opinion presents evidence from the literature that dysfluent reading may be associated with teacher behaviors. Although the focus of the teaching strategies was dysfluent reading, these strategies could be helpful with prosodic problems (Allington, 2006.) Literacy problems; child, adolescent https://clinicalprosody.wordpress.com/2014/03/16/allington-2006/

 

 

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GENERAL PROSODIC OUTCOMES

______________________________________________________

Moderate Evidence, plus

  

Moderate Evidence

 

 

 

 

Moderate Evidence, minus

  • This Systematic Review (SR) with broad criteria is concerned with a variety of treatments and outcomes. The authors of the SR rated sources for quality of certainty of results. The source that targeted prosody accuracy was rated as Suggestive (Murray et al., 2014.) Childhood Apraxia of Speech; Children https://wordpress.com/post/clinicalprosody.wordpress.com/1329

 

  • The evidence is fair to weak but the program shows promise to improve accuracy and intensity ratings on the Prosody Test (McDonald et al., 2012.) Nonprogresssive Brain Injury, Affect Comprehension Problems; Adults https://clinicalprosody.wordpress.com/?s=McDonald

 

 

Fair Evidence

  

Fair Evidence, minus

 

 

  • Music therapy results in improved performance on an author designed test, pragmatic outcomes, semantic outcomes, phonology outcomes, and prosody outcomes (Lim, 2010.) Autism Spectrum Disorders; Children https://clinicalprosody.wordpress.com/?s=Lim

 

  • Support for an intervention procedure to improve a prosodic abnormality score, discrimination of prosodic contrasts, discrimination of affective and grammatical functions of prosody, and discrimination of semantic functions of prosody (Scott & Caird,1984.) Parkinson’s Disease; Adults  https://clinicalprosody.wordpress.com/?s=Scott+%26+Caird+%281984%29

 

Limited Evidence, plus

  • Use of visual (oscilloscope and intraoral pressure) feedback shows promise for increasing normalcy ratings of some (but not all) Ps’ overall prosody (Caligiuri & Murry, 1983,) Dysarthria; Adults https://clinicalprosody.wordpress.com/?s=Caligiuri

 

 

Limited Evidence

  • Some acoustic measures (Fo, intensity) associated with stress improved but not the acoustic measures (Fo) associated with affect using Rosenbeks 6 – Step Imitative program (Russell et al., 2010.) Aprosodia associated with Bilateral Stroke; Adults https://clinicalprosody.wordpress.com/2013/09/16/russell-2010

 

  • This case study provides limited support for a procedure involving modeling and biofeedback to improve prosodic as well as imitation and production on an author designed test (Stringer, 1996.) Aprosodia; Adults https://clinicalprosody.wordpress.com/?s=Stringer

 

 

Limited Evidence, minus

  

No Evidence Provided

 

  • Prosody Pyramid procedures were designed for second language learners but have potential to guide SLPs in treating phrasing, pausing, terminal contour, duration, sentence stress, lexical stress, rhythm, and intonation problems (Gilbert, 2008). Second Language Learning; Adolescents, Adults  https://clinicalprosody.wordpress.com/2014/01/31/gilbert-2008/

 

 

Contraindicated:

 

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INTONATION OUTCOMES

––––––––––––––––––––––––––––––––––––––––––––––––––––––––

Moderate Evidence

 

 

Fair Evidence, plus

 

  • Dutch speakers diagnosed with Parkinson’s disease received an intensive course of speech therapy focusing on rate and intonation to improve intelligibility. Perception of intonation representing questions and statements as well as maximum fundamental frequency of the last syllable (Fo-max last syllable) of questions in reading and repetition tasks improved significantly (Martens et al., 2015.) Parkinson’s Disease; Adults https://clinicalprosody.wordpress.com/2015/11/30/martens-et-al-2015/

 

Fair Evidence

 

  • Speech-language pathologists found SpeechPrompts, a mobile app, enjoyable and easy to use in a school setting and they perceived that it resulted in perceived improvements in the Ss’ ability to produce intonation. The improvements were reported despite a low dose of the intervention over an 8 week period (Simmons et al., 2016.) Autism Spectrum Disorders, Speech-Language Impairment; Children, Adolescents https://clinicalprosody.wordpress.com/2016/12/28/simmons-et-al-2016/

 

Fair Evidence, minus

 

 

 

  • Results of LSVT indicated a significant improvement in fundamental frequency (f0) variability/range and speech-language pathologist ratings of voice monotony among patients exposed to intensive treatment. The fo range was tested in following up sessions and progress was maintained (Ramig et al., 1994.) Parkinson’s Disease; Adults  https://clinicalprosody.wordpress.com/2014/12/11/ramig-et-al-1994/

 

Limited Evidence, plus

 

Limited Evidence

 

 

Limited Evidence, minus

  • Descriptive statistics indicated that pairing of music notation with imitation and/or reading of selective linguistic units has potential to improve intonation (Staum, 1987.) Hearing Impairment; Child  https://clinicalprosody.wordpress.com/?s=Staum

 

 Minimal Evidence

  • These case studies yielded minimally applicable clinical results because the sessions were very brief. The perceptual measures of intonation improved following both interventions—Lee Silverman Voice Treatment and Intonation Only Therapy (Kobayashi et al., 2004.). Dysarthria; Adult https://clinicalprosody.wordpress.com/2013/11/13/kobayashi-et-al-2004/

 

  • Although no effectiveness data are provided, the author provides explicit instructions concerning establishing baseline, administering procedures, recording data, and advancing/discontinuing for each exercise (Dworkin, 1991.) Motor Speech Disorders; Adult  https://clinicalprosody.wordpress.com/2014/11/30/dworkin-1991/

 

Contraindicated

 

No Evidence Provided

 

 

______________________________________________________

 

INTONATION –OVERALL CONTOUR OUTCOMES

______________________________________________________

 

Fair Evidence, plus

  • Dutch speakers diagnosed with Parkinson’s disease received an intensive course of speech therapy focusing on rate and intonation to improve intelligibility. Perception of intonation representing questions and statements as well as maximum fundamental frequency of the last syllable (Fo-max last syllable) of questions in reading and repetition tasks improved significantly (Martens et al., 2015.) Parkinson’s Disease; Adults https://clinicalprosody.wordpress.com/2015/11/30/martens-et-al-2015/

 

Limited Evidence

  • This Narrative (or Traditional) review of the literature contains reviews of several investigations suggesting that the inclusion of music/singing in intervention directed intonation can be associated with improvement (Michel & May, 1974.) General Language Development; Children https://clinicalprosody.wordpress.com/2016/04/27/michel-may-1974/

  

Limited Evidence, minus

 

  • Following the intervention which involved an existing treatment program paired with visual feedback, the production of SVO sentences more closely resembled a typical peer with respect to pitch patterns associated with contrastive stress (O’Halpin, 2001). Hearing Impairment; Child https://clinicalprosody.wordpress.com/2014/11/08/ohalpin-2001/

 

 

Evidence Contra-indicates the Use of the Intervention for the Specific Outcomes

 

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INTONATION – TERMINAL CONTOUR OUTCOMES

––––––––––––––––––––––––––––––––––––––––––––––––––––––––

Strong Evidence, minus

 

Moderate Evidence, plus

  • This single-subject experimental design investigation provides strong support for an intervention involving auditory and visual feedback to modify terminal contours (Le Dorze et al., 1992.) Parkinson’s Disease; Adult  https://clinicalprosody.wordpress.com/?s=Le+Dorze

 

Moderate Evidence, minus

  • This single-subject experimental design investigation provides limited evidence that falling terminal contour can be modified in the using an elicitation task (Hargrove et al.,1989b.) Specific Language Impairment; Child  https://clinicalprosody.wordpress.com/2013/03/06/278/

 

Fair Evidence, plus

  • Dutch speakers diagnosed with Parkinson’s disease received an intensive course of speech therapy focusing on rate and intonation to improve intelligibility. Perception of intonation representing questions and statements as well as maximum fundamental frequency of the last syllable (Fo-max last syllable) of questions in reading and repetition tasks improved significantly (Martens et al., 2015.) Parkinson’s Disease; Adults https://clinicalprosody.wordpress.com/2015/11/30/martens-et-al-2015/

 

Limited Evidence, plus

  • Case studies provide fair to weak support for an academic year-long curriculum to teach discrimination, imitation, and production of falling terminal contours (Friedman, 1985.) Hearing Impairment; Adolescent  https://clinicalprosody.wordpress.com/?s=Friedman

 

Limited Evidence

 

  • The authors provide treatment recommendations for receptive and expressive goals associated with linguistic and affective prosody. The recommendations are accompanied by 3 illustrative case studies in which real and/or potential treatment plans are presented (Robin et al., 1991). Brain Damage; Neurogenic Conditions; Adults  https://clinicalprosody.wordpress.com/2014/09/30/robin-et-al-1991/

 

 

No Evidence Provided•

 

 

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LOUDNESS OUTCOMES

______________________________________________________

Strong Evidence, minus

  • Comparisons with  Face-to-face (FTF) and Online versions of Lee Silverman Voice Treatment (LVST) revealed that  FTF and Online interventions resulted in similar changes in several loudness measures. Moreover, there were no significant differences between the Online and FTF versions of LVST (Theodoros et al., 2016.) Parkinson’s Disease; Adults https://clinicalprosody.wordpress.com/2017/02/11/theodoros-et-al-2016/

 

 

Moderate Evidence, plus

 

  • A behavioral program for increasing loudness in a child diagnosed with selective mutism (Facon et al., 2008.) Selective Mutism, Second Language Learning, Developmental Disability; Child https://clinicalprosody.wordpress.com/?s=Facon

 

 

Moderate Evidence

  • The intensity based pairwise variability index measuring differences between 2 adjacent syllables (stressing) yielded strong change (Ballard et al., 2010.) Childhood Apraxia of Speech; Child  https://clinicalprosody.wordpress.com/?s=Ballard

 

Moderate Evidence, minus

  • The evidence was fair to weak but the program shows promise to improve intensity ratings on the Prosody Test (McDonald et al., 2012.) Nonprogresssive Brain Injury, Affect Comprehension; Adult  https://clinicalprosody.wordpress.com/?s=McDonald

 

Fair Evidence, plus

  • Speech-language pathologists found SpeechPrompts, a mobile app, enjoyable and easy to use in a school setting and they perceived that it resulted in perceived improvements in the Ss’ ability to produce loudness. The improvements were reported despite a low dose of the intervention over an 8 week period (Simmons et al., 2016.) Autism Spectrum Disorders, Speech-Language Impairment; Children, Adolescents https://clinicalprosody.wordpress.com/2016/12/28/simmons-et-al-2016/   

Fair Evidence

 

 

Fair Evidence, minus

  • Use of visual (oscilloscope and intraoral pressure) feedback shows promise for increasing normalcy ratings of some (but not all) Ps’ intensity for marking stress (Caligiuri & Murry, 1983.) Dysarthria; Adult  https://clinicalprosody.wordpress.com/?s=Caligiuri
  • Single subject experimental design investigation provides acoustic evidence (Intensity mean, Intensity variability) supporting change in emotional prosody using either of Rosenbek’s 6 step continuum programs: Imitative or Cognitive-Linguistic (Jones et al., 2009.) Expressive Aprosodia; Adult https://clinicalprosody.wordpress.com/?s=Jones

 

Limited Evidence, plus

  • Three case studies suggest that Lee Silverman Voice Treatment has variable effectiveness in increasing the intensity of sustained vowels and overall loudness as well as loudness during reading and speaking (Countryman et al., 1994.) Parkinsonian Plus Syndromes; Adult https://clinicalprosody.wordpress.com/?s=Countryman
  • Two case studies provide variable support for use of Lee Silverman Voice Treatment to increase loudness perception and acoustic measures of loudness in a variety of speaking contexts (Sapir et al., 2001.) Multiple Sclerosis; Adult  https://clinicalprosody.wordpress.com/?s=Sapir
  • This case study reported improvement in the perception of loudness following Lee Silverman Voice Treatment (LSVT) but not Combination Treatment which involves LSVT plus Respiration therapy and Physical therapy (Solomon et al., 2001). Traumatic Brain Injury, Hypokinetic- spastic dysarthria; Adult https://clinicalprosody.wordpress.com/2014/04/23/solomom-et-al-2001
  • This case study reported improvement in sound pressure level (SPL) following Lee Silverman Voice Treatment (LSVT) as well as Combination Treatment which involves LSVT plus Respiration therapy and Physical therapy (Solomon et al., 2001). Traumatic Brain Injury, Hypokinetic- spastic dysarthria; Adult https://clinicalprosody.wordpress.com/2014/04/23/solomom-et-al-2001
  • This case study presented evidence of the effectiveness of Lee Silverman Voice Treatment (LSVT) in improving SPL in a variety of contexts (Sapir et al., 2003.) Ataxic Dysarthria; Adult

 

Limited Evidence

  • The evidence from these case studies inconsistently supports the use of delayed auditory feedback (DAF) as a compensatory device to improve sound pressure level in reading and conversation. The changes do not generalize to speech when the DAF is not worn (Hanson & Metter, 1983.) Parkinson’s Disease; Adult https://clinicalprosody.wordpress.com/?s=Hanson

 

Limited Evidence, minus

  • This traditional narrative review provides a guide to incorporating Lee Silverman Voice Treatment (LVST-Loud) into telepractice and reviews research documenting its effectiveness as well as its costs and P satisfaction (Theodoros & Ramig, 2011) Parkinson’s Disease; Adults  https://clinicalprosody.wordpress.com/2014/05/23/theodoros-ramig-2011

 

Minimal Evidence

  • Although no effectiveness data are provided, the author provides explicit instructions concerning establishing baseline, administering procedures, recording data, and advancing/discontinuing for each exercise (Dworkin, 1991.) Motor Speech Disorders; Adult  https://clinicalprosody.wordpress.com/2014/11/30/dworkin-1991/

 

No Intervention Evidence Provided

 

  • This investigation is not classified as an intervention study. The results grading intensity, although inconsistent can inform therapeutic practice regarding the use of Clear Speech (CS.) Significant improvements in the intensity throughout the passage decreased throughout a read passage following the provision of CS cues suggesting that the gains from CS cues were not maintained. However, gains in intensity associated with word stress were maintained throughout the. The investigator suggested that when using CS with adults with PD, clinicians should consider modifications to enhance the cues effectiveness over time (Diekema, 2016.) Parkinson Disease; Adults https://clinicalprosody.wordpress.com/2017/03/23/diekema-2016/

     

     

 

Evidence Contraindicates the Use of the Intervention for the Specific Outcome(s)

 

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PAUSE OUTCOMES

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Strong Evidence, minus

 

 

Moderate Evidence

 

Fair Evidence, plus

 

Fair Evidence

  • This case study provides limited support for a treatment approach that combines explicit and interactive components to resolve lengthening and pausing (Bellon-Harn et al., 2007.) Childhood Apraxia Of Speech; Child https://clinicalprosody.wordpress.com/?s=Bellon

 

 

Limited Evidence

  • This preliminary report suggests that a computer game that present acoustic feedback has some promise in reducing pauses (Hoque et al., 2009.) Autism Spectrum Disorder; Adolescent  https://clinicalprosody.wordpress.com/?s=Hoque

 

 

  • This case study reported limited improvement in interturn pauses following Lee Silverman Voice Treatment (LSVT) and not for Combination Treatment which involves LSVT plus Respiration therapy and Physical therapy (Solomon et al., 2001). Traumatic Brain Injury, Hypokinetic- spastic dysarthria; Adult  https://clinicalprosody.wordpress.com/2014/04/23/solomom-et-al-2001

  

Limited Evidence, minus

 

 

Minimal Evidence

 

Contraindicated

•  One of the sources reviewed in this Systematic Review (SR) was concerned with the treatment of speed of response in patients with schizophrenia. The Ps did not exhibit progress in therapy targeting speed of response (Joyal et al., 2016.) Schizophrenia; Adults   https://clinicalprosody.wordpress.com/2016/05/31/joyal-et-al-2016/

 

No Evidence

 

  • This investigation is not classified as an intervention study. The results, however, can inform therapeutic practice regarding the use of Clear Speech (CS.) Significant improvements in the percent pause time decreased throughout a read passage following the provision of CS cues suggesting that the gains from CS cues were not maintained. The investigator suggested that when using CS with adults with PD, clinicians should consider modifications to enhance the cues effectiveness over time (Diekema, 2016.) Parkinson Disease; Adults

    https://clinicalprosody.wordpress.com/2017/03/23/diekema-2016/

     

______________________________________________________

PHRASING OUTCOMES

______________________________________________________

Moderate Evidence, plus

  • Three of four single subject experimental design investigations resulted in overall improvement of the production of speech targets. The perceptual measure involved a combination of speech sounds, lexical stress, segmentation/concordance (Maas & Farinella, 2012). Childhood Apraxia of Speech; Child https://clinicalprosody.wordpress.com/2014/08/12/maas-farinella-2012/

 

 

Fair Evidence, minus

  • This single group investigation revealed that a comprehension-based Readers Theatre intervention for 2nd graders who are English Language Learners can improve timing (phrasing) of oral reading (Daly, 2009). Literacy (fluency), ELL; Child https://clinicalprosody.wordpress.com/2014/06/02/daly-2009/

 

 

Minimal Evidence, minus

  • This single subject study describes an approach to improving oral reading fluency as measured by the number of words read correctly in a minute. However, treatment involved working on phrasing so there may have been some improve on this aspect of prosody (Morra & Tracey, 2006) Literacy Problems; Child https://clinicalprosody.wordpress.com/2014/02/15/morra-tracey-2006/

 

 

No Evidence Provided•

 

 

 

 

______________________________________________________

 

PITCH OUTCOMES

______________________________________________________

 

Strong Evidence, minus

 

Moderate Evidence, plus

  • This single-subject experimental design investigation provides some support for an intervention involving auditory and visual feedback to mean fo (Le Dorze et al., 1992.) Parkinson’s Disease; Adult https://clinicalprosody.wordpress.com/?s=Le+Dorze

 

Moderate Evidence

 

 

  • The Fo based pairwise variability index measuring pitch differences between 2 adjacent syllables (stressing) yielded strong change (Ballard et al., 2010.) Childhood Apraxia of Speech; Child https://clinicalprosody.wordpress.com/?s=Ballard

 

Moderate Evidence, minus

 

 

Fair Evidence

 

Fair Evidence, minus

  • Boys with muscle tension dysphonia (MTD) received an intervention focusing on awareness, relaxation, breathing, phonation, and homework. The results of this retrospective, descriptive, single group investigation revealed progress several aspects of voice quality and in the reduction of hypercontraction (Lee & Son, 2005.) Voice Quality, Muscle Tension Dysphonia; Children https://clinicalprosody.wordpress.com/2015/12/07/lee-son-2005/

 

  • Single subject experimental design investigation provides acoustic evidence (fo mean, fo variability) supporting change in emotional prosody using either of Rosenbek’s 6 step continuum programs: Imitative or Cognitive-Linguistic (Jones et al., 2009.) Expressive Aprosodia; Adult https://clinicalprosody.wordpress.com/?s=Jones

 

Limited Evidence, plus

  • Use of visual (oscilloscope and intraoral pressure) feedback shows promise for increasing normalcy ratings of some (but not all) Ps’ pitch for marking stress (Caligiuri & Murry, 1983.) Dysarthria; Adult https://clinicalprosody.wordpress.com/?s=Caligiuri

 

  

  • This case study presented evidence of the effectiveness of Lee Silverman Voice Treatment (LSVT) in improving Fo in a variety of contexts (Sapir et al., 2003.) Ataxic Dysarthria; Adult

 

Limited Evidence

  • This preliminary report suggests that a computer game that presents acoustic feedback has some promise in reducing pitch breaks and modulating pitch range (Hoque et al., 2009.) Autism Spectrum Disorder; Adolescent https://clinicalprosody.wordpress.com/?s=Hoque

 

 

 

 

______________________________________________________

PITCH LEVEL OUTCOMES

______________________________________________________

 

Strong Evidence, minus

  

Moderate Evidence, plus

  • This single-subject experimental design investigation provides some support for an intervention involving auditory and visual feedback to modify mean Fo (Le Dorze et al., 1992.) Parkinson’s Disease; Adult  https://clinicalprosody.wordpress.com/?s=Le+Dorze

 

Moderate Evidence

 

 

  • This Systematic Review found no controlled research sources but identified some observational research suggesting that using prosody in an intervention can result in improved pitch level including fundamental frequency   (Pennington et al., 2009). Cerebral Palsy, Dysarthria; Child  https://clinicalprosody.wordpress.com/2014/04/30/pennington-et-al-2009/

 

Fair Evidence, minus

  • Single subject experimental design investigation provides acoustic evidence (fo mean, fo variability) supporting change in emotional prosody using either of Rosenbek’s 6 step continuum programs: Imitative or Cognitive-Linguistic (Jones et al., 2009.) Expressive Aprosodia; Adult  https://clinicalprosody.wordpress.com/?s=Jones

  

Limited Evidence

  • The evidence from these case studies inconsistently supports the use of delayed auditory feedback (DAF) as a compensatory device to improve Fo in reading. The changes do not generalize to speech when the DAF is not worn (Hanson & Metter,1983). Parkinson’s Disease; Adult  Http://clinicalprosody.wordpress.com/?s=Hanson

 

  

Limited Evidence, minus

  • This single subject experimental design investigation provide acoustic evidence (Fo mean) supporting change in emotional prosody using either of Rosenbek’s 6 step continuum programs: Imitative or Cognitive-Linguistic (Jones et al., 2009.) Expressive Aprosodia; Adult  https://clinicalprosody.wordpress.com/?s=Jones

 

Minimal Evidence

  • The evidence from these case studies inconsistently supports the use of delayed auditory feedback (DAF) as a compensatory device to improve Fo in reading. The changes do not generalize to speech when the DAF is not worn (Hanson & Metter,1983.) Parkinson’s Disease; Adult  https://clinicalprosody.wordpress.com/?s=Hanson

 

  • Although no effectiveness data are provided, the author provides explicit instructions concerning establishing baseline, administering procedures, recording data, and advancing/discontinuing for each exercise (Dworkin, 1991.) Motor Speech Disorders; Adult  https://clinicalprosody.wordpress.com/2014/11/30/dworkin-1991/

 

  

Minimal Evidence, minus

  

No Supporting Data Provided

  • This investigation is not classified as an intervention study. The results, however, can inform therapeutic practice regarding the use of Clear Speech (CS.). Gains in mean fo were maintained throughout the passage following the provision of CS cues suggesting CS is effective, at least for a read passage (Diekema, 2016.) Parkinson Disease; Adults https://clinicalprosody.wordpress.com/2017/03/23/diekema-2016/

     

Evidence Contra-indicates the Use of the intervention for the Specific Outcome(s)

 

 

______________________________________________________

 

PITCH VARIABILITY/RANGE OUTCOMES

______________________________________________________

 

Strong Evidence, minus

  • This prospective, randomized group design with controls investigation supports the effectiveness of the Lee Silverman Voice Treatment (LSVT) and respiration-based (R) therapy in improving pitch variability and monotonicity (Ramig et al., 1995.) Parkinson’s Disease; Adult  https://clinicalprosody.wordpress.com/2014/02/04/ramig-et-al-1995/

  

Moderate Evidence

 

 

 

  

Moderate Evidence, minus

  • Single-subject experimental design studies determined that 2 interventions (visual and auditory) yield equivocal improvement for Fo range and standard deviation. The combination of the 2 interventions varied from very effective to fairly effective (Bouglé et al., 1995.) Closed Head Injury; Adult  https://clinicalprosody.wordpress.com/?s=Bougle

  

Fair Evidence, plus

 

  

Fair Evidence, minus

 

Limited Evidence

  • The evidence from these case studies inconsistently supports the use of delayed auditory feedback (DAF) as a compensatory device to improve standard deviation of Fo in reading and conversation. The changes do not generalize to speech when the DAF is not worn (Hanson & Metter, 1983.) Parkinson’s Disease; Adult  https://clinicalprosody.wordpress.com/?s=Hanson

 

  • This preliminary report suggests that a computer game that presents acoustic feedback has some promise in modulating pitch range (Hoque et al., 2009.) Autism Spectrum Disorder; Adolescent  https://clinicalprosody.wordpress.com/?s=Hoque

 

 

 

Limited Evidence, minus

 

  • This traditional narrative reviews provides a guide to incorporating Lee Silverman Voice Treatment (LVST-Loud) into telepractice and reviews research documenting its effectiveness as well as its costs and P satisfaction (Theodoros & Ramig, 2011) Parkinson’s Disease; Adults  https://clinicalprosody.wordpress.com/2014/05/23/theodoros-ramig-2011

 

Minimal Evidence

  • Although no effectiveness data are provided, the author provides explicit instructions concerning establishing baseline, administering procedures, recording data, and advancing/discontinuing for each exercise (Dworkin, 1991.) Motor Speech Disorders; Adult  https://clinicalprosody.wordpress.com/2014/11/30/dworkin-1991/

 

 

No Intervention Evidence Provided

 

  • This investigation is not classified as an intervention study. The results, however, can inform therapeutic practice regarding the use of Clear Speech (CS.) Significant improvements in fo variability, decreased throughout a read passage following the provision of CS cues suggested that the gains from CS cues were not maintained. The investigator suggested that when using CS with adults with PD, clinicians should consider modifications to enhance the cues effectiveness over time (Diekema, 2016.) Parkinson Disease; Adults https://clinicalprosody.wordpress.com/2017/03/23/diekema-2016/

     

 

Evidence Contra-indicates the Use of the Intervention for the Specific Outcomes 

 

  • Comparisons with  Face-to-face (FTF) and Online versions of Lee Silverman Voice Treatment (LVST) revealed that the FTF and Online interventions resulted  in similar changes in several pitch variability measures. However,  the changes  from pre intervention to post intervention for neither the Online nor FTF versions of LVST were significant (Theodoros et al., 2016.) Parkinson’s Disease; Adults    https://clinicalprosody.wordpress.com/2017/02/11/theodoros-et-al-2016/

 

 

  • Overall results of 2 Experiments involved French children diagnosed with reading impairments treated with Cognitive-Musical Training (CMT) indicated no significant improvement in measures of pitch variation discrimination (Habib et al., 2016.) Literacy Problems; Children https://clinicalprosody.wordpress.com/2017/03/12/habib-et-al-2016/

______________________________________________________ 

RATE OUTCOMES

______________________________________________________ 

Strong Evidence, minus

  • This prospective, randomized group design with controls investigation supports the effectiveness of the Lee Silverman Voice Treatment (LSVT) and respiration-based (R) therapy in improving rate/utterance duration (Ramig et al., 1995.) Parkinson’s Disease; Adult https://clinicalprosody.wordpress.com/2014/02/04/ramig-et-al-1995/

 

Moderate Evidence, plus

 

  • This single-subject experimental design investigation provides moderate support for an intervention involving auditory and visual feedback to modify duration/speaking rate (Le Dorze et al., 1992.) Parkinson’s Disease; Adult https://clinicalprosody.wordpress.com/?s=Le+Dorze

 

  

Moderate Evidence, minus

  • Evidence from a single subject experimental design supports use of rhythmic tasks to decrease speaking rate. Rhythmic only tasks may be more effective than the combined rhythmic plus melody as in music (Cohen, 1988.) Brain damage (Kluver-Buey Syndrome); Adolescent  https://clinicalprosody.wordpress.com/?s=Cohen+%281988%29

 

 

Moderate Evidence, minus

  • Evidence from a single subject experimental design supports use of rhythmic tasks to decrease speaking rate. Rhythmic only tasks may be more effective than the combined rhythmic plus melody as in music (Cohen, 1988.) Brain damage (Kluver-Buey Syndrome); Adolescent https://clinicalprosody.wordpress.com/?s=Cohen+%281988%29

 

  

Fair Evidence, plus

 

  • This narrative review provides moderate support for the use of rigid rate control approaches with Ps with severe dysarthria and naturalistic approaches for Ps with less severe dysarthria (Blanchet & Snyder, 2010.)   Dysarthria; Adult https://clinicalprosody.wordpress.com/?s=Blanchet

  

Fair Evidence

 

 

Fair Evidence, minus

 

  • In this learning (i.e., not intervention) research, this investigation revealed that any one of 4 computerized rate control strategies could reduce speaking rate to 80% and to 60% of the individual speakers habitual speaking rate (Yorkston et al., 1990.) Parkinson’s Disease, Dysarthria—Ataxic; Dysarthria—Hypokinetic; Adults https://clinicalprosody.wordpress.com/2015/01/04/yorkston-et-al-1990/

  

Limited Evidence, plus

  • This narrative review provides support for the use of rigid rate control approaches with Ps with severe dysarthria and naturalistic approaches for Ps with less severe dysarthria (Blanchet & Snyder, 2010.) Dysarthria; Adult https://clinicalprosody.wordpress.com/?s=Blanchet

 

  • This case study presented evidence of the effectiveness of Lee Silverman Voice Treatment (LSVT) in improving rate of speech (Sapir et al., 2003.) Ataxic Dysarthria; Adult

 

Limited Evidence

  • This single case study investigated the effect of an adapted form of Melodic Intonation Therapy (AMIT) on a patient (P) with Broca’s Aphasia who was a speaker of Brazilian Portuguese. The investigators monitored 73 outcomes the rate of speech outcome improved (da Fontoura et al., 2014.) Aphasia, Adults https://clinicalprosody.wordpress.com/2016/12/05/da-fontoura-et-al-2014/

 

  • This preliminary report suggests that a computer game that presents acoustic feedback has some promise in slowing speaking rate (Hoque et al., 2009.) Autism Spectrum Disorder; Adolescentshttps://clinicalprosody.wordpress.com/?s=Hoque

 

 

 

  • The evidence from these case studies inconsistently supports the use of delayed auditory feedback (DAF) as a compensatory device to improve average words per minute in reading and conversation. The changes do not generalize to speech when the DAF is not worn (Hanson & Metter, 1983.) Parkinson’s Disease; Adult https://clinicalprosody.wordpress.com/?s=Hanson

  

Limited Evidence, minus

 

 

 

Minimal Evidence

 

  • Although no effectiveness data are provided, the author provides explicit instructions concerning establishing baseline, administering procedures, recording data, and advancing/discontinuing for each exercise (Dworkin, 1991.) Motor Speech Disorders; Adult https://clinicalprosody.wordpress.com/2014/11/30/dworkin-1991/

 

 

 No Data Provided

 

  •  This investigation is not classified as an intervention study. The results, however, can inform therapeutic practice regarding the use of Clear Speech (CS.) Significant improvements in the following measures decreased throughout a read passage after the provision of CS cues suggesting that the gains in rate from CS cues were not maintained: speech rate and articulation rate. The investigator suggested that when using CS with adults with PD, clinicians should consider modifications to enhance the cues effectiveness over time (Diekema, 2016.) Parkinson Disease; Adults https://clinicalprosody.wordpress.com/2017/03/23/diekema-2016/ 

Evidence Does Not Support Use

  • • Dutch speakers diagnosed with Parkinson’s disease received an intensive course of speech therapy focusing on rate and intonation to improve intelligibility. Although measures associated with other aspects of prosody as well as intelligibility improved significantly, none of the rate measures (speech rate, articulation rate, mean pause time) improved significantly (Martens et al., 2015.) Parkinson’s Disease; Adults https://clinicalprosody.wordpress.com/2015/11/30/martens-et-al-2015/

 

  • This case study failed to observe improvement in the number of syllables per breath group following Lee Silverman Voice Treatment (LSVT) and Combination Treatment which involves LSVT plus Respiration therapy and Physical therapy (Solomon et al., 2001). Traumatic Brain Injury, Hypokinetic- spastic dysarthria; Adult https://clinicalprosody.wordpress.com/2014/04/23/solomom-et-al-2001

 

 

  • Speech-language pathologists found SpeechPrompts, a mobile app, enjoyable and easy to use in a school setting. However, they perceived that it did not result in perceived improvements in the Ss’ ability to produce an acceptable speaking rate (Simmons et al., 2016.) Autism Spectrum Disorders, Speech-Language Impairment; Children, Adolescents https://clinicalprosody.wordpress.com/2016/12/28/simmons-et-al-2016/

______________________________________________________

RHYTHM OUTCOMES

______________________________________________________

 

Strong Evidence, minus

 

Limited Evidence

  

Limited Evidence, minus

  • Descriptive statistics indicated that pairing of music notation with imitation and/or reading of selective linguistic units has potential to improve speech rhythm (Staum, 1987.) Hearing Impairment; Child https://clinicalprosody.wordpress.com/?s=Staum

 

  • The authors provide treatment recommendations for expressive goals associated with rhythm. The recommendations are accompanied by 1 illustrative case study in which some potential treatment ideas are presented (Robin et al., 1991). Brain Damage; Neurogenic Conditions; Adults https://clinicalprosody.wordpress.com/2014/09/30/robin-et-al-1991/

 

 

No Evidence Provided

  • Prosody Pyramid procedures were designed for second language learners but have potential to guide SLPs in treating rhythm problems (Gilbert, 2008.) Second Language Learning; Adolescents, Adults

https://clinicalprosody.wordpress.com/2014/01/31/gilbert-2008/

 

 

 

______________________________________________________ 

RHYTHM — STRESS SEQUENCES OUTCOMES

______________________________________________________

Limited Evidence, minus

 

______________________________________________________

STRESS OUTCOMES

––––––––––––––––––––––––––––––––––––––––––––––––––––––––

Moderate Evidence

 

Moderate Evidence, minus

  •  This Systematic Review (SR) with broad criteria is concerned with a variety of treatments and outcomes. The authors of the SR rated sources for quality of certainty of results. The source that targeted stress was rated as Preponderant (Murray et al., 2014.) Childhood Apraxia of Speech; Children https://wordpress.com/post/clinicalprosody.wordpress.com/1329

 

 

Fair Evidence, minus

 

 

Limited Evidence

 

  • The authors provide treatment recommendations for receptive and expressive goals associated with stress. The recommendations are accompanied by 3 illustrative case studies in which real and/or potential treatment plans are presented (Robin et al., 1991). Brain Damage; Neurogenic Conditions; Adults https://clinicalprosody.wordpress.com/2014/09/30/robin-et-al-1991/

 

No Evidence Provided

•  This expert opinion describes briefly the role of focusing on coarticulation or concordance (i.e., the smooth transition from one speech sound to the next) in the treatment of childhood apraxia of speech (CAS.) The author recommends targeting tempo (blending phonemes, pausing) and stress (weak-strong forms) in Gee (2010.) Childhood Apraxia of Speech; Children https://clinicalprosody.wordpress.com/2016/08/20/gee-2010/

 

Evidence Contraindicates the Use of the Intervention for Specific Outcome(s)

  • The results from this case study indicate that this computer-based intervention was not effective in reducing scanning speech by increasing the temporal variability (duration) of adjacent syllables (Tjaden, 2000.) Expressive Aphasia, Scanning Speech; Adult. https://clinicalprosody.wordpress.com/2013/05/24/tjaden-2000/

 

______________________________________________________

STRESS- EMPHATIC OUTCOMES

_____________________________________________________

Strong Evidence, minus

 

 Moderate Evidence, plus

  • This single-subject experimental design investigation provides variable evidence that stress patterns can be modified in the using an elicitation task (Hargrove et al., 1989b.) Specific Language Impairment; Child  https://clinicalprosody.wordpress.com/2013/03/06/278/

 

Limited Evidence, plus

  

Limited Evidence, minus

 

  • Following the intervention which involved an existing treatment program paired with visual feedback, the production of SVO sentences more closely resembled a typical peer with respect to pitch patterns associated with contrastive stress (O’Halpin, 2001), Hearing Impairment; Child https://clinicalprosody.wordpress.com/2014/11/08/ohalpin-2001/

  

Minimal Evidence

  • Although no effectiveness data are provided, the author provides explicit instructions concerning establishing baseline, administering procedures, recording data, and advancing/discontinuing for each exercise (Dworkin, 1991.) Motor Speech Disorders; Adult

https://clinicalprosody.wordpress.com/2014/11/30/dworkin-1991/

 

––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––

STRESS—LEXICAL OUTCOMES

––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––

Moderate Evidence, plus

  • Three of four single subject experimental design investigations resulted in overall improvement of the production of speech targets. The perceptual measure involved a combination of speech sounds, lexical stress, segmentation/concordance (Maas & Farinella, 2012). Childhood Apraxia of Speech; Child https://clinicalprosody.wordpress.com/2014/08/12/maas-farinella-2012/

 

 Moderate Evidence

 

 

  • Variable support for this cognitive-linguistic approach to teaching w-S stress patterns in multisyllable words (Shea & Tyler, 2001.) Specific Language Impairment and Phonological Impairment; Child  https://clinicalprosody.wordpress.com/?s=Shea

 

 

Fair Evidence

 

  • Speech-language pathologists found SpeechPrompts, a mobile app, enjoyable and easy to use in a school setting and they perceived that it resulted in perceived improvements in the Ss’ ability to produce lexical stress. The improvements were reported despite a low dose of the intervention over an 8 week period (Simmons et al., 2016.) Autism Spectrum Disorders, Speech-Language Impairment; Children, Adolescents https://clinicalprosody.wordpress.com/2016/12/28/simmons-et-al-2016/ 

Limited Evidence, minus

  • Based on the critique of 2 investigations of children with childhood apraxia of speech this narrative review contends that Rapid Syllable Transition Treatment (ReST) has potential for success with adults with apraxia of speech (Ballard et al., 2010b). Apraxia of Speech; Adult  https://clinicalprosody.wordpress.com/2014/06/13/ballard-et-al-2010/

  

Minimal Evidence

  • Although no effectiveness data are provided, the author provides explicit instructions concerning establishing baseline, administering procedures, recording data, and advancing/discontinuing for each exercise (Dworkin, 1991.) Motor Speech Disorders; Adult  https://clinicalprosody.wordpress.com/2014/11/30/dworkin-1991/

  

No Evidence Provided

 

 

  • This investigation is not classified as an intervention study. The results, however, can inform therapeutic practice regarding the use of Clear Speech (CS.) Gains in intensity associated with word stress were maintained throughout the reading of a passage after CS cues were provided, This suggests that CS is effective over a short time for this measure (Diekema, 2016.) Parkinson Disease; Adults

    https://clinicalprosody.wordpress.com/2017/03/23/diekema-2016/

 ________________________________________________________________

STRESS – SENTENCE OUTCOMES

–––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––

Strong Evidence, minus

 

Moderate Evidence

  • Variable support for this cognitive-linguistic approach to teaching w-S stress patterns in phrases (Shea & Tyler, 2001.) Specific Language Impairment and Phonological Impairment; Child  https://clinicalprosody.wordpress.com/?s=Shea

 

 

Moderate Evidence, minus

  • This single-subject experimental design investigation provides variable evidence that stress patterns can be modified in the using an elicitation task (Hargrove et al., 1989b.) Specific Language Impairment; Child https://clinicalprosody.wordpress.com/2013/03/06/278/ 

 

Fair Evidence

 

Fair Evidence, minus

 

Limited Evidence, minus

 

  • Speech-language pathologists found SpeechPrompts, a mobile app, enjoyable and easy to use in a school setting and they perceived that it resulted in perceived improvements in the Ss’ ability to produce sentence stress. The improvements were reported despite a low dose of the intervention over an 8 week period (Simmons et al., 2016.) Autism Spectrum Disorders, Speech-Language Impairment; Children, Adults https://clinicalprosody.wordpress.com/2016/12/28/simmons-et-al-2016/

 

Minimal Evidence

  • Although no effectiveness data are provided, the author provides explicit instructions concerning establishing baseline, administering procedures, recording data, and advancing/discontinuing for each exercise (Dworkin, 1991.) Motor Speech Disorders; Adult https://clinicalprosody.wordpress.com/2014/11/30/dworkin-1991/

 

No Evidence Provided•

 

  ________________________________________

TEMPO OUTCOMES

_______________________________________

No Evidence Provided

•  This expert opinion describes briefly the role of focusing on coarticulation or concordance (i.e., the smooth transition from one speech sound to the next) in the treatment of childhood apraxia of speech (CAS.) The author recommends targeting tempo (blending phonemes, pausing) and stress (weak-strong forms) in Gee (2010.) Childhood Apraxia of Speech; Children https://clinicalprosody.wordpress.com/2016/08/20/gee-2010/

 

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