Hutchinson (2015)

October 17, 2018

EBP THERAPY ANALYSIS

Single Case Design

NOTE:  The summary of the intervention procedure(s) can be viewed by scrolling about two-thirds of the way down on this page.

Key:

ASD =  Autism Spectrum Disorders

C =  Clinician

EBP =  evidence-based practice

F0=  Fundamental frequency (F0)

HFA =  High Functioning Autism

NA =  not applicable

P =  Patient or Participant

pmh =  Patricia Hargrove, blog developer

PVSP =  Prosody Voice Screening Profile (PVSP)

SLP =  speech–language pathologist

WNL =  within normal limits

 

SOURCE:  Hutchison, A. K. (2015).  Aprosodia therapy: The impact on affective prosody in a child with High Functioning Autism. Thesis from the Arkansas State University  December 2015.  ProQuest Dissertations Publishing, 2015.Retrieved from https://search.proquest.com/openview/2cfdd684ebaf87963fb69a1012b3e7ac/1?pq-origsite=gscholar&cbl=18750&diss=y

 

REVIEWER(S):  pmh

 

DATE:  October 9, 2018

 

ASSIGNED OVERALL GRADE: D (The highest Assigned Overall Grade is based on the design of the investigation. In this case, the design was a Single Case investigation with the highest possible grade being D+.  The Assigned Overall Grade in not a judgment about the quality of the intervention; it is an evaluation of the quality of the evidence supporting the intervention.)

 

TAKE AWAY:  This single case investigation provides support for the use of an imitative approach to improve the expressive affective prosody of a 14-year-old male who had been diagnosed with High Functioning Autism.  Outcomes associated with the participant’s (P’s) production of fundamental frequency (f0) did not change significantly. Outcomes associated with P’s production of duration and intensity changed significantly for the signaling of Anger and Sadness but not Happiness. Subjective Outcomes associated with the production of Phrasing, Rate, and Stress significantly improved.

 

 

  1. What was the focus of the research? Clinical Research

 

 

  1. What type of evidence was identified?
  • Whattype of single subject design was used?  Case Study:  Description with Pre and Post Test Results
  • What was the level of support associated with the type of evidence?

Level =  D     

 

 

  1. Was phase of treatment concealed?
  • from participants? No
  • from clinicians?No
  • from data analyzers?No

 

 

  1. Was the participant (P) adequately described? Yes

–  How many Ps were involved in the study? 1

 

 CONTROLLED CHARACTERISTICS

  • age:between the ages of 8 years and 15 years
  • language:verbal and nonverbal skills within normal limits (WNL)
  • cognitive skills:WNL
  • diagnosis:Autism Spectrum Disorder (ASD) but not Asperger syndrome:
  • physical or sensory impairment:none
  • prosody:disturbance noted

 

–  DESCRIBED CHARACTERISTICS

  • age:14 years
  • gender:male
  • cognitive skills:WNL
  • language skills:WNL
  • hearing acuity:WNL
  • oral-peripheral skills:WNL

 

– Were the communication problems adequately described?  Yes

  • Disorder type:ASD, High Functioning Autism (HFA)
  • Other aspects of communication that were described:

–  stereotypical behaviors

–  communication problems

–  social interaction problems

–  prosodic problems:

  • phrasing (slight)
  • rate (slight)
  • stress

–  prosodic strengths

  • pitch
  • loudness
  • voice

 

 

  1. Was membership in treatment maintained throughout the study?Yes, there was only one P.
  • Were any data removed from the study? No

 

 

  1. Did the design include appropriate controls? No, this was a case study
  • Were preintervention data collected on all behaviors?Yes
  • Did preintervention data include untrained stimuli?Yes
  • Did preintervention data include trained stimuli?Yes
  • Was the data collection continuous? No
  • Were different treatment counterbalanced or randomized? Not Applicable (NA), there was only one treatment.

 

 

  1. Were the outcome measures appropriate and meaningful? Yes

ACOUSTIC MEASURES

  • OUTCOME #1:Fundamental frequency (F0) of imitative sentences representing the emotion Happiness changes from preintervention to post intervention
  • OUTCOME #2:F0of imitative sentences representing the emotion Anger changes from preintervention to post intervention
  • OUTCOME #3: F0of imitative sentences representing the emotion Sadness changes from preintervention to post intervention

 

  • OUTCOME #4: Duration of imitative sentences representing the emotion Happiness changes from preintervention to post intervention
  • OUTCOME #5: Duration of imitative sentences representing the emotion Anger changes from preintervention to post intervention
  • OUTCOME #6: Duration of imitative sentences representing the emotion Sadness changes from preintervention to post intervention

 

  • OUTCOME #7: Duration of unstressed syllables in imitative sentences representing the emotion Happiness changes from preintervention to post intervention
  • OUTCOME #8: Duration of unstressed syllables in imitative sentences representing the emotion Anger changes from preintervention to post intervention
  • OUTCOME #9:Duration of unstressed syllables in imitative sentences representing the emotion Sadness changes from preintervention to post intervention

 

  • OUTCOME #10: Duration of stressed syllables in imitative sentences representing the emotion Happiness changes from preintervention to post intervention
  • OUTCOME #11: Duration of stressed syllables in imitative sentences representing the emotion Anger changes from preintervention to post intervention
  • OUTCOME #12:Duration of stressed syllables in imitative sentences representing the emotion Sadness changes from preintervention to post intervention

 

  • OUTCOME #13: Intensity of unstressed syllables in imitative sentences representing the emotion Happiness changes from preintervention to post intervention
  • OUTCOME #14: Intensity of unstressed syllables in imitative sentences representing the emotion Anger changes from preintervention to post intervention
  • OUTCOME #15:Intensity of unstressed syllables in imitative sentences representing the emotion Sadness changes from preintervention to post intervention

 

  • OUTCOME #16:Intensity of stressed syllables in imitative sentences representing the emotion Happiness changes from preintervention to post intervention
  • OUTCOME #17: Intensity of stressed syllables in imitative sentences representing the emotion Anger changes from preintervention to post intervention
  • OUTCOME #198: Intensity of stressed syllables in imitative sentences representing the emotion Sadness changes from preintervention to post intervention

 

PERCEPTUAL MEASURES

  • OUTCOME #19: Changes in the judgment of Phrasing of 25 spontaneous utterances on the Prosody Voice Screening Profile (PVSP) from preintervention to post intervention
  • OUTCOME #20:Changes in the judgment of Rate of 25 spontaneous utterances on the PVSP from preintervention to post intervention
  • OUTCOME #21:Changes in the judgment of Stress of 25 spontaneous utterances on the PVSP from preintervention to post intervention
  • OUTCOME #22:Changes in the judgment of Quality of 25 spontaneous utterances on the PVSP from preintervention to post intervention – 100% at preintervention
  • OUTCOME #23: Changes in the judgment of Pitch of 25 spontaneous utterances on the PVSP from preintervention to post intervention– 100% at preintervention
  • OUTCOME #24:Changes in the judgment of Loudness of 25 spontaneous utterances on the PVSP from preintervention to post intervention– 100% at preintervention

 

 

–  The subjective outcomes are

  • OUTCOME #19: Changes in the judgment of Phrasing of 25 spontaneous utterances on the Prosody Voice Screening Profile (PVSP) from preintervention to post intervention
  • OUTCOME #20:Changes in the judgment of Rate of 25 spontaneous utterances on the PVSP from preintervention to post intervention
  • OUTCOME #21:Changes in the judgment of Stress of 25 spontaneous utterances on the PVSP from preintervention to post intervention
  • OUTCOME #22:Changes in the judgment of Quality of 25 spontaneous utterances on the PVSP from preintervention to post intervention – 100% at preintervention
  • OUTCOME #23: Changes in the judgment of Pitch of 25 spontaneous utterances on the PVSP from preintervention to post intervention– 100% at preintervention
  • OUTCOME #24:Changes in the judgment of Loudness of 25 spontaneous utterances on the PVSP from preintervention to post intervention– 100% at preintervention

 

–  The objective outcomes are

  • OUTCOME #1:Fundamental frequency (F0) of imitative sentences representing the emotion Happiness changes from preintervention to post intervention
  • OUTCOME #2:F0of imitative sentences representing the emotion Anger changes from preintervention to post intervention
  • OUTCOME #3: Fundamental frequency (F0) of imitative sentences representing the emotion Sadness changes from preintervention to post intervention

 

  • OUTCOME #4: Duration of imitative sentences representing the emotion Happiness changes from preintervention to post intervention
  • OUTCOME #5: Duration of imitative sentences representing the emotion Anger changes from preintervention to post intervention
  • OUTCOME #6: Duration of imitative sentences representing the emotion Sadness changes from preintervention to post intervention

 

  • OUTCOME #7: Duration of unstressed syllables in imitative sentences representing the emotion Happiness changes from preintervention to post intervention
  • OUTCOME #8: Duration of unstressed syllables in imitative sentences representing the emotion Anger changes from preintervention to post intervention
  • OUTCOME #9:Duration of unstressed syllables in imitative sentences representing the emotion Sadness changes from preintervention to post intervention

 

  • OUTCOME #10: Duration of stressed syllables in imitative sentences representing the emotion Happiness changes from preintervention to post intervention
  • OUTCOME #11: Duration of stressed syllables in imitative sentences representing the emotion Anger changes from preintervention to post intervention
  • OUTCOME #12:Duration of stressed syllables in imitative sentences representing the emotion Sadness changes from preintervention to post intervention

 

  • OUTCOME #13: Intensity of unstressed syllables in imitative sentences representing the emotion Happiness changes from preintervention to post intervention
  • OUTCOME #14: Intensity of unstressed syllables in imitative sentences representing the emotion Anger changes from preintervention to post intervention
  • OUTCOME #15:Intensity of unstressed syllables in imitative sentences representing the emotion Sadness changes from preintervention to post intervention

 

  • OUTCOME #16:Intensity of stressed syllables in imitative sentences representing the emotion Happiness changes from preintervention to post intervention
  • OUTCOME #17: Intensity of stressed syllables in imitative sentences representing the emotion Anger changes from preintervention to post intervention
  • OUTCOME #18: Intensity of stressed syllables in imitative sentences representing the emotion Sadness changes from preintervention to post intervention

 

–  Reliability Data:

  • The investigator provided some intraobserver (but not interobserver) reliability data. The metric involved remeasuring 10% of the samples for fo. duration, and stress. The investigator then noted the difference in the original and the reliability measurements

∞  F0differed by 0.97 Hz (Outcomes 1 to 3)

∞  Duration of full sentences differed by 20 ms (Outcomes 4-6)

∞  Duration of unstressed syllables differed by 4.96 ms (Outcomes 7-9)

∞  Duration of stressed syllables differed by 2.67 ms  (Outcomes 10-12)

∞  Intensity of unstressed syllables differed by 0.02 volts (Outcomes 13-15)

∞  Intensity of stressed syllables differed by 0.013 volts (Outcomes 16-18)

 

 

  1. Results:

–  Did the target behavior(s) improve when treated? Yes, for the most part, although the fooutcomes did not improve significantly.

 

ACOUSTIC MEASURES

  • OUTCOME #1:Fundamental frequency (F0) of imitative sentences representing the emotion Happiness changes from preintervention to post interventionNo significant difference; ineffective
  • OUTCOME #2:F0of imitative sentences representing the emotion Anger changes from preintervention to post intervention- No significant difference; ineffective
  • OUTCOME #3: Fundamental frequency (F0) of imitative sentences representing the emotion Sadness changes from preintervention to post intervention– No significant difference; ineffective

 

  • OUTCOME #4: Duration of imitative sentences representing the emotion Happiness changes from preintervention to post intervention – Significant Difference;  moderate improvement
  • OUTCOME #5: Duration of imitative sentences representing the emotion Anger changes from preintervention to post intervention – Significant Difference;  moderate improvement
  • OUTCOME #6: duration of imitative sentences representing the emotion Sadness changes from preintervention to post intervention – Significant Difference;  moderate improvement

 

  • OUTCOME #7: Duration of unstressed syllables in imitative sentences representing the emotion Happiness changes from preintervention to post intervention – No significant difference; ineffective
  • OUTCOME #8: Duration of unstressed syllables in imitative sentences representing the emotion Anger changes from preintervention to post intervention – No significant difference; ineffective
  • OUTCOME #9:Duration of unstressed syllables in imitative sentences representing the emotion Sadness changes from preintervention to post intervention – Significant Difference;  moderate

 

  • OUTCOME #10: Duration of stressed syllables in imitative sentences representing the emotion Happiness changes from preintervention to post intervention – No significant difference; ineffective
  • OUTCOME #11:Duration of stressed syllables in imitative sentences representing the emotion Anger changes from preintervention to post intervention – Significant Difference;  moderate improvement
  • OUTCOME #12:Duration of stressed syllables in imitative sentences representing the emotion Sadness changes from preintervention to post intervention – Significant Difference;  moderate improvement

 

  • OUTCOME #13: Intensity of unstressed syllables in imitative sentences representing the emotion Happiness changes from preintervention to post intervention – No significant difference; ineffective
  • OUTCOME #14: Intensity of unstressed syllables in imitative sentences representing the emotion Anger changes from preintervention to post intervention –  Significant Difference;  strong improvement
  • OUTCOME #15:Intensity of unstressed syllables in imitative sentences representing the emotion Sadness changes from preintervention to post intervention –  Significant Difference; strong improvement

 

  • OUTCOME #16:Intensity of stressed syllables in imitative sentences representing the emotion Happiness changes from preintervention to post intervention – No significant difference; ineffective
  • OUTCOME #17: Intensity of stressed syllables in imitative sentences representing the emotion Anger changes from preintervention to post intervention – Significant Difference;  strong improvement
  • OUTCOME #18: Intensity of stressed syllables in imitative sentences representing the emotion Sadness changes from preintervention to post intervention – Significant Difference;  strong improvement

 

PERCEPTUAL MEASURES

  • OUTCOME #19: Changes in the judgment of Phrasing of 25 spontaneous utterances on the Prosody Voice Screening Profile (PVSP) from preintervention to post intervention—preintervention = 12% correct , post intervention = 100% correct; strong improvement
  • OUTCOME #20: Changes in the judgment of Rate of 25 spontaneous utterances on the PVSP from preintervention to post intervention —preintervention = 16% correct , post intervention = 84% correct; moderate improvement  
  • OUTCOME #21:Changes in the judgment of Stress of 25 spontaneous utterances on the PVSP from preintervention to post intervention —preintervention = 56% correct, 84% post intervention =  84% correct; moderate improvement  
  • OUTCOME #22:Changes in the judgment of Quality of 25 spontaneous utterances on the PVSP from preintervention to post intervention – 100% at preintervention; not considered a treatment outcome
  • OUTCOME #23: Changes in the judgment of Pitch of 25 spontaneous utterances on the PVSP from preintervention to post intervention– 100% at preintervention; not considered a treatment outcome
  • OUTCOME #24:Changes in the judgment of Loudness of 25 spontaneous utterances on the PVSP from preintervention to post intervention– 100% at preintervention; not considered a treatment outcome

 

 

  1. Description of baseline:
  • Were preintervention data provided?Yes. But the  preintervention data for all outcomes  were generated with only one data point.

 

 

  1. What is the clinical significance? NA

 

 

  1. Was information about treatment fidelity adequate? NA

 

 

  1. Were maintenance data reported?No

 

 

  1. Were generalization data reported?Yes
  • Performance on the PVSP (see item 8b- Perceptual Measures) could be considered generalization data because the PVSP was derived from spontaneous samples and spontaneous speech was not the focus of the intervention.
  • Changes in the 3 PVSP outcomes that were used in the pre- and post- intervention comparisons ranged from moderate to strong improvement. (NOTE: The three other PVSP outcomes were not included in the pre-and post- intervention comparisons because preintervention performance was 100% correct. )

 

 

  1. Brief description of the design:
  • A single P, who was diagnosed as having High Functioning Autism, was administered 10 weeks of therapy.
  • Prior to (preintervention) and after (post intervention), the investigator collected the same measurements from the P.
  • For the most part, the investigator compared the measures using the parametric statistic the paired sample t-test.

 

 

ASSIGNED OVERALL GRADE OF THE QUALITY OF SUPPORT FOR THE INTERVENTION:  D-

 

 

SUMMARY OF INTERVENTION

 

PURPOSE:  To improve the production of affective prosody.

 

POPULATION:   ASD (HFA); children

 

MODALITY TARGETED:  production

 

ELEMENTS/FUNCTIONS OF PROSODY TARGETED:  affect, stress, intensity, fo, duration/rate, phrasing

 

DOSAGE:   1 hour sessions; 1 time a week; 10 weeks

 

ADMINISTRATOR:  Graduate Student in SLP

 

MAJOR COMPONENTS:

 

  • The intervention (The Imitative Approach) contained 6 steps in which the clinician (C) initially provided maximal cues and gradually faded the cues.
  • Three consecutive correct responses were required to move from one step to the next.

 

STEP 1:

  • C identifies target affect (happy, sad, angry, or neutral) and the P’s task.
  • C directs P to listen and she models a written sentence using the target emotion.
  • C and P repeat the target sentence with the targeted emotion together (in unison.),

 

STEP 2:

  • C models the target written sentence with the appropriate prosody and facial expression.
  • C directs P to produce the modeled sentence and affect.
  • Correct response = correct sentence and prosody (appropriate facial expression is not required).

 

STEP 3:

  • C models the target written sentence with the appropriate prosody.C covers his/her face thus obstructing the P’s view of her facial expression.

 

STEP 4:

  • C presents a sentence with a neutral prosody and directs the P to imitate the sentence with a targeted prosody (i.e., happy, sad, or angry).

 

STEP 5:

  • C asks a question designed to elicit the target written sentence with a specific affect.
  • For example, to elicit a happy(or sad or angry) affect for the target written sentence “The fair starts tomorrow,“ C asks “Why are you so happy (or sad or angry?”)

 

STEP 6:

  • Using the same target written sentence, the C directs a role playing task in which the P shares a targeted affective/ emotional state with a family member.

 

 

 

Advertisements

Sousa (2017)

June 1, 2018

CRITIQUE OF UNSUPPORTED PROCEDURAL DESCRIPTIONS

(also known as Expert Opinion)

NOTE:  A summary of the intervention can be found by scrolling about one-half of the way down this page.

KEY

ASD =  autism spectrum disorder

C =  clinician

NA = not applicable

P =  patient or participant

pmh =  Patricia Hargrove, blog developer

SLP = speech-language pathologist 

Source:  Sousa, M. S. S. (2017).  Prosodic exercises for children with ASD via virtual therapy. Thesis in Electrical and Computer Engineering, Técnico Lisboa (Portugal).  Retrieved from Semantic Scholar (https://www.semanticscholar.org/paper/Prosodic-exercises-for-children-with-ASD-via-Sousa-Trancoso/800334b2054586baaa055b01f08c2932df93eb77) 

Reviewer(s):  pmh

Date:  May 31.2018 

Overall Assigned Grade for Evidence (because there are no supporting data, the highest grade will be F, ):  The grade of F should not be interpreted as an evaluation of the intervention described in this paper or the quality of the paper itself. It merely reflects the quality of the support for the intervention. Because there were no data, the grade is F.

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

Take Away:  The author detailed the strategies for developing a mobile phone-based prosodic intervention for young Portuguese speaking children diagnosed with autism spectrum disorder (ASD.) The author described methods for assessing the quality of the auditory stimuli used in the treatment and for evaluating acoustically imitations produced during the intervention by the children with ASD. The author consulted the existing literature as well as “therapists”  to identify important learning strategies and targets. Although this mobile-phone prosodic intervention was not administered, it does have potential as a model for future development.

  1. Was there a review of the literature supporting components of the intervention?Yes
  • Narrative Review

 

  1. Were the specific procedures/components of the intervention tied to the reviewed literature? Yes

  

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

 

  1. Did the author(s) provide a rationale for components of the intervention? Yes

 

  1. Description of outcome measures:

–  Are outcome measures suggested?  Yes

  • Outcome #1: Discrimination of same and different using visual stimuli

 

  • Outcome #2: Discrimination of nonspeech auditory stimuli (affirmation versus question; pleasure versus displeasure) that differ only in intonation

 

  • Outcome #3: Discrimination of single words as representing pleasure or displeasure affective states

 

  • Outcome #4: Discriminate low versus high pitches in single words

 

  • Outcome #5: Identification of the direction of the pitches of 2 syllable productions

 

  • Outcome #6: Imitate intonation of single words

  

  1. Was generalization addressed? No

 

  1. Was maintenance addressed? No

  

SUMMARY OF INTERVENTION

 

PURPOSE: to develop an Android application for teaching the comprehension and production of intonation

POPULATION:  Autism Spectrum Disorder; children

MODALITY TARGETED: comprehension, production (imitation)

 ELEMENTS/FUNCTIONS OF PROSODY TARGETED: pitch, intonation

OTHER TARGETS:  concepts of same/different

DOSAGE: not applicable because the program was not administered

ADMINISTRATOR:  mobile phones? (this is virtual therapy)

MAJOR COMPONENTS:

  • This intervention was developed to fulfill the thesis requirement for the Master of Science in Electrical and Computer Engineering at Ténico Lisboa (Portugal.)

 

  • Several tasks were developed for nonreading children to use on Android phones including

–  2 activities to teach the concept of same/different

– one activity to teach the discrimination of single words as being same or different when they could differ only by intonation patterns representing question/affirmation  or pleasure/displeasure.

–  one activity to teach the imitation of single words that differed only by intonation patterns representing question/affirmation  or pleasure/displeasure.

– one activity to teach the identification of pleasure/displeasure affective states of single words.

– one activity to teach the identification of high versus low pitches on auditory stimuli (initially nonspeech sounds, moving to speech sounds)

– one activity to teach the identification of sequences of pitches produced on sounds (e.g., high-high, low-low, high-low, etc.)

 

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

 


Chenausky & Schlag (2018)

April 29, 2018

EBP THERAPY ANALYSIS

Treatment Groups 

Note: Scroll about 80% of the way down the page to read the summary of the procedure.

 Key:

AMMT =  Auditory-motor mapping training

approximately correct =  P produced consonant bisyllable target with 2 of 3

features (manner, place, voicing)  of an adult form of the consonant AND the

vowel portion of the bisyllable target was of the same class (i.e., same height

and degree of backness)

ASD =  Autism Spectrum Disorder

C = Clinician

EBP = evidence-based practice

f = female

m = male

MV =  Minimally Verbal

NA = not applicable

P = Patient or Participant

pmh =  Patricia  Hargrove, blog developer

SLP = speech–language pathologist

SRT =  Speech Repetition Therapy

 

 

SOURCE: Chenausky, K. V., & Schlaug, G. (2018). From intuition to intervention: Developing an intonation-based treatment for autism.  Annals of the New York Academy of Sciences, 1-13. doi: 10.1111/nyas. 13609 (Early Online Version before inclusion in an issue)

 

 

REVIEWER(S):  pmh

 

DATE:   April 24, 2018

 

ASSIGNED GRADE FOR OVERALL QUALITY: 

– Proof of Concept Study =  C-

– Replication Study =  C-

– Comparison Study =  B-

 

TAKE AWAY: Although the article provides information that could be used as a summary of stages of program assessment, the focus of this review is limited to the evidence for the effective of a music-based intervention: Auditory-motor mapping training (AMMT.) Three studies were reported in this investigation:  Proof of Concept, Replication, and Comparison. Some participants’ data were used in more than one investigation. Each of the studies is reviewed separately and indicate that AMMT has potential for success.

 

 

  1. What type of evidence was identified?

                                                                                                           

  • What was the type of evidence?

     – Prospective, Nonrandomized Group Design with Controls?   Comparison Study

– Prospective, Single Group with Pre- and Post-Testing  Proof of Concept Study, Replication Study

 

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

     – Proof of Concept Level = C+

     – Replication Level = C+

     – Comparison Level = B+

 

PROOF OF CONCEPT STUDY

                                                                                                           

  1. Group membership determination:

                                                                                                           

  • If there was more than one group, were participants (Ps) randomly assigned to groups?Not Applicable

 

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

 

 

  1. Was administration of intervention status concealed?

                                                                                                           

  • from participants?No
  • from clinicians? No
  • from analyzers? Yes

                                                                    

 

  1. Was the group adequately described? No

 

–  How many  Ps were involved in the study?

  • total # of Ps:   6
  • # of groups:  1

 

–  CONTROLLED CHARACTERISTICS

  • expressive vocabulary:less than 20 words
  • imitation skills: able to imitate at least 2 sounds
  • diagnosis:Minimally Verbal (MV) Autism Spectrum Disorder (ASD)
  • other diagnoses:excluded sensorineural disorders (e.g., deafness, Down syndrome)

 

–  DESCRIBED CHARACTERISTICS

  • age:5 years 9 months to  8 years 9 months (mean = 6 years 7 months)
  • gender: 1f; 5m

 

–   Were the groups similar before intervention began? NA, there was only one group.

                                                         

–  Were the communication problems adequately described?  No

  • disorder type:  MV ASD
  • functional level:  baseline phonetic inventory =  7.9 (+/- 5.3)

 

 

  1. Was membership in the group maintained throughout the study?

                                                                                                             

  • Did the group maintain at least 80% of their original members? Yes
  • Were data from outliers removed from the study? No 

 

 

  1. Was the group controlled acceptably?  No, this was a single group study.

 

 

  1. Was the outcome measure appropriate and meaningful? Yes

 

  • OUTCOME #1:Percentage of “syllables approximately correct” (p. 4)  from a list of 30 bisyllable words/phrases

 

NOTE:  approximately correct =  P produced consonant bisyllable target with 2 of 3 features (manner, place, voicing)  of an adult form of the consonant AND the vowel portion of the bisyllable target was of the same class (i.e., same height and degree of backness)

 

  • The outcome measures was subjective.

 

*  The outcome measure was NOTobjective.

                                         

 

  1. Were reliability measures provided?

                                                                                                             

  • Interobserver for analyzers?Yes

    –  OUTCOME #1:  Percentage of “syllables approximately correct” (p. 4)  from a list  of 30 bisyllable words/phrases

–  for the measure “approximately correct”

            ∞ percent of interobserver agreement was 68%

            ∞ difference in from change agreement–  Cohen’s K = 0.55 (p <

                0.0005)

            ∞ investigators claimed these measures were “favorable” (p. 5) and

                 “at least ‘moderate’ or ‘good’)

 

  • Intraobserver for analyzers?No 

 

  • Treatment fidelity for clinicians? No , but the investigators developed a manual describing treatment procedures.

 

 

  1. What were the results of the statistical (inferential) testing and/or the description of the results?

 

– Summary Of Important Results

     ∞  What level of significance was required to claim significance? p = 0.05

 

 

PRE AND POST TREATMENT ONLY ANALYSES

 

 

  • OUTCOME #1:Percentage of “syllables approximately correct” (p. 4)  from a list of 30 bisyllable words/phrases:  Ps scores were significantly better following treatment compared to pretreatment data

 

  • What was the statistical test used to determine significance?

–  t-test

     –  binominal test of significant

 

  • Were confidence interval (CI) provided?Yes

     –  95% CI:  xxx, investigators reported that the Ps pretreatment scores were beyond the 95% CI for the post intervention scores.

 

 

  1. What is the clinical significanceNo EBP data provided but investigators claim clinical significance by describing the increase of percentage of approximately correct bisyllables.

 

 

  1. Were maintenance data reported?No

 

 

  1. Were generalization data reported?No, but the outcome measure included trained and untrained stimuli but the trained/untrained data were not presented separately.

 

 

  1. Describe briefly the experimental design of the investigation.

 

  • Six Ps were selected to determine if AMMT regularly resulted in improvements in the outcome.

 

  • The 6 Ps each participated in 40 treatment sessions and served as his/her control.

 

  • The investigators performed multiple baseline assessment of the outcome and used the best performance of each P as his/her baseline.

 

  • Following the 10thsession and every 5 sessions after the 10th, the investigators performed an assessment or probe session. Probe sessions were similar to the treatment session except they included both trained and untrained (generalization) stimuli.

 

  • Each Ps’ clinician (C) administered the probes but the ratings of correct/incorrect were performed by a blinded rater.

 

 

GRADE= C-

 

 

REPLICATION STUDY

 

 

  1. Group membership determination:

                                                                                                           

  • If there was more than one group, were participants (Ps) randomly assigned to groups? Not Applicable (NA), there was only one group.

 

 

  1. Was administration of intervention status concealed?

                                                                                                           

  • from participants? No
  • from clinicians?No
  • from analyzers? Yes

                                                                    

 

  1. Was the group adequately described? No

 

– How many  Ps were involved in the study?

  • total # of Ps: 17
  • # of groups:1

 

–  CONTROLLED CHARACTERISTICS

  • expressive vocabulary:less than 20 words
  • imitation skills: able to imitate at least 2 sounds
  • diagnosis:Minimally Verbal (MV) Autism Spectrum Disorder (ASD)
  • other diagnoses:excluded sensorineural disorders (e.g., deafness, Down syndrome)

 

–  DESCRIBED CHARACTERISTICS

  • age:3 years; 5 months to 9 years; 8 months (mean =6 years; 6 months)
  • gender:2f; 15m

 

–   Were the groups similar before intervention began? NA , there was only one group.

                                                         

–  Were the communication problems adequately described?  No

  • disorder type: MV ASD
  • functional level: baseline phonetic inventory:  mean = 7.2 (+/- 4.3)

 

 

  1. Was membership in the group maintained throughout the study?

                                                                                                             

  • Did the group maintain at least 80% of their original members? Yes
  • Were data from outliers removed from the study?No 

 

 

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

 

 

  1. Was the outcome measure appropriate and meaningful? Yes

 

  • OUTCOME #1:Percentage of “syllables approximately correct” (p. 4)  from a list of 30 bisyllable words/phrases

 

  • The outcome measures was subjective.
  • The outcome measure was NOTobjective.

                                         

 

  1. Were reliability measures provided?

                                                                                                             

  • Interobserver for analyzers?No, but see the results for interobserver reliability for the Proof of Concept study.

 

  • Intraobserver for analyzers?No 

 

  • Treatment fidelity for clinicians?Yes

–  All of the reviewed sessions included the major AMMT components (intoned speech) and drums.

 

 

  1. What were the results of the statistical (inferential) testing and/or the description of the results?

 

–  Summary Of Important Results

 

—  What level of significance was required to claim significance?  p = 0.05

 

PRE AND POST TREATMENT ONLY ANALYSES

 

OUTCOME #1:  Percentage of “syllables approximately correct” (p. 4)  from a list  of 30 bisyllable words/phrases imitated

  • There post treatment scores were significantly better than thepretreatment score.
  • The investigators compared the results of the Replication Group and the Proof of Concept Group at 25 sessions and determined

∞  that there was no significant difference between the groups,

∞  that their combined outcomes were significantly better after treatment, and

∞  that the trajectories of their improvement were similar

∞  overall the number of correct syllables in the combined groups was about 15 at baseline and 27 following 25 sessions.

 

 

—  What was the statistical test used to determine significance?

  • t-test
  • ANOVA

 

–  Were confidence interval (CI) provided?  No

 

 

  1. What is the clinical significance(List outcome number with data with the appropriate Evidence Based Practice, EBP, measure.) No 

 

 

  1. Were maintenance data reported?No

 

 

  1. Were generalization data reported?No, treated bisyllables were included in the assessment data but they were not described separately.

 

 

  1. Describe briefly the experimental design of the investigation.
  • Seventeen Ps were selected to determine to replicate the finding of the Proof of Concept study with a larger group.

 

  • The 17 Ps each participated in 25 treatment sessions and served as his/her control. The 25 sessions dosage is markedly reduced from the Proof of Concept study but was used because of the burden of 40 sessions for families. The decision also was made to use 25 sessions because almost 90% of the change in the Proof of Concept study had been achieved by session 25.

 

  • The investigators performed multiple initial preintervention assessments of the outcome and used the best performance of each P as his/her baseline.

 

  • Following the 10thsession and every 5 sessions after the 10th, the investigators performed an assessment or probe session. Probe sessions were similar to the treatment sessions except they included both trained and untrained (generalization) stimuli. Each Ps’ clinician (C) administered the probes but the ratings of correct/incorrect were performed by a blinded rater.

 

  • The investigators combinedthe data from the Ps in the Proof of Concept and the Replication studies because the performance of the 2 groups was similar.

 

GRADE C-

 

 

COMPARISON STUDY

 

  1. Group membership determination:

                                                                                                           

  • If there was more than one group, were participants (Ps) randomly assigned to groups? No 

 

  • If there were groups andthe Ps were not randomly assigned to groups, were members of groups carefully matched?  Yes
  • -Seven Ps from the original Ps in the Replication study were matched to 7 Ps who were to be assigned to the control group, Speech Repetition Therapy (SRT.)

     –  The Ps were matched on the basis of

∞  chronological age

∞  mental age

∞  baseline phonemic (phonetic) repetition ability

                                                                    

 

  1. Was administration of intervention status concealed?

                                                                                                           

  • from participants? No
  • from clinicians? No
  • from analyzers? Yes

                                                                    

 

  1. Were the groups adequately described? No

 

–  How many  Ps were involved in the study?

  • total # of Ps: probably
  • # of groups:2
  • List names of groups and the # of participants in each group:

     –  AMMT = 7  (a subgroup of Ps from the AMMT treated Replication study)

–  SRT = 7

 

–  CONTROLLED CHARACTERISTICS

  • expressive vocabulary:less than 20 words
  • imitation skills: able to imitate at least 2 sounds
  • diagnosis:Minimally Verbal (MV) Autism Spectrum Disorder (ASD)
  • other diagnoses:excluded sensorineural disorders (e.g., deafness, Down syndrome)

 

–  DESCRIBED CHARACTERISTICS

  • age:

     –  AMMT = 3 years; 5 months to 8 years; 11 months (mean =  6 years, 1 month)

     –  SRT =  3 years; 9  months to 8 years; 5 months (means = 5 years; 8 months)

  • gender:

     –  AMMT = 7m

     –  SRT = 2f; 5m

 

–   Were the groups similar before intervention began? Yes

                                                         

–  Were the communication problems adequately described?  No 

  • disorder type: (List) MV  ASD
  • functional level: baseline phonetic inventory

– AMMT =  7.1 (+/- 3.4)

– SRT =  8.9 (+/- 5.4)

 

 

  1. Was membership in groups maintained throughout the study?

                                                                                                             

  • Did each of the groups maintain at least 80% of their original members? Yes

                                                               

  • Were data from outliers removed from the study? No 

 

 

  1. Were the groups controlled acceptably? Yes

                                                                                                             

  • Was there a no intervention group?No   
  • Was there a foil intervention group? No
  • Was there a comparison group?Yes
  • Was the time involved in the foil/comparison and the target groups constant? Yes

 

 

  1. Was the outcome measure appropriate and meaningful? Yes

                                                                                                             

  • OUTCOME #1:Percentage of “syllables approximately correct” (p. 4)  from a list of 30 bisyllable words/phrases

 

  • The outcome measure was subjective.
  • The outcome measure was NOT objective.

                                         

 

  1. Were reliability measures provided?

                                                                                                             

  • Interobserver for analyzers?No, but see the results for interobserver reliability for the Proof of Concept study.

 

  • Intraobserver for analyzers?No 

 

  • Treatment fidelity for clinicians?Yes

     – Every AMMT reviewed trial reviewed contained the 2 major components of AMMT:  intoned speech and drumming.

     – None of the SRT  trials reviewed contained the 2 major components of AMMT: intoned speech and drumming.

 

 

  1. What were the results of the statistical (inferential) testing and/or the description of the results?

 

  • Summary Of Important Results

 

—  What level of significance was required to claim significance?  p = 0.05

 

TREATMENT AND FOIL/COMPARISON/NO TREATMENT GROUP ANALYSES

 

  • OUTCOME #1:  Percentage of “syllables approximately correct” (p. 4)  from a list  of 30 bisyllable words/phrases

–  Overall, both the AMMT and the SRT groups improved significantly from baseline to the end of treatment.

     –  The 2 groups (AMMT, SRT) scores were not significantly different from one another over the 4 testing periods.

 

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

 

  • Were confidence interval (CI) provided? No

 

 

  1. What is the clinical significanceNA

 

 

  1. Were maintenance data reported? Yes  __x__  No ______
  • Improvements following treatment of 25 weeks were maintained 4 and 8 weeks post treatment.(That is, there no significant difference between outcomes immediately after treatment and 4 and 8 weeks post treatment.

 

  • There were no significantly different outcome scores for the 2 groups .

 

 

  1. Were generalization data reported?Yes

 

  • Trained stimuli were significantlymore likely to be correct than untrained stimuli.

 

  • There were no significantly different outcome scores for the 2 groups .

 

 

  1. Describe briefly the experimental design of the investigation.

 

  • The investigators matched 7 of the Ps from the Replication study to a group of Ps who received SRT.

 

  • The 14 Ps each participated in 25 treatment sessions and served as his/her control.

 

  • The investigators compared the outcomes of the AMMT and SRT groups following 25 sessions and analyzed the data.

 

  • For the maintenance analysis, the investigators then selected 10 AMMT Ps for the Replication study and the 7 SRT Ps from this Comparison study and compared their performance 4 and 8 weeks following the termination of treatment.

 

ASSIGNED OVERALL GRADE FOR QUALITY OF EXTERNAL EVIDENCE:  B-

 

 

 

SUMMARY OF INTERVENTION

 

PURPOSE: To determine if a music-based intervention (AMMT), based on Melodic Intonation Therapy, warrants additional research

 

POPULATION:  ASD

 

MODALITY TARGETED:  production

 

 

ELEMENTS OF PROSODY USED AS INTERVENTION:  music (rhythm, intonation, pitch), rate.

 

OTHER ASPECTS OF LANGUAGE/COMMUNICATION TARGETED: Articulation

 

DOSAGE:  45 minute individual sessions for 40 (Proof of Concept study) or 25 sessions (Replication study or Comparison study)

 

ADMINISTRATOR:  probably SLP

 

 

MAJOR COMPONENTS:

 

  • Two treatments were described in the article:AMMT and SRT

 

 

AUDITORY-MOTOR MAPPING TRAINING (AMMT)

 

  • AMMT is derived from Melodic Intonation Therapy.

 

  • The main objective of AMMT is to increase speech sound accuracy and intelligibility.

 

  • AMMT involves scaffolding, massed practice, spaced practice, and several behavioral management techniques.

 

  • Clinicians (Cs) model intoned bisyllables at 1 syllable per second using 2 pitch levels that corresponded to naturalspeech. The C accompanied the production of the intoned bisyllables with tapping of an electronic drum using the same pitches as the intoned modeled bisyllables. Again, the rate is one tap per second.

 

  • There are 5 hierarchical steps in AMMT:

–  Listening:  The C produces a model of the bisyllable target word at the end of a sentence. Example: “It is fun to blow bubbles” (p. 6.)  The target was intoned using the 2 pitches and the intoning was accompanied the tapping of an electronic drum.

 

–  Unison: C and P produce the bisyllable target word together. Example:  C says: “Let’s say it together:  bubbles” (p. 6.) The target was intoned using the 2 pitches and the intoning was accompanied the tapping of an electronic drum.

 

–  Unison Fade: C says the first syllable of the bisyllable target word, cuing P to produce the whole target. Example:  C says: Again:  bu….”   (p. 6.) The target was intoned using the 2 pitches and the intoning was accompanied the tapping of an electronic drum.

 

–  Imitation: C models the target word and directs P to imitate. The target was intoned using the 2 pitches and the intoning was accompanied the tapping of an electronic drum. Example:

∞  C says: “My turn: bubbles.” (p. 6)

∞  C says: “You turn …..”  (p. 6)

 

–  Cloze: C elicits the independent production of the bisyllable target from P. Example: “Last time It’s fun to blow …..” (p. 6.).

 

  • Each session involved 15 bisyllable target words in which each was practiced 5 times before moving to the next target.

 

 

SPEECH REPETITION THERAPY  (SRT)

 

  • SRT used the same procedures at AMMT without the intoning and drumming.

 


Ankari & Davis (2018)

April 3, 2018

EBP THERAPY ANALYSIS for

Single Case Designs

NOTES: 

  • The summary of the intervention procedure(s) can be viewed by scrolling about two-thirds of the way down on this page. 

Key:

ASD =  Autism Spectrum Disorder

C = Clinician

EBP = evidence-based practice

F0 =  fundamental frequency

NA = not applicable

P = Patient or Participant

pmh = Patricia Hargrove, blog developer

PVSP =  Perceived performance on the Prosody-Voice Screening Profile

SLP = speech–language pathologist

WNL = within normal limits

 

SOURCE:  Akbari, C. C., & Davis. A. H. (2018).  Treating expressive affective prosody in Autism Spectrum Disorder: A case study.  Communication Disorders Quarterly. Article first published online: February 27, 2018 DOI; 10.1177/1525740118755669  cdq.sagepub.com

 

REVIEWER(S):  pmh

 

DATE: March 22, 2018

 

ASSIGNED OVERALL GRADE:  D-  The highest possible grade for this investigator is D+. This grade is based on the design of the investigation, a single case study. This grade does not represent a judgment regarding the quality of the investigation nor the quality of the intervention. It solely represents the level of the support for the intervention in this investigation.

 

TAKE AWAY:  This single case study revealed that an adaptation of an intervention used with adults with aphasia to improve expressive affective prosody was used effectively with an adolescent with Autism Spectrum Disorder. The outcomes were acoustic and perceptual measures of features used to expressive affective prosody.

                                                                                                           

 

  1. What was the focus of the research? Clinical

 

 

  1. What type of evidence was identified?
  • What type of single subject design was used?  Case Study– Description with Pre and Post Test Results
  • What was the level of support associated with the type of evidence?

Level = D+   

                                                                                                           

 

  1. Was phase of treatment concealed?
  • from participants?No
  • from clinicians? No
  • from data analyzers?No

 

 

  1. Was the participant (P) adequately described? Yes

 

–  How many Ps were involved in the study?  1

 

–  DESCRIBED CHARACTERISTICS

  • age:14 years
  • gender:male                               
  • cognitive skills:within normal limits (WNL)
  • language scores:WNL
  • oral peripheral status: WNL
  • diagnosis:Autism Spectrum Disorder (ASD)
  • hearing: WNL

 

–  Were the communication problems adequately described?  Yes

  • The disorder type(s):ASD
  • Other aspects of communication that were described:

–  Problems in the following aspects of prosody

         ∞  phrasing

         ∞  rate

         ∞  stress

    –   Voice quality was WNL.

 

                                                                                                                       

  1. Was membership in treatment maintained throughout the study?Yes

                

  • If there was more than one participant, did at least 80% of the participants remain in the study?Not applicable (NA) 
  • Were any data removed from the study? No 

 

 

  1. Did the design include appropriate controls? No, it was a single case study.

                                                                      

  • Were preintervention data collected on all behaviors?Yes
  • Did pre and post intervention data include untrained stimuli? Yes
  • Did pre and post intervention data include trained stimuli? No
  • Was the data collection continuous?No
  • Were different treatment counterbalanced or randomized?NA

 

 

  1. Were the outcome measures appropriate and meaningful? Yes, but I did not see an outcome targeting the accuracy of listeners’ interpretation of the expressive affect.

 

OUTCOMES

 

  • OUTCOME #1: Perceived performance on the Prosody-Voice Screening Profile (PVSP): Phrasing
  • OUTCOME #2:Perceived performance on the PVSP: Rate
  • OUTCOME #3: Perceived performance on the PVSP: Stress
  • OUTCOME #4: Perceived performance on the PVSP: Loudness
  • OUTCOME #5:Perceived performance on the PVSP: Pitch
  • OUTCOME #6: Perceived performance on the PVSP: Quality
  • OUTCOME #7: Production of duration of full sentences representing happiness
  • OUTCOME #8:Production of duration of full sentences representing anger
  • OUTCOME #9: Production of duration of full sentences representing sadness
  • OUTCOME #10: Production of fundamental frequency (F0) in sentences representing happiness
  • OUTCOME #11:Production of F0 in sentences representing anger
  • OUTCOME #12: Production of F0 in sentences representing sadness
  • OUTCOME #13: Production of duration of unstressed syllables in sentences representing happiness
  • OUTCOME #14:Production of duration of unstressed syllables in sentences representing anger
  • OUTCOME #15: Production of duration of unstressed syllables in sentences representing sadness
  • OUTCOME #16: Production of duration of stressed syllables in sentences representing happiness
  • OUTCOME #147:Production of duration of stressed syllables in sentences representing anger
  • OUTCOME #18: Production of duration of stressed syllables in sentences representing sadness
  • OUTCOME #19: Production of intensity of unstressed syllables in sentences representing happiness
  • OUTCOME #21:Production of intensity of unstressed syllables in sentences representing anger
  • OUTCOME #22: Production of intensity of unstressed syllables in sentences representing sadness
  • OUTCOME #23: Production of intensity of stressed syllables in sentences representing happiness
  • OUTCOME #24:Production of intensity of stressed syllables in sentences representing anger
  • OUTCOME #25: Production of intensity of stressed syllables in sentences representing sadness

 

SUBJECTIVE OUTCOMES

  • OUTCOME #1: Perceived performance on the Prosody-Voice Screening Profile (PVSP): Phrasing
  • OUTCOME #2:Perceived performance on the PVSP: Rate
  • OUTCOME #3: Perceived performance on the PVSP: Stress
  • OUTCOME #4: Perceived performance on the PVSP: Loudness
  • OUTCOME #5:Perceived performance on the PVSP: Pitch
  • OUTCOME #6: Perceived performance on the PVSP: Quality

 

OBJECTIVE OUTCOMES

  • OUTCOME #7: Production of duration of full sentences representing happiness
  • OUTCOME #8:Production of duration of full sentences representing anger
  • OUTCOME #9: Production of duration of full sentences representing sadness
  • OUTCOME #10: Production of fundamental frequency (F0) in sentences representing happiness
  • OUTCOME #11:Production of F0 in sentences representing anger
  • OUTCOME #12: Production of F0 in sentences representing sadness
  • OUTCOME #13: Production of duration of unstressed syllables in sentences representing happiness
  • OUTCOME #14:Production of duration of unstressed syllables in sentences representing anger
  • OUTCOME #15: Production of duration of unstressed syllables in sentences representing sadness
  • OUTCOME #16: Production of duration of stressed syllables in sentences representing happiness
  • OUTCOME #147:Production of duration of stressed syllables in sentences representing anger
  • OUTCOME #18: Production of duration of stressed syllables in sentences representing sadness
  • OUTCOME #19: Production of intensity of unstressed syllables in sentences representing happiness
  • OUTCOME #21:Production of intensity of unstressed syllables in sentences representing anger
  • OUTCOME #22: Production of intensity of unstressed syllables in sentences representing sadness
  • OUTCOME #23: Production of intensity of stressed syllables in sentences representing happiness

 

 

–  Reliability data

 

  • Intra rater reliability of acoustic measurement:Authors claim little variation in the following measures:

–  F0

–  stressed syllable duration

– unstressed syllable duration

– stressed syllable intensity

– unstressed syllable intensity

 

 

  1. Results:

 

–  Did the target behavior(s) improve when treated?  Yes, for the most part

 

  • OUTCOME #1: Perceived performance on the Prosody-Voice Screening Profile (PVSP): Phrasing — WNL for both pre and post testing

 

  • OUTCOME #2: Perceived performance on the PVSP: Rate —WNL for both pre and post testing

 

  • OUTCOME #3: Perceived performance on the PVSP: Stress– pretest =  approximately 44% correct; post test = approximately 84% correct

 

  • OUTCOME #4: Perceived performance on the PVSP: Loudness-WNL for both pre and post testing

 

  • OUTCOME #5: Perceived performance on the PVSP: Pitch — WNL for both pre and post testing

 

  • OUTCOME #6: Perceived performance on the PVSP: Quality  — WNL for both pre and post testing

 

  • OUTCOME #7: Production of duration of full sentences representing happiness —Significantly longer following post testing

 

  • OUTCOME #8: Production of duration of full sentences representing anger  —Significantly longer following post testing

 

  • OUTCOME #9: Production of duration of full sentences representing sadness  Significantly longer following post testing

 

  • OUTCOME #10:Production of fundamental frequency (F0) in sentences representing happiness  —No significant differences between pre and post testing

 

  • OUTCOME #11: Production of F0 in sentences representing anger  —No significant differences between pre and post testing

 

  • OUTCOME #12: Production of F0 in sentences representing sadness —No significant differences between pre and post testing 

 

  • OUTCOME #13: Production of duration of unstressed syllables in sentences representing happiness —No significant differences between pre and post testing

 

  • OUTCOME #14: Production of duration of unstressed syllables in sentences representing anger  —No significant differences between pre and post testing

 

  • OUTCOME #15: Production of duration of unstressed syllables in sentences representing sadness  —Significantly longer following post testing

 

  • OUTCOME #16: Production of duration of stressed syllables in sentences representing happiness anger  —No significant differences between pre and post testing

 

  • OUTCOME #147: Production of duration of stressed syllables in sentences representing anger  —Significantly shorter following post testing

 

  • OUTCOME #18: Production of duration of stressed syllables in sentences representing sadness —Significantly longer following post testing

 

  • OUTCOME #19: Production of intensity of unstressed syllables in sentences representing happiness  —No significant differences between pre and post testing

 

  • OUTCOME #21: Production of intensity of unstressed syllables in sentences representing anger– Significantly reduced following post testing

 

  • OUTCOME #22: Production of intensity of unstressed syllables in sentences representing sadness — Significantly reduced following post testing

 

  • OUTCOME #23:Production of intensity of stressed syllables in sentences representing happiness —No significant differences between pre and post testing

 

  • OUTCOME #24: Production of intensity of stressed syllables in sentences representing anger —Significantly reduced following post testing

 

  • OUTCOME #25: Production of intensity of stressed syllables in sentences representing sadness — Significantly reduced following post testing

 

 

  1. Description of baseline:
  • Were baseline data provided? No,but there was pretesting for all measures

numbering as needed)

 

 

  1. What is the clinical significanceNo data provided.

 

  1. Was information about treatment fidelity adequate? No

 

 

  1. Were maintenance data reported?No

 

 

  1. Were generalization data reported?Yes. The sentences used in the pre- and post-testing differed from the sentences usedin the intervention

 

 

  1. Brief description of the design:
  • This was a single case study.
  • The second investigator served as the clinician (C) and as the pre and post intervention assessor.
  • Pre and post testing comprised

– 24 spontaneous utterances

–  12 sentences (4 sentences representing each of 3 emotions) read aloud

  • The C used 24 sentences during Intervention that differed from the pre-and post-testing sentences.
  • All testing and intervention sentences were provided in the appendixes.

 

 

ASSIGNED OVERALL GRADE OF THE QUALITY OF SUPPORT FOR THE INTERVENTION: D-

 

SUMMARY OF INTERVENTION

 

PURPOSE: To explore the effectiveness of an intervention designed for adults with aphasia in improving the expressive affective prosody of an adolescent with ASD

 

POPULATION:  ASD; Children (Adolescence)

 

MODALITY TARGETED:  Expressive

 

ELEMENTS/FUNCTIONS OF PROSODY TARGETED (do not list the specific dependent variables here):intensity, duration, F0, loudness, pitch, stress, rate,

 

OTHER ASPECTS OF LANGUAGE/COMMUNICATION TARGETED (Dependent variable):  voice quality

 

DOSAGE:  individual sessions, 1 hour per week, for 10 weeks

 

ADMINISTRATOR:  the second author

 

MAJOR COMPONENTS:

 

  • The intervention was an adaptation of a six step program designed to improve the expressive affective prosody of Ps with aphasia.

 

  • The investigators included all the treatment (practice) and testing (assessment targets) in the appendices.

 

  • The steps of the intervention are outlined in Appendix B. Treatment involves providing maximum cueing and fading to minimal or no cueing.

 

  • To move from one step to the next, P needed to produce 3 consecutive correct response.

 

  • A summary of the 6 steps of the intervention:

 

  1. C reads aloud a practice sentence with one of the 3 targeted prosodic affects and identified the targeted affect to the P. C and P produce the sentence in unison.
  2. C models the practice sentence with the targeted prosodic affect and facial expression then directs P to imitate her.
  3. C models the practice sentence with the targeted prosodic affect but ot with facial expression then directs P to imitate her prosody.
  4. C produces the practice sentence with a neutral affect and directs P to reproduce with but to include the targeted affective prosody.
  5. C asks a question designed to elicit the targeted emotion and P answers with the practice sentence and the targeted prosodic affect.
  6. C engages in role-playing in which P produces the practice sentence with the targeted affective prosody.

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


Pack et al. (2016)

July 26, 2017

 

EBP THERAPY ANALYSIS for

Single Case Designs

 

NOTES:

  • The summary of the intervention procedure can be viewed by scrolling about two-thirds of the way down on this page.

 

Key:

ALL = Advancing Language and Literacy

ASD = autism spectrum disorders (ASD)

C = Clinician

EBP = evidence-based practice

NA = not applicable

P = Patient or Participant

pmh = Patricia Hargrove, blog developer

SLP = speech–language pathologist

 

SOURCE: Pack, A., Colozzo, P., Bernhardt, B. M., Radanov , B., Rosebush, R., Marinova-Todd, S. H. (2015). A case study on vocal loudness with a young adult with Autism Spectrum Disorder and developmental delay. American Journal of Speech-Language Pathology, 24, 587-593.

 

REVIEWER(S): pmh

 

DATE: July 22, 2017

 

ASSIGNED OVERALL GRADE: D-   (The highest possible grade based on the case study design is D+. The grade represents the strength of the design for providing evidence. It does not reflect a judgment about the quality of the intervention.)

 

TAKE AWAY: In this case study, a P diagnosed with autism spectrum disorder and developmental delay improved his rate of the production of acceptable loudness levels during treatment sessions in a generalization context.

                                                                                                           

 

  1. What was the focus of the research? Clinical Research

 

 

  1. What type of evidence was identified?
  •  What type of single subject design was used? Case Study: Description with Pre and Post Test Results

                                                                                                           

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

                                                                                                           

 

  1. Was phase of treatment concealed?
  • from participants (Ps)? No
  • from clinicians? No
  • from data analyzers? Unclear

 

 

  1. Was the participant (P) adequately described? No

 

– How many Ps were involved in the study? 1

 

– What the P characteristics were described?

  • age: mid-20s
  • gender: male
  • cognitive skills: problems in adaptive functioning; developmentally delayed
  • social emotional status: anxiety problems
  • diagnosis: autism spectrum disorders (ASD)
  • hearing: within normal limits

                                                 

–  Were the communication problems adequately described? Yes

  • Type of problems: ASD; developmentally delayed; severe communication disability
  • Other aspects of communication that were described:

– short utterances

     – intelligibility problems

     – “occasional sudden outbursts with loud voice and agitated expression” (p. 589)

 

                                                                                                                       

  1. Was membership in treatment maintained throughout the study? Not applicable, this was a single case study

 

  • Were any data removed from the study? No

 

 

  1. Did the design include appropriate controls? No, this was a single case study.

                                                                      

  • Were baseline data collected on all behaviors? Yes

 

  • Was the data collection continuous? No

 

  • Were different treatment counterbalanced or randomized? NA

 

 

  1. Were the outcome measures appropriate and meaningful? Yes

 

– OUTCOMES

 

  • OUTCOME #1: To identify the loudness level of sounds and speech as quiet, medium, or loud
  • OUTCOME #2: To produce unprompted acceptable levels of loudness in his speech

 

  • Both outcomes were subjective.

 

  • Neither outcome was objective.

 

–   RELIABILITY: only Outcome #2 was associated with reliability data.

 

  • OUTCOME #2: To produce unprompted acceptable levels of loudness in his speech: 93% agreement between student clinician and judge for loudness rating in selected individual sessions

 

 

  1. Results:

 

Did the target behavior(s) improve when treated? Yes, for the most part

 

The overall quality of improvement was

 

  • OUTCOME #1: To identify the loudness level of sounds and speech as quiet, medium, or loud: strong; P achieved this outcome by the 4th session

 

  • OUTCOME #2: To produce unprompted acceptable levels of loudness in his speech: strong evidence for improvement
  • percentage of unprompted utterances with acceptable loudness levels increased in the individual sessions from 42% in session 1 to the 90s (91% to 97%)in the final 3 sessions.
  • percentage of unprompted utterances with acceptable loudness levels increased in the group/generalization sessions from 25% in session 1 to the 80s (83% to 88%) in the final 3 sessions.

 

 

  1. Description of baseline:

 

– Were baseline data provided? Yes. I have accepted data as baseline that is not really baseline. The investigators reported data from the first 2 sessions (out of a total of 9 sessions) as their comparison data.

 

  • OUTCOME #1: To identify the loudness level of sounds and speech as quiet, medium, or loud—2 sessions

 

  • OUTCOME #2: To produce unprompted acceptable levels of loudness in his speech—2 sessions

 

Was baseline low (or high, as appropriate) and stable

 

  • OUTCOME #1: To identify the loudness level of sounds and speech as quiet, medium, or loud—baseline was high and stable

 

  • OUTCOME #2: To produce unprompted acceptable levels of loudness in his speech:– baseline was unstable (from low to moderate) with one set of data missing

 

Was the percentage of nonoverlapping data (PND) provided? No

 

 

 

  1. What is the clinical significanceNA, data were not provided.

 

  1. Was information about treatment fidelity adequate? Not Provided

 

 

  1. Were maintenance data reported? No

 

 

  1. Were generalization data reported? Yes

 

  • OUTCOME #2: To produce unprompted acceptable levels of loudness in his speech – P’s performance in the Group was regarded as generalization data. P’s performance lagged in the Group compared to the Individual sessions but by the end of the intervention is was 88%.

 

 

  1. Brief description of the design:

 

  • Single case study in which P’s performance in the first 2 treatment sessions were compared to his performance in the last 3 session (sessions 7 through 9,)

 

  • P had been participating in the Advancing Language and Literacy (ALL) Group which involved young adults with developmental delay (including ASD) and speech, language, and/or literacy problems.

 

  • P continued in the ALL program but was pulled out for speech therapy.

 

ASSIGNED OVERALL GRADE OF THE QUALITY OF SUPPORT FOR THE INTERVENTION: D-;

 

 

SUMMARY OF INTERVENTION

 

PURPOSE: to investigate the effectiveness of an intervention designed to modify the loudness level of speech

 

POPULATION: Autism Spectrum Disorder, Developmental Delay; Adult

 

MODALITY TARGETED: comprehension and production

 

ELEMENT/FUNCTION OF PROSODY TARGETED: loudness

 

DOSAGE:

  • ALL (group) intervention = 1 time a week; for 2 hours; 10 months of the year

 

  • Loudness (individual) intervention = pullout from ALL for 30 minutes for 9 weeks

 

ADMINISTRATOR: student speech-language pathology student supervised by a faculty member

 

MAJOR COMPONENTS:

 

  • The invention comprised 2 activities:

– Identification of soft, medium, and loud levels of sounds and speech

– Production of speech at acceptable loudness levels in

  • Individual sessions
  • ALL sessions

 

IDENTIFICATION ACTIVITIES

 

  • Sessions 1 through 3– The Clinician (C) provided 6 to 12 trials in which P was directed to identify whether the loudness level of a sound was quiet, medium, or loud.
  • P modeled the pairing of each loudness level with a picture.
  • C played a nonspeech sound (e.g., knocking, musical instrument) and directed P to indicate the loudness level by pointing to the appropriate picture
  • For sessions 1 and 2, C provided corrective feedback when P misidentified a loudness level by

∞ pointing to the misidentified picture,

∞ replaying the trial, and

∞ asking P to choose another picture.

∞ If P again responded inaccurately, C pointed to the appropriate picture.

 

The Clinician (C) provided 6 to 12 trials in which P was directed to identify whether the loudness level of speech was quiet, medium, or loud.

  • P modeled the pairing of each loudness level with a picture.
  • C played a brief sample of speech and directed P to indicate the loudness level by pointing to the appropriate picture.
  • For sessions 1 and 2, C provided corrective feedback when P misidentified a loudness level by

∞ pointing to the misidentified picture,

∞ replaying the trial, and

∞ asking P to choose another picture.

∞ If P again responded inaccurately, C pointed to the appropriate picture.

 

  • Sessions 4 through 9—Sound Identification activities were suspended due to P’s accurate performance. Speech Identification activities continued. The number of trials in each each session was 9.

 

PRODUCTION ACTIVITIES

 

  • Activities were administered in individual and group (ALL) sessions.

 

  • INDIVIDUAL SESSIONS:

 

– Using a question-answer conversational format, C asked P questions and P replied.

– These interactions were recorded the sessions for use in later sessions and for data analysis.

– On a regular basis but apparently not a continuous basis, C provided positive feedback to P when his response was produced with an acceptable loudness level. In the first 3 sessions, the feedback involved the pictures from the Identification activities (i.e., C pointed to the picture representing a medium loudness level) and noted that C had used his “medium voice” (p. 591.)

– When P produced a response that was of an unacceptable loudness level, C provided a corrective prompt at approximately the same rate as positive feedback.

  • For Sessions 1-3, C provided corrective feedback by

∞ pointing to the picture that represented a loud voice,

∞ noting P had used a loud voice, and

∞ asking him to point again while pointing to the picture representing a medium loudness level

  • For Sessions 4 – 9, C

∞ C displayed a cell-phone app that represented loudness levels by changes in a face.

∞ Following P’s orientation to the app, C asked him to interpret his loudness level using the read-out from the app.

 

  • SELF-CORRECTION

 

– Because P displayed considerable anxiety, C gradually introduced self-correction activities. As he progressed through the program, the rate of self-correction increased to 100% of errors.

 

 

GROUP (ALL) ACTIVITIES

 

  • Two speech-language pathologists (SLPs) led a group of 10 -12 young adults. Volunteers assisted the SLPs.

 

  • Activities in the group included

– “information sharing,

– conversational exchanges, and

– planning” (p. 591)

– review and wrap-up

 

  • On an irregular basis, C or one of the SLPs acknowledged P’s acceptable loudness levels during group conversations. The acknowledgements varied from public to private.

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.

 


Kargas et al. (2016)

August 9, 2016

ANALYSIS

Comparison Research

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

KEY:

 ADOS = Autism Diagnostic Observation Scale

ASD = autism spectrum disorders

eta =   partial eta squared

f = female

m = male

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: Kargas, N., López, B., Morris, P., & Reddy, V. (2016). Relations among detection of syllable stress, speech abnormalities, and communicative ability in adults with autism spectrum disorders. Journal of Speech, Language, and Hearing Research, 59, 206-215.

 

REVIEWER(S): pmh

 

DATE: August 4, 2016

 

ASSIGNED GRADE FOR OVERALL QUALITY: No grade assigned. This investigation is concerned with aspects of prosody in a clinical population. Nevertheless, it has application to the clinical practice.

 

TAKE AWAY: The investigators compared adults diagnosed with autism spectrum disorders to typical peers on a task tapping the perception of syllable stress (primary speech perception). The results revealed that adults with ASD have significantly lower scores on the Syllable Stress Perception Task compared to TD peers, although perception varied markedly within the ASD group. Also, within the ASD group, poor stress perception was associated with increased speech production (i.e., stress, intonation, rate) problems but not communication/language problems.

 

 

  1. What type of evidence was identified?
  • What was the type of design? Comparison Research — Prospective, Nonrandomized Group Design

 

  • 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
  • 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? Yes, the Ps responses were collected on the computer.

 

 

  1. Were the groups adequately described? Variable

 

– How many participants were involved in the study?

 

  • total # of Ps:  42
  • # of groups: 2
  • List names of groups and the number of Ps in each group:

     – Autism Spectrum Disorders (ASD) = 21

– Typically Developing (TD) = 21

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

                                                                                

– CONTROLLED CHARACTERISTICS                                                  

  • age: adults
  • gender: 18m; 3f in each group
  • diagnosis of Ps with ASD: Asperger’s syndrome using Autism Diagnostic Observation Scale (ADOS)
  • psychiatric or developmental diagnosis of the TD group: Self report of no diagnosis of either of these problems.
  • Hearing: within normal limits based on audiometric testing

 

== DESCRIBED CHARACTERISTICS

  • age:

     – ASD = mean 30.3 years

     – TD = mean 29.5 years

  • gender:
  • cognitive skills:

     – ASD

  • mean Full range IQ = 109.5
  • mean Verbal IQ = 109.8
  • mean Performance IQ 107.2

     – TD

  • mean Full range IQ = 115.9
  • mean Verbal IQ = 113.9
  • mean Performance IQ = 114.2

 

– Were the groups similar? Yes

 

– Were the communication problems adequately described? No

 

 

  1. What were the different conditions for this research?

                                                                                                             

— Subject (Classification) Groups? Yes

  • Diagnosis (ASD, TD)

                                                               

— Experimental Conditions? Yes

  • performance of the Syllable Stress Perception Task (described below in item #9)

 

— Criterion/Descriptive Conditions? Yes

  • performance on Language and Communication Measure of the ADOS

 

 

  1. Were the groups controlled acceptably? Yes

 

 

  1. Was the dependent measure appropriate and meaningful? Yes

 

  • OUTCOME #1: The accuracy of responses on the Syllable Stress Perception Task

 

  • The dependent measure was NOT subjective.

 

  • The dependent measure WAS objective? Ps entered their responses into the computer

 

 

  1. Were reliability measures provided?

                                                                                                            

– Interobserver for analyzers? No _

 

Intraobserver for analyzers? No

 

– Treatment or test administration fidelity for investigators? No

 

 

  1. Description of design:

 

  • Testing for each Ps was accomplished during 3 hour individual sessions.
  • Prior to the Experimental Phase of the testing, an IQ test and the ADOS were administered.
  • The Experimental Phase included:

– tests were administered in a quiet room.

– practice with the Experimental Task.

– the administration of the Experimental Task — Syllable Stress Perception Task in which the P pressed a button via the computer indicating whether the words were same or different

  • The Syllable Stress Perception Task involved

– Ps individually listening to word pairs in which the same 4 syllable word was presented 2 times in one of the 4 following sets:

  • first syllable stressed for both versions (same)
  • first syllable stressed for 1 version, second syllable stressed for the other version (different)
  • second syllable stressed for both versions (same)
  • second syllable stressed for 1 version, first syllable stressed for the other version (different)

 

  • Statistical analyses controlled for overall IQ, Verbal IQ, and Performance IQ.

 

 

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

 

  • OUTCOME #1: The accuracy of responses on the Syllable Stress Perception Task

– Ps with ASD performed significantly more poorly on the Syllable Stress Perception Task than the TD Ps. The response was stable irrespective of whether the stress was on the first or second syllable.

– Response bias for providing “Same” or “Different” response was similar for the Ps with ASD and the TD group.

– The investigators explored whether there were previously unrecognized subgroups within the 2 major groups (ASD, TD.) They determined that the ASD group had significantly more poor performers (2 standard deviations below the group mean) than the TD group (33% vs 10.5%)

 

  • What statistical tests were used to determine significance? t-test, ANOVA, Chi square

 

  • Were effect sizes provided? No, for the most part.

 

  • Were confidence interval (CI) provided? No

 

 

  1. Summary of correlational results:

 

  • OUTCOME #1: The accuracy of responses on the Syllable Stress Perception Task

– Correlation between accuracy and communication quality:

  • Significant correlation between syllable stress perception accuracy and Speech Abnormalities score on the ADOS (i.e., atypical production of rate, stress, intonation; higher scores signify more problems) — r = – 0.75
  • The correlation between syllable stress perception accuracy and language communication score on the ADOS was not significant

 

 

  1. Summary of descriptive results: Qualitative research NA

 

 

  1. Brief summary of clinically relevant results:
  • Adults with ASD have significantly lower scores on the Syllable Stress Perception Task compared to TD peers, although perception varied markedly within the ASD group.
  • Within the ASD group, poor stress perception was associated with and increased speech production (i.e., stress, intonation, rate) problems.

 

 

 

ASSIGNED GRADE FOR QUALITY OF EXTERNAL EVIDENCE: B