Holbrook & Israelsen, 2020

August 28, 2020



ASD = autism spectrum disorders

C = clinician

f =  female

m =  male

NA = not applicable

P = patient or participant

pmh = Patricia Hargrove, blog developer

SLP = speech-language pathologist

SR = Systematic Review

Source: Holbrook, S., & Israelson, M. (2020). Speech prosody interventions for persons with autism spectrum disorders: A systematic review. American Journal of Speech-Language Pathology, 1-17. https://doi.org/10.1044/2020_AJSLP-19-00127

Reviewer(s): pmh

Date: August 27, 2020

Overall Assigned Grade: The highest grade reflecting overall quality of the evidence presented in this investigation is B due to the design of the investigation—Systematic Review with broad criteria. The Overall Assigned Grade does not reflect a judgment of the effectiveness of the treatments described in the investigation; rather, it represents the quality of the evidence provided by the investigators.

Level of Evidence:  B

Take Away: The results of this investigation provide evidence that prosody of speakers with autism spectrum disorders (ASD) may be treated successfully using selected interventions.

What type of secondary review?  Narrative Systematic Review

  1. Were the results valid? Yes
  • Was the review based on a clinically sound clinical question? Yes
  • Did the reviewers clearly describe reasonable criteria for inclusion and exclusion of literature in the review (i.e., sources)? Yes
  • The authors of the secondary research noted that they reviewed the following resources:

     – hand searches

     – internet based databases

     – references from identified literature

  • Did the sources involve only English language publications? Yes
  • Did the sources include unpublished studies? Yes
  • Was the time frame for the publication of the sources sufficient? Yes
  • Did the authors of the secondary research identify the level of evidence of the sources? Yes
  • Did the authors of the secondary research describe procedures used to evaluate the validity of each of the sources? Yes
  • Was there evidence that a specific, predetermined strategy was used to evaluate the sources?
  • Did the authors of the secondary research or review teams rate the sources independently? Yes
  • Were interrater reliability data provided? Yes _

– Interrater reliability for inclusion of studies = 92.6%

– Interrater reliability for all coding except effect size and calculation = 93.3%

– Interrater reliability for effect size and calculation = 94.6%

– Disagreements were resolved by consensus.

  • Were assessments of sources sufficiently reliable? Yes
  • Was the information provided sufficient for the reader to undertake a replication? Yes
  • Did the sources that were evaluated involve a sufficient number of participants? Yes
  • Were there a sufficient number of sources? Yes


  1. Description of outcome measures: (this is a list of the ‘prosody traits’ in one or more of the sources)
  • Outcome #1: Improved overall prosody
  • Outcome #2: Improved intensity
  • Outcome #3: Improved pitch
  • Outcome #4: Improved pauses
  • Outcome #5: Improved rate
  • Outcome #6: Improved contrastive stress
  • Outcome #7: Improved stress
  • Outcome #8: Improved affective intonation


  1. Description of results:
  • What measures were used to represent the magnitude of the treatment/effect size?

     – Cohen’s d

     – Hedge’s g

     – Tau U

  • Summary of overall findings of the secondary research: The investigators identified 13 articles that provided adequate (2) or weak (11) evidence of improved prosody in speakers with ASD.
  • Were the results precise? Unclear/Variable
  • If confidence intervals were provided in the sources, did the reviewers consider whether evaluations would have varied if the “true” value of metrics were at the upper or lower boundary of the confidence interval? NA
  • Were the results of individual studies clearly displayed/presented? Yes
  • For the most part, were the results similar from source to source? Yes
  • Were the results in the same direction? No
  • Did a forest plot indicate homogeneity? NA
  • Was heterogeneity of results explored? No
  • Were the findings reasonable in view of the current literature? Yes
  • Were negative outcomes noted? Yes


  1. Were maintenance data reported? Yes


  1. Were generalization data reported? Yes