Hallam (2018)

July 16, 2018

EBP THERAPY ANALYSIS

Treatment Groups

Note: Scroll about two-thirds of the way down the page to read the summary of the procedure(s).

Key:

C = Clinician

EBP = evidence-based practice

f = female

m = male

NA = not applicable

P = Patient or Participant

pmh =  Patricia  Hargrove, blog developer

RFR =  Rhythm for Reading program

SES = socioeconomic status

SLP = speech–language pathologist

 

SOURCE:  Hallam, S. (2018). Can a rhythmic intervention support reading development in poor readers?  Psychology of Music, 1-14. DOI:  10.1177/0305735618771491

REVIEWER(S):  pmh

 

DATE: July 13, 2018

 

ASSIGNED GRADE FOR OVERALL QUALITY:  B+ The highest possible grade, based on the design of the investigation, is  A. The Grade for Overall Quality reflects the quality of the evidence supporting the intervention. It is not an evaluation of the quality of the intervention nor is it an evaluation of the paper itself.

 

TAKE AWAY: Rhythm for Reading (RFR), a music-based intervention, resulted in improved reading accuracy and comprehension (but not reading rate) in poor readers in London schools who were 11-12 years of age.

 

  1. What type of evidence was identified?

                                                                                                           

  • What was the type of evidence?Prospective, Randomized Group Design with Controls

                                                                                                           

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

 

                                                                                                           

  1. Group membership determination:

                                                                                                           

  • If there was more than one group, were participants (Ps) randomly assigned to groups? Yes, but  the investigators claimed that the Ps also were distributed equally on several variable.

 

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

                                                                    

 

  1. Was administration of intervention status concealed?

                                                                                                           

  • from participants? No

                                                                    

  • from clinicians? No

                                                                    

  • from analyzers? Unclear

                                                                    

 

  1. Were the groups adequately described? Yes

 

– How many  Ps were involved in the study?

  • total # of Ps: 421
  • # of groups:2
  • List names of groups and the # of participants in each group:
  • Treatment group = 209
  • Control group (no treatment) = 212

 

CONTROLLED CHARACTERISTICS

  • age:only included Ps who had just achieved or not achieved national reading criteria
  • Treatment group =  11 to 12 years old
  • Control group =  11 to 12 years old

 

  • gender:
  • Treatment group =  147 (m); 62 (f)
  • Control group =  141 (m); 71 (f)

 

  • Reading accuracy:
  •   Treatment group =  91.98
  • Control group =  91.34

 

  • Reading comprehension:
  • Treatment group =  85.57
  • Control group =  86.03

 

  • Reading rate:
  • Treatment group =  89.65
  • Control group =  98.58

 

  • Educational Level:
  • Treatment group =  year 7; first year of secondary school (British school system)
  • Control group =  year 7; first year of secondary school (British school system)

 

DESCRIBED CHARACTERISTICS

 

  • eligible for Free Lunch:
  • Treatment group =  70
  • Control group = 75

 

–   Were the groups similar before intervention began? Yes

                                                         

–  Were the communication problems adequately described?  Yes

  • disorder type: Literacy skills were labeled as ‘poor.’

 

 

  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?Yes
  • Was there a foil intervention group? No
  • Was there a comparison group?No
  • Was the time involved in the foil/comparison and the target groups constant? NA, the control group was a No Intervention group.

 

 

  1. Were the outcomes measure appropriate and meaningful? Yes

 

–  OUTCOMES

  • OUTCOME #1:Changes in reading accuracy as measured by NARA II
  • OUTCOME #2:Changes in reading comprehension as measured by NARA II
  • OUTCOME #3:Changes in reading rate as measured by NARA II

 

–  The outcome measures that are subjective were

  • OUTCOME #1:Changes in reading accuracy as measured by NARA II
  • OUTCOME #2:Changes in reading comprehension as measured by NARA II

 

–  The outcome measure that is objective is

  • OUTCOME #3:Changes in reading rate as measured by NARA II

                                         

 

  1. Were reliability measures provided?
  • Interobserver for analyzers?No
  • Intraobserver for analyzers?No 
  • Treatment fidelity for clinicians? No

 

 

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

 

SUMMARY OF IMPORTANT RESULTS

TREATMENT AND NO TREATMENT GROUP ANALYSES

 

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

 

  • OUTCOME #1:Changes in reading accuracy as measured by NARA II—

Treatment group produced significantly more change than the control group

 

  • OUTCOME #2:Changes in reading comprehension as measured by NARA II–

–  Treatment group produced significantly more change than the control group

     – For the subgroup of Ps who received free lunches, Ps who received intervention performed significantly better than the control group

 

  • OUTCOME #3:Changes in reading rate as measured by NARA II—

–  The changes produced by the Treatment and Control groups were not significantly different.

 

–   What was the statistical test used to determine significance?

  • ANOVA xxx
  • MANOVA: xxx

 

–  Were confidence interval (CI) provided?  No

 

 

  1. What is the clinical significance

 

–   EBP measure provided: ETA

–  Results of EBP testing and the interpretation:

  • OUTCOME #1:

∞  Changes in reading accuracy for intervention group  versus control group as measured by NARA II—  Eta was 0.012  (small treatment effect)

 

  • OUTCOME #2:

–  Changes in reading comprehension for intervention group versus control group as measured by NARA II– Eta was 0.028  (small treatment effect)

–  Changes in reading comprehension for the subgroup of Ps who received free lunches fo intervention group versus control group as measured by NARA II– Eta was 0.014  (small treatment effect)

 

 

  1. Were maintenance data reported?No

 

  1. Were generalization data reported?No

 

 

  1. Describe briefly the experimental design of the investigation.
  • The Ps were low socioeconomic status (SES), inner city children who had been classified as having poor reading skills.
  • Ps were randomly assigned to treatment or no treatment groups. However, the assignments were not fully random because the investigators controlled for several P characteristics.
  • All Ps were assessed at the beginning and end of the treatment phase for the Treatment group. The investigators assessed the reading skills of the Ps using a published test of reading. Outcome measures were derived from the assessments.
  • The investigators compared the change for the Outcome measures to assess the effectiveness of the treatment.
  • The Ps in the Treatment group received the intervention in their home schools. The investigators reported that there was variability with respect to implementation.

 

 

ASSIGNED OVERALL GRADE FOR QUALITY OF EXTERNAL EVIDENCE:  B+

 

 

SUMMARY OF INTERVENTION

 

PURPOSE:Does musical rhythmic intervention improve reading skills?

 

POPULATION: Poor readers

 

MODALITY TARGETED:  production, comprehension

 

 

ELEMENTS OF PROSODY USED AS INTERVENTION:  music (rhythm, pitch, pausing)

 

OTHER ASPECTS OF LANGUAGE/COMMUNICATION TARGETED:literacy

 

DOSAGE:  group, 10 minutes a week, for 10 weeks

 

MAJOR COMPONENTS:

 

  • The intervention was the Rhythm for Reading program (RFR.)

 

  • RFR was developed for economically disadvantaged children with educational challenges.

 

  • RFR is an intensive, group intervention designed to improve selected aspects of cognitive attention

–  stability,

– strength, and

– resilience.

 

  • The focus of RFR was to improve auditory processing and attention.

 

  • RFR used a variety of musical styles including

– classical western music,

– funk,

– rock,

– pop,

– syncopation, and

– metrical complexity.

 

  • Intervention activities included reading simple musical notation and the following in time with the beat of music by

– clapping,

– chanting, and

– stamping feet

 

  • Simple musical notation consisted of

–  2 levels of beat,

– restricted pitch levels, and

– restricted intervals between pitches.

 

_______________________________________________________________

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Pinto & Navas (2011)

January 7, 2018

EBP THERAPY ANALYSIS

Groups 

Note: Scroll about two-thirds of the way down the page to read the summary of the procedure(s). 

Key:

A = Administrator

C = Clinician

EBP = evidence-based practice

f = female

NA = not applicable

m = male

P = Patient or Participant

pmh = Patricia Hargrove, blog developer

SLP = speech–language pathologist

WNL = within normal limits

wpm = words per minute

WRI = Words read Incorrectly

 

 

SOURCE: Pinto, J. C. B. R., & Navas, A. L. G. P. (2011). Effects of reading fluency stimulation with emphasis on prosody. Jornal da Sociedade Brasileira de Fonoaudiologia, 23 (1), 21- 26. Retrieved December 27, 2017 from http://www.scielo.br/pdf/jsbf/v23n1/en_v23n1a07.pdf

 

REVIEWER(S): pmh

 

DATE: January 6, 2018

 

ASSIGNED GRADE FOR OVERALL QUALITY: C+ (The highest possible grade for overall quality is B- based on the design of the intervention, Single Group with Pre and Post testing. This grade reflects the quality of the experimental support for the intervention. It is not intended to be a judgment regarding the quality of the intervention.)

 

TAKE AWAY: This therapy- related research involved typically developing Brazilian fourth graders who were speakers of Portuguese. The investigators administered a prosody-based reading-rate acceleration program to the participants (Ps.) The following outcomes improved following the 5 group sessions: oral reading rate, reading prosody, and words read Incorrectly. The following outcomes did not change or were poorer: reading comprehension, number of revisions in texts read aloud, and rate of speech during picture description task.

 

 

  1. What type of evidence was identified?
  • What was the type of evidence? Prospective, Single Group with Pre- and Post-Testing

                                                                                                          

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

Level = B-

 

                                                                                                           

  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? No

                                                                    

 

  1. Were the groups adequately described? No

– How many Ps were involved in the study?

  • total # of Ps:   32
  • # of groups: one

 

– CONTROLLED CHARACTERISTICS

  • cognitive skills: within normal limits (WNL)
  • literacy: WNL
  • educational level of clients: fifth grade
  • vision: WNL
  • hearing level: WNL

 

– DESCRIBED CHARACTERISTICS

  • age: 10 to 12 years (mean 10.62 years)
  • gender: 14m; 18f

 

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

                                                         

– Were the communication problems adequately described? NA, Ps were typically developing and their reading was WNL.

 

 

  1. Was membership in groups maintained throughout the study?
  • Did the group maintain at least 80% of its original members? Yes

                                                               

  • Were data from outliers removed from the study? No

 

 

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

 

 

  1. Were the outcomes measure appropriate and meaningful? Yes

OUTCOMES

 

  • OUTCOME #1: Reading rate (words per minute, wpm)

 

  • OUTCOME #2: Reading prosody adequacy categorization (adequate—appropriate prosody, intonation, and stress; average—limited prosodic variation, inappropriate stress and intonation,; inadequate—monotonous reading)

 

  • OUTCOME #3: Reading comprehension

 

  • OUTCOME #4: Words read Incorrectly (WRI)

 

  • OUTCOME #5: Number of revisions in texts read aloud

 

  • OUTCOME #6: Rate of speech during picture description task in wpm (Speech WPM)

 

— The outcome measures were subjective were

  • OUTCOME #2: Reading prosody adequacy categorization (adequate, average, inadequate)
  • OUTCOME #3: Reading comprehension
  • OUTCOME #4: Words read Incorrectly (WRI)
  • OUTCOME #5: Number of revisions in texts read aloud

 

The outcome measures that were objective were

  • OUTCOME #1: Reading rate (words per minute, wpm)
  • OUTCOME #6: Rate of speech during picture description task in wpm (Speech WPM) p. 22

 

 

  1. Were reliability measures provided?
  • Interobserver for analyzers? No
  • Intraobserver for analyzers?   No
  • Treatment fidelity for clinicians? No

 

 

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

 

PRE AND POST TREATMENT ANALYSES

 

Summary Of Important Results

 

— What level of significance was required to claim significance? p = 0.01

 

 

  • OUTCOME #1: Reading rate (words per minute, wpm)   Reading wpm increased significantly from pre-intervention testing to post-intervention testing.

 

  • OUTCOME #2: Reading prosody adequacy categorization (adequate, average, inadequate) Ratings of prosody were significantly higher in post-intervention testing compared to pre-intervention testing

 

  • OUTCOME #3: Reading comprehension — The difference between pre-intervention and post-intervention reading comprehension was not significant.

 

  • OUTCOME #4: Words read Incorrectly (WRI) –WRI was significantly lower in post-intervention testing compared to pre-intervention testing.

 

  • OUTCOME #5: Number of revisions in texts read aloud – The   number of revisions was stable between pre-intervention and post-intervention testing.

 

  • OUTCOME #6: Rate of speech during picture description task in wpm (Speech WPM) — The difference between pre-intervention and post-intervention speaking rate was not significant.

 

– What was the statistical test used to determine significance? t-test

 

– Were confidence interval (CI) provided? No

 

 

  1. What is the clinical significanceNA, evidence-based practice metrics were not provided.

 

 

  1. Were maintenance data reported? No

 

  1. Were generalization data reported? No

 

 

  1. Describe briefly the experimental design of the investigation.
  • All Ps were considered developmentally WNL and free of literacy problems (i.e., this is therapy-related research.)

 

  • The pre-intervention assessment measured the outcomes prior to the intervention.

 

  • Although there were 3 treatment subgroups (10Ps, 10Ps, and 12Ps), data were combined for statistical analysis.

 

  • The investigators administered the reading intervention to all the Ps in their classrooms for 5 sessions weekly sessions.

 

  • Following the fifth session, Ps were reassessed on the outcome measures.

 

ASSIGNED OVERALL GRADE FOR QUALITY OF EXTERNAL EVIDENCE: C+

 

 

SUMMARY OF INTERVENTION

 

PURPOSE: To investigate the effectiveness of a fluency acceleration program in improving oral reading rate among typical readers

 

POPULATION: Typically developing; Children

 

MODALITY TARGETED: production and comprehension

 

ELEMENTS/FUNCTIONS OF PROSODY TARGETED: intonation, stress, overall reading prosody

 

ELEMENTS OF PROSODY USED AS INTERVENTION: rate of speech and reading, intonation

 

OTHER ASPECTS OF LANGUAGE/COMMUNICATION TARGETED: reading rate, reading comprehension, reading accuracy (wri, revisions)

 

DOSAGE: 5 sessions, 15 minutes, once a week, group treatment (2 groups = 10P; 1 group = 12 P)

 

ADMINISTRATOR (A): Investigators

 

MAJOR COMPONENTS:

 

  • In each of the 3 subgroups of Ps, half of the Ps were categorized as higher rate readers and the other half were categorized as lower rate readers. The Ps in each subgroup were paired with one P being a faster reader and the other being a slower reader.

 

  • The pairs were consistent thoroughout the intervention. They helped one another identify errors and omissions as well as monitored reading rate.

 

  • The intervention focused on rate acceleration as a treatment and as an outcome.

 

  • During each of the 5 sessions, a different passage/text was used. The Administrator (A) monitored the targeted reading prosody and provided feedback on the following: variation of intonation and reading rate.

 

  • SESSION 1: A “exposed” (p. 23) Ps to prosody.

 

  • SESSION 2 and 3: A divided the Ps within the group into their pairs. Then using silent reading, A “exposed” Ps to the content and the vocabulary of the passage followed by modeling the reading aloud using the targeted prosody. Ps were directed to read aloud in pairs the passage using the modeled prosody.

 

  • SESSION 4: A modeled the targeted behaviors when reading aloud while Ps silently read the passage. Then, A directed the pairs of Ps to read aloud the passage (text.)

 

  • SESSION 5: Ps silently read the targeted passage and they were allowed to ask questions about unfamiliar vocabulary. Then, the Ps and A read aloud the passage in unison two times. Finally, Ps read aloud the passage in pairs.

 


Heggie & Wade-Woolley (2017)

August 30, 2017

 

SECONDARY REVIEW CRITIQUE

 

 

KEY:

 

C = clinician

NA = not applicable

P = patient or participant

pmh = Patricia Hargrove, blog developer

SLP = speech-language pathologist

SR = Systematic Review

 

 

Source: Heggie, L., & Wade-Woolley, L. (2017) Reading longer words: Insights into multisyllabic word reading. Perspectives of the ASHA Special Interest Groups-SIG 1, 2 (Part 2), 86 – 94.

 

Reviewer(s): pmh

 

Date: August 25, 2017

 

Overall Assigned Grade: D   (The highest possible grade based on the design of the publication was D, Traditional/Narrative Review of the Literature.)

 

Level of Evidence: D, Traditional/Narrative Review of the Literature

 

Take Away: Although this review of the literature focused on teaching the reading of multisyllabic words, some of the interventions appear to have potential for teaching stress, weak/strong forms, and alterations. Only a prosody related interventions is analyzed and summarized in this review. This intervention yielded more gains than a control group.

 

What type of secondary review? Narrative 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)? No

 

  • The authors of the secondary research did not describe the search strategy.

 

  • Did the sources involve only English language publications? Yes

 

  • Did the sources include unpublished studies? No _

 

  • 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? No

 

  • Did the authors of the secondary research describe procedures used to evaluate the validity of each of the sources? No

 

  • Was there evidence that a specific, predetermined strategy was used to evaluate the sources? No

 

Did the authors of the secondary research or review teams rate the sources independently? No

 

  • Were interrater reliability data provided? No

 

  • If there were no interrater reliability data, was an alternate means to insure reliability described? No

 

  • Were assessments of sources sufficiently reliable? Unclear

 

  • Was the information provided sufficient for the reader to undertake a replication? Unclear

 

  • Did the sources that were evaluated involve a sufficient number of participants? Unclear

 

  • Were there a sufficient number of sources? Yes

 

 

  1. Description of outcome measures:

 

  • Outcomes #1: Production of stress in multisyllablic words

 

  • Outcome #2: Improved reading skills

 

 

  1. Description of results:

 

  • What measures were used to represent the magnitude of the treatment/effect size? No measures of the magnitude of the treatment effect/effect size were reported

 

  • Summary of overall findings of the secondary research:

 

  • There is only limited research focusing on multisyllabic word reading. The authors noted that this condition exists despite the fact that over 90% of the words in English are multisyllabic. They also noted that secondary students who struggle with reading may be able readers of monosyllabic words.

 

  • The authors summarized factors that make multisyllabic words more difficult to read:

   – the length of the word and its relationship to working memory

   – the relationship between word/lexical stress and vowel reduction*

   – vowel pronunciation variations

   – grapheme-phoneme correspondences

   – morphological complexity

* the focus of this review

 

  • The authors summarized why they considered the teaching of word/lexical stress to be important to the teaching of multisyllabic word reading.

 

  • The word/lexical stress instructional program they summarized was

     – Diliberto et al.’s English accenting patterns (p. 91) – The authors reported that this approach resulted in greater gains (not described) than a control group.

 

 

  • Were the results precise? No

 

  • 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? Variable

 

  • For the most part, were the results similar from source to source? Yes

 

  • Were the results in the same direction? Yes

 

  • 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? No

           

                                                                                                                   

  1. Were maintenance data reported? No

 

 

  1. Were generalization data reported? No

 

 

SUMMARY OF INTERVENTION

 

 

Population: literacy problems

 

Prosodic Targets: word/lexical stress

 

Nonprosodic Targets: literacy

 

Aspects of Prosody Used in Treatment of Nonprosodic Targets: word/lexical stress

 

Description of Procedure/Source —(Diliberto et al.’s English accenting patterns)

 

  • This intervention comprises 20 lessons
  • The instructors teach students about

– syllable patterns and

– syllabification

  • Stimuli include

– nonsense words

– low frequency monosyllable words

– low frequency multisyllabic words

  • Encoding and decoding are targeted.
  • Teachers note

– students should stress the root of the word, not the affix or suffix,

– in a disyllable word, stress should be placed on the first syllable,

– in multisyllabic words of 3 or more syllables, place the stress on the 3rd syllable from the end.

 

 

Evidence Supporting Procedure/Source —(Diliberto et al.’s English accenting patterns)

 

  • The authors reported that this approach resulted in greater gains (not described) than a control group.

 

 

————————————————————————————————————

 


Creek & Boomsliter (1975)

August 30, 2017

CRITIQUE OF UNSUPPORTED PROCEDURAL DESCRIPTIONS

(also known as Expert Opinion)

 

 

KEY
C = clinician

NA = not applicable

P = patient or participant

pmh = Patricia Hargrove, blog developer

SLP = speech-language pathologist

 

 

Source: Creel, W., & Boomsliter, P. C, (1975). Rhythm patterns in language: Connecting the links of human thought. Northeast Regional Learning Center, Empire State College, State University of New York: Albany, NY.

 

Reviewer(s):  pmh

 

Date: August 28, 2017

 

Overall Assigned Grade: Not grade because there are no supporting data.

 

Level of Evidence: F = Expert Opinion, no supporting evidence for the effectiveness of the intervention.

 

Take Away: This review is unique because the book is out of print and I have not been able to locate copies of it in Worldcat or in the Library of Congress. Nevertheless, it has potential and some of the sources may be useful for ideas about teaching speech rhythm. See the Summary of the Intervention section of this review for more information about the rationale for the interventions and a description of the types of information provided in the book.

 

 

  • Was there a review of the literature supporting components of the intervention? Yes

 

– The type of literature review was a Narrative Review.

 

 

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

 

 

  • Was the intervention based on clinically sound clinical procedures? Yes

 

 

  • Did the authors provide a rationale for components of the intervention? Yes

 

 

  • Were outcome measures provided? No _

 

 

  • Was generalization addressed? No

 

 

  • Was maintenance addressed? No

 

 

SUMMARY OF INTERVENTION

 

 

PURPOSE:  to provide a rationale and procedures for treating rhythm and using rhythm to treat communication problems

 

POPULATION: communication disorders and English Language Learners (ELL)

 

MODALITY TARGETED: comprehension (mainly) and production

 

ELEMENTS/FUNCTIONS OF PROSODY TARGETED: rhythm

 

ELEMENTS OF PROSODY USED AS INTERVENTION: rhythm

 

OTHER ASPECTS OF LANGUAGE/COMMUNICATION TARGETED: naming, phrases and sentences, literacy

 

MAJOR COMPONENTS:

 

  • The authors of this book explored the rhythm of English and it application to intervention. Following the introductory section in which they defined rhythm, described its role in communication, they offered several potential uses for rhythm in speech-language therapy.

 

  • Creel and Boomsliter focused on teaching students of all ages to perceive rhythm. They provided guidance, references, and training materials to help clinicians teach themselves and their clients to perceive English rhythm by adapting Kodaly Music techniques, scansion marking, poetic meter, and musical rhythm to the task. The recommendations were grounded in acoustic/speech science and music research. The authors themselves had extensive research records.

 

  • Although the review of the literature is dated because the book was published in 1975, it was relevant at the time of publication. The extensive number of recommended teaching strategies still have potential for those of us who have struggled with learning to identify English rhythm reliably and accurately as well for those of us who have tried to teach others (including bright college students) to perceive rhythm.

 

  • The authors provided multiple strategies for teaching rhythm perception as well a an informal test of rhythm perception. Additionally, they provided several brief case studies of speakers with a variety of communication disorders to illustrate how the teaching of rhythm can be incorporated into a course of treatment.

 

 

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

 


Habib et al. (2016)

March 12, 2017

EBP THERAPY ANALYSIS

Treatment Groups

 

 

Note: Scroll about two-thirds of the way down the page to read the summary of the procedure(s).

 

Key:

BALE = Batterie Analytique du Langage Ecrit

C = Clinician

CMT = Cognitive-Musical Training

D = Ps with Dyslexia

DT = Dance Teacher

EBP = evidence-based practice

f = female

m = male

NA = not applicable

NEPSY II = A Developmental NEuroPSYchological Assessment

P = Patient or Participant

pmh = Patricia Hargrove, blog developer

PP = Professor of Piano

PM = Psychomoter Therapist

Professor of Piano (PP), Psychomoter Therapist (PMT)

SLP = speech–language pathologist

TD = Ps with Typically Developing reading skills

 

 

SOURCE:

 

REVIEWER(S): Habib, M., Lardy, C., Desiles, T., Commeiras, C., Chobert, J., & Besson, M. (2016.) Music and dyslexia: A new musical training method to improve reading and related disorders. Frontiers in Psychology, 7:26, doi: 10.3389/fpsyg.2016.00026

 

DATE: March 6, 2017

 

ASSIGNED GRADE FOR OVERALL QUALITY: C (The highest possible grade for this investigation, based on the experimental design of the study is B-. This grade represents the quality of the evidence supporting the intervention. It is not a judgment about the quality of the intervention.)

 

TAKE AWAY: French children diagnosed with reading impairments responded positively to music based interventions in two experiments. Overall, the results indicated that intensive (Experiment 1) and Traditional (Experiment 2) dosages of Cognitive-Musical Training (CMT) yielded improvements in measures associated with categorical perception, literacy, perception of duration and pitch, auditory attention. The improvements tended to be maintained 6 weeks after the termination of the intervention.

 

 

  1. What type of evidence was identified?

                                                                                                           

  • What was the type of evidence?

– Prospective, Nonrandomized Group Design with Controls. In Experimental 1, there was a Control Group but it was typically developing readers

– Prospective, Single Group with Pre- and Post-Testing. Experimental 2

                                                                                                          

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

 

NOTE: THERE WERE 2 EXPERIMENTS IN THIS INVESTIGATION. THEY WILL BE REVIEWED SEPARATELY.

 

EXPERIMENT 1

INTENSIVE INTERVENTION SCHEDULE

 

                                                                                                           

  1. Group membership determination:

                                                                                                           

  • If there was more than one group, were participants (Ps) randomly assigned to groups?

 

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

                                                                    

  • Describe the assignment strategy: The investigators claimed to match participants (Ps) by reading age but I did not see evidence of this in the data.

 

 

  1. Was administration of intervention status concealed?

                                                                                                           

  • from participants? No

                                                                    

  • from clinicians? No

                                                                    

  • from analyzers? No

 

 

  1. Were the groups adequately described? No

 

– How many Ps were involved in the study?

  • total # of Ps: 34
  • # of groups: 2
  • List names of groups and the # of participants in each group:
  • Ps with Dyslexia (D) = 12
  • Ps with Typically Developing reading skills (TD) = 22

 

– CONTROLLED CHARACTERISTICS

  • age:

     – TD = matched to D Ps on reading age

  • diagnosis:

– D = severe dyslexia

     – TD = classified as normal reading

 

–DESCRIBED CHARACTERISTICS

  • age:

– D = range 8.2 to 11.7 years (mean 10.7)

     – TD = on an average they were 30 months younger than Ps from the D group

  • cognitive skills:

– D = investigators reported they overall intelligence was “largely preserved” (p. 3)

     – TD = not described

 

– Were the groups similar before intervention began? Yes BUT it was variable. On some measures the 2 groups were similar; for others they were different.

                                                         

– Were the communication problems adequately described? No

  • disorder type:

– D = diagnosed with severe dyslexia

– TD = classified as typically developing reading

  • functional level

     – D = investigators noted the following problems

  • spelling
  • auditory-verbal short term memory
  • working memory

 

 

  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? No

– Was there a no intervention group? Unclear, the TD group was measured one time and served as a normative group rather than a control group.  

                                   

– Was there a foil intervention group? No

 

– Was there a comparison group? No

 

– Was the time involved in the foil/comparison and the target groups constant? NA , the TD group did not receive intervention. It was used as a normative group.

 

 

  1. Were the outcomes measure appropriate and meaningful? Yes

 

                                                                                                             

– Outcomes (dependent variables):

 

CATEGORICAL PERCEPTION (identification, discrimination)

  • OUTCOME #1: The boundary for the discrimination of [ba] versus [pa]
  • OUTCOME #2: The correct discrimination of [ba] versus [pa] in a categorical perception task

 

SYLLABIC DURATION

  • OUTCOME #3: Judgment of normalcy or inappropriate lengthening of the penultimate syllable in a trisyllabic word

 

PITCH VARIATION

  • OUTCOME #4: Judgment of normalcy for nursery rhymes played on the piano with one of four variations (normal, pitch changes within a melody, pitch change out of melody, pitch change out of melody and harmony)

 

All the outcome measures were subjective.

 

None of outcome measures were objective.

                                         

 

  1. Were reliability measures provided?

                                                                                                            

  • Interobserver for analyzers? No

 

  • Intraobserver for analyzers? No

 

  • Treatment fidelity for clinicians? No

 

 

  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 ANALYSES

 

CATEGORICAL PERCEPTION MEASURES (identification, discrimination)

 

  • OUTCOME #1: The boundary for the discrimination of [ba] versus [pa]

     – preintervention: D group compared to the TD group = the categorical boundary for the D group was not as steep as the boundary for the TD group (descriptive data)

     – preintervention: inferential comparisons revealed that the location/patterns of the boundary for [ba] differed for TD and D groups.

     – preintervention: the overall scores for the identification of [ba] of the D group and the TD group were not significantly different

     – postintervention: D group was similar to the TD group (descriptive data)

     – postintervention inferential statistical analysis indicated

  • the location of the boundary for the D group’s for [ba] changed

 

  • OUTCOME #2: The correct discrimination of [ba] versus [pa] in a categorical perception task

    – preintervention: D group compared to the TD group-  D groups Ps had more trouble with discrimination near the categorical boundary (descriptive data)

     – preintervention: inferential statistical analysis revealed that for all Ps (i.e., both groups), the highest rate of correct comparisons of [ba] versus [pa] was boundaries 4 versus 5.

   – postintervention: D group was similar to the TD group (descriptive data)

postintervention:

  • the difference between the pre- and post- intervention scores of the D group was not significantly different
  • inferential statistical analysis revealed correct discrimination improved for comparisons within a sound (i.e., versions of [ba]) and between sounds [ba] versus [pa]

 

SYLLABIC DURATION MEASURE

 

  • OUTCOME #3: Judgment of normalcy or inappropriate lengthening of the penultimate syllable in a trisyllabic word

– preintervention:

  • The performance of all Ps was significantly lower words with (inappropriate) lengthening on the penultimate syllable compared to the normal stressing.
  • D group’s overall performance was significantly lower than the TD norm group.
  • The differences in performance in the groups could be localized to performance on words with penultimate lengthening rather than normal productions.

– postintervention :

  • Ds performed significantly better post intervention compared to preintervention and normally lengthened words were easier for them than words with lengthening on the penultimate syllable.
  • More improvement for words with penultimate syllable lengthening than for normally produced words.

 

PITCH VARIATION MEASURE

 

  • OUTCOME #4: Judgment of normalcy for nursery rhymes played on the piano with one of four variations (normal, pitch changes within a melody, pitch change out of melody, pitch change out of melody and harmony)

– preintervention:

  • There was no significant difference in the overall performance of D and TD groups.
  • But the differences between the D and TD groups were significantly larger for the exact version of the nursery rhyme than for the other 3 versions.

– postintervention:

  • There was not a significant difference for the pre and post scores for the D group.
  • The D group’s performance on the exact version continued to be significantly better than the other versions.

 

 

  • What statistical were test used to determine significance?

– ANOVA

– Fischer’s PLSD

 

  • Were confidence interval (CI) provided? No

 

 

  1. What is the clinical significanceNA

 

 

  1. Were maintenance data reported? No

 

 

  1. Were generalization data reported? No

 

 

  1. Describe briefly the experimental design of the investigation:

 

  • The investigators pretested 12 Ps with Dyslexia (D group) and 22 reading age matched peers who were developing reading typically (TD group.)
  • Outcome measures were concerned with Categorical Perception, Syllable Duration, and Pitch Discrimination.
  • The D groups received 18 hours of group Cognitive-Musical Training (CMT) over 3 days with 6 hours of treatment per day.
  • The D group was divided into 3 groups of 4 for treatment.
  • Following treatment, the D group (but not the TD group) was retested.
  • The results of the testing were analyzed using descriptive and inferential statistics.

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

 

EXPERIMENT 2

TRADITIONAL INTERVENTION SCHEDULE

 

                                                                                                           

  1. Group membership determination:

                                                                                                           

  • If there was more than one group, were participants (Ps) randomly assigned to groups? Not Applicable, 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:   12
  • # of groups: 1
  • List names of groups and the # of participants in each group:

     – There was one group of P but the group was divided into 3 subgroups of Ps for treatment, although all the data were analyzed together:

  • beginning readers [4 males (m); 7-11 years]
  • midlevel readers who were not yet at the automation level [2 m, 2 females (f); 9-10 years]
  • more advanced reader who were at the automation level (2m. 2f; 11-12 years)

 

— CONTROLLED CHARACTERISITCS

  •  reading skills: all diagnosed with dyslexia

 

— DESCRIBED CHARACTERISTICS

  • age: 7 to 12 years
  • gender: 8m; 4f

                                                         

– Were the communication problems adequately described? No

  • disorder type: dyslexia
  • functional level: Ps were classified in one of three categories:
  • beginning readers
  • midlevel readers who were not yet at the automation level
  • more advanced reader who were at the automation level

 

 

  1. Was membership in groups 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, but there was some missing data due to technical problems.

 

 

  1. Were the groups controlled acceptably? NA, this was a single group investigation.

 

 

  1. Were the outcomes measure appropriate and meaningful? Yes

                                                                                                             

– OUTCOMES:

 

CATEGORICAL PERCEPTION (identification, discrimination) OUTCOMES

  • OUTCOME #1: The boundary for the discrimination of [ba] versus [pa]
  • OUTCOME #2: The correct discrimination of [ba] versus [pa] in a categorical perception task

 

SYLLABIC DURATION OUTCOME

  • OUTCOME #3: Judgment of normalcy or inappropriate lengthening of the penultimate syllable in a trisyllabic word

 

LANGUAGE AND COGNITIVE TASK OUTCOMES [from A Developmental NEuroPSYchological Assessment (NEPSY II)]

  • OUTCOME #4: Performance on Auditory Attention and Response Set Tasks
  • OUTCOME #5: Performance on the Visuo-Spatial Attention Task
  • OUTCOME #6: Performance on the Repetition of Non-sense Words Task

 

LANGUAGE AND COGNITIVE TASK OUTCOMES [from Batterie Analytique du Langage Ecrit (BALE)]

  • OUTCOME #7: Performance on the Digit Repetition Task
  • OUTCOME #8: Performance on the Phonemic Fusion Task
  • OUTCOME #9: Performance on the Visual Identification of Letters (Sequential Analysis) Task
  • OUTCOME #10: Performance on the Contour Discrimination Task

 

READING ABILITIES, RHYTHM REPRODUCTION, WRITING OUTCOMES

  • OUTCOME #11: Performance on a task tallying the number of words read in one minute
  • OUTCOME #12: Performance on a task tallying the number of accurate repetitions of rhythmic patterns
  • OUTCOME #13: Performance on the BHK Task (Concise Evaluation Scale for Children’s Handwriting, French Version)

 

ALL the outcome measures were subjective.

 

– NONE of the outcome measures were objective.

                                         

 

  1. Were reliability measures provided?

– Interobserver for analyzers? No

 

– Intraobserver for analyzers? No

 

– Treatment fidelity for clinicians? No

 

 

  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 ≤ 0.01; this was a correction for the large number of comparisons.

 

PRE AND POST TREATMENT ANALYSES

 

 

CATEGORICAL PERCEPTION (identification, discrimination) MEASURES

 

  • OUTCOME #1: The boundary for the discrimination of [ba] versus [pa]
  • the differences between pre and post intervention overall scores were not significantly different
  • but one of the comparisons around the [ba] versus [pa] indicated that pre and post intervention scores was significantly different
  • OUTCOME #2: The correct discrimination of [ba] versus [pa] in a categorical perception task
  • the differences between pre and post intervention overall scores were not significantly different
  • the pre and post intervention comparison for one pair of [ba] versus [pa] comparisons was significantly difference

 

SYLLABIC DURATION MEASURE

 

  • OUTCOME #3: Judgment of normalcy or inappropriate lengthening of the penultimate syllable in a trisyllabic word
  • none of the differences were significant

 

LANGUAGE AND COGNITIVE TASK MEASURES (from NEPSY II)

 

  • OUTCOME #4: Performance on Auditory Attention and Response Set Tasks
  • there were significant differences in the immediate pre and post intervention comparisons for both tasks

 

  • OUTCOME #5: Performance on the Visuo-Spatial Attention Task
  • there was no significant difference between the immediate pre and post intervention scores.
  • there was a significant difference between the two pre intervention scores.

 

  • OUTCOME #6: Performance on the Repetition of Non-sense Words Task
  • there was no significant difference between the immediate pre and post intervention scores.

 

LANGUAGE AND COGNITIVE TASK MEASURES (from BALE)

 

  • OUTCOME #7: Performance on the Digit Repetition Task
  • none of the differences were significant

 

  • OUTCOME #8: Performance on the Phonemic Fusion Task
  • there were significant differences in the immediate pre and post intervention comparisons for accuracy but not time

 

  • OUTCOME #9: Performance on the Visual Identification of Letters (Sequential Analysis) Task
  • there were significant differences in the immediate pre and post intervention comparisons for time but not accuracy

 

  • OUTCOME #10: Performance on the Contour Discrimination Task
  • There was no significant difference in scores from immediate preintervention to postintervention.
  • There was a significant difference between the two preintervention testings.

 

READING ABILITIES, RHYTHM REPRODUCTION, WRITING MEASURES

 

  • OUTCOME #11: Performance on a task tallying the number of words read in one minute
  • there was a significant difference in the immediate pre and post intervention comparisons

 

  • OUTCOME #12: Performance on a task tallying the number of accurate repetitions of rhythmic patterns
  • none of the differences were significant

 

  • OUTCOME #13: Performance on the BHK Task
  • the differences between pre and post intervention overall scores were not significantly different.

 

– The statistical tests used to determine significance were

  • t-test
  • ANOVA
  • Fischer’s PLSD

 

– Were confidence interval (CI) provided? No

 

 

  1. What is the clinical significance

 

– The EBP measure provided was Standardized Mean Difference with Cohen’s d for interpretation.

 

– Results of EBP testing and the interpretation:

 

NOTE: Comparisons listed in this section

  1. were significantly different for pre and post testing AND
  2. had results reported by the investigators

 

 

LANGUAGE AND COGNITIVE TASK MEASURES (from NEPSY II)

 

  • OUTCOME #4: Performance on Auditory Attention and Response Set Tasks
  • Subtest A: d = 2.31 (Large Treatment Effect)
  • Subtest B: d = 1.12. (Large Treatment Effect)

 

  • OUTCOME #6: Performance on the Repetition of Non-sense Words Task
  • d = 0.52 (Moderate Treatment Effect)

 

LANGUAGE AND COGNITIVE TASK MEASURES (from BALE)

 

  • OUTCOME #8: Performance on the Phonemic Fusion Task
  • Accuracy comparison; d = 2.90 (Large Treatment Effect)

 

  • OUTCOME #9: Performance on the Visual Identification of Letters (Sequential Analysis) Task (same/difference task)
  • Time metric: d = 1.02 (Large Treatment Effect)

 

READING ABILITIES, RHYTHM REPRODUCTION, WRITING MEASURES

 

  • OUTCOME #11: Performance on a task tallying the number of words read in one minute
  • d = 0.29 (Small Treatment Effect)

 

 

  1. Were maintenance data reported? Yes

 

NOTE: Comparisons listed in this section

  1. were significantly different for pre and post testing AND
  2. had results reported by the investigators

 

LANGUAGE AND COGNITIVE TASK MEASURES (from NEPSY II)

 

  • OUTCOME #4: Performance on Auditory Attention and Response Set Tasks
  • there was no significant difference between the immediate post intervention and the 6-week after intervention comparisons for both tasks, indicating maintenance of gains

 

LANGUAGE AND COGNITIVE TASK MEASURES (from BALE)

 

  • OUTCOME #8: Performance on the Phonemic Fusion Task
  • there was no significant difference between the immediate post intervention and the 6-week after intervention comparisons for accuracy, indicating maintenance of gains.

 

  • OUTCOME #9: Performance on the Visual Identification of Letters (Sequential Analysis) Task
  • there was no significant difference between the immediate post intervention and the 6-week after intervention comparisons for time, indicating maintenance of gains.

 

READING ABILITIES, RHYTHM REPRODUCTION, WRITING MEASURES

 

  • OUTCOME #11: Performance on a task tallying the number of words read in one minute
  • there was no significant difference between the immediate post intervention and the 6-week after intervention comparison, indicating that gains were maintained.

 

 

  1. Were generalization data reported? Not clear

 

— The results for several of the outcomes could be considered to be generalization measures because they do not appear to be taught in the CMT. The outcomes that potentially indicate generalization are listed below. They are only considered to potentially indicate generalization because the entire content of CMT was not provided. Also, only comparisons that were significantly different between the immediate pre and post intervention testing are listed here.

 

 

LANGUAGE AND COGNITIVE TASK MEASURES (from NEPSY II)

 

  • OUTCOME #4: Performance on Auditory Attention and Response Set Tasks
  • there were significant differences in the immediate pre and post intervention comparisons for both tasks

 

LANGUAGE AND COGNITIVE TASK MEASURES (from BALE)

 

  • OUTCOME #8: Performance on the Phonemic Fusion Task
  • there were significant differences in the immediate pre and post intervention comparisons for accuracy but not time

 

  • OUTCOME #9: Performance on the Visual Identification of Letters (Sequential Analysis) Task
  • there were significant differences in the immediate pre and post intervention comparisons for time but not accuracy

 

READING ABILITIES, RHYTHM REPRODUCTION, WRITING MEASURES

 

  • OUTCOME #11: Performance on a task tallying the number of words read in one minute
  • there was a significant difference in the immediate pre and post intervention comparisons

 

 

  1. Describe briefly the experimental design of the investigation.

 

  • The investigators recruited 12 French children who had been diagnosed with severe dyslexia as Ps.
  • The group comprised 3 subgroups based on their current reading level, each subgroup had 4 Ps.
  • The data, however, were analyzed as a single group (n = 12.)
  • Invention was administered as group therapy with children.
  • The investigators tested the children 4 times:

– approximately 6 weeks before intervention (T1)

– immediately before intervention (T2)

– immediately after intervention (T3)

– approximately 6 weeks after intervention (T4; maintenance)

  • Intervention lasted 6 weeks with dosage of 3 hours per week for 6 weeks.
  • Depending on the task, group size ranged from 12 to 4.
  • The investigators compared performances for T1 to T2; T2 to T3; T3 to T4;

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

 

ASSIGNED OVERALL GRADE FOR QUALITY OF EXTERNAL EVIDENCE: C

 

 

SUMMARY OF INTERVENTION

 

PURPOSE: To explore the effectiveness of two forms (intensive dosage and traditional dosage) of musically based training on reading and other linguistic and nonlinguistic outcomes

 

POPULATION: Dyslexia; Children

 

MODALITY TARGETED: perception and production

 

ELEMENTS OF PROSODY USED AS INTERVENTION : music (pitch, rhythm, timing-duration)

 

OTHER ASPECTS OF LANGUAGE/COMMUNICATION TARGETED: literacy skills (word reading, phonemic fusion, writing, visual identification of letters), nonword repetition, perception of speech sounds (categorical perception of [ba] versus [pa])

 

OTHER TARGETS: digit span, rhythm reproduction, visuo-spatial attention, contour discrimination

 

DOSAGE: 18 hours of therapy delivered in one of 2 schedules:

  1. Intensive schedule: 6 hours a day over 3 days (Experiment 1)
  2. Traditional schedule: 3 hours a week over 6 weeks (Experiment 2)

 

ADMINISTRATOR: Speech Language Pathologist (SLP), Professor of Piano (PP), Psychomoter Therapist (PMT), Dance Teacher (DT)

 

MAJOR COMPONENTS:

 

  • Cognitive-Musical Training (CMT) was used in both experiments, although there were some variations which will be listed in the sections pertaining to each of the experiments.

 

  • CMT is based on the following links between music and the brain:

– music training with students diagnosed with dyslexia may facilitate the improvement of brain circuitry associated with music and language,

– temporal and rhythmic training associated with music may improve rhythmic problems often seen in children with dyslexia, and

– the cross-modality nature of CMT many facilitate integration or connectivity among regions of the brain

 

  • CTM involves musical exercises

– tapping sensory and motor systems simultaneously (sensory systems include visual, auditory, and somatosensory systems)

– providing special emphasis on the perception and production of rhythm

– highlighting selected aspects of the music perceptually

 

  • CMT incorporates the following treatment principles:

– goal directed,

– systematic

– hierarchical

 

  • CMT focused on the production and perception of the following components of music:

– pitch

– duration

– tempo

– pulsation

– rhythm

 

  • Treatment procedures involve

– sensory components (auditory, visual)

– motor components

– cross-modality activities (e.g., tapping in unison with an auditory rhythm, correcting other Ps’ instrumental performances of a simple melody)

 

  • CMT also taught Ps to use the piano.

 

  • Several exercises involved body movement paired with music and others involved pairing language and music (e.g. nursery rhymes, representing the prosody of a passage by sketching it onto paper.)

 

EXPERIMENT 1—INTENSIVE SCHEDULE

 

  • During the CMT sessions, speech-language therapy as well as other reading and writing exercises were suspended. However, Ps were permitted to attend their regularly scheduled speech-language therapy sessions.

 

  • CMT was administered as a 3 day workshop during winter vacation. The Ps attended the workshop for 6 hours a day.

 

  • The 12 Ps were divided into 3 groups of 4 Ps and they cycled through 3 training sessions as a subgroup.

 

  • Each training session lasted 45 minutes, with a 15 minute break between sessions.

 

  • The 3 training sessions focused on different components of CMT:

– music exercises (administered by the SLP)

– music education (PP)

– percussion and body rhythm exercises (PMT)

 

  • The schedule for the day involved:

– Cycling through the 3 training sessions with breaks

– Folk Dancing administered by a DT.

 

 

EXPERIMENT 2 –TRADITIONAL SCHEDULE

 

  • CMT Intervention was scheduled to occur within the regularly scheduled school day over a 6week period. The Ps received 3 hours of CMT per week.

 

  • The CMT intervention was similar to CMT intervention in Experiment 1, although dancing instruction was not included in Experiment 2.

 

  • For some activities all 12 Ps participated as a group and for other activities, the overall group was divided into 3 smaller groups based on reading level. The administrators modified the difficulty level of their interventions to meet the needs of the Ps, although the content was consistent.

 

  • The following activities were schedule within the 3 hours of CMT each week:

– 2 one-hour CMT workshops, all Ps in a single group, administered by SLP

– 2 half hour musical sessions per week, multiple groups with 4 Ps in each group. Content of these sessions involved practice in piano and percussion.

______________________________________________________________


Poore & Ferguson (2008)

November 5, 2016

ANALYSIS GUIDELINES

Comparison Research

 

NOTE: No summary of intervention is included in the review because the investigation does not involve therapy.

 KEY:

 eta =   partial eta squared

f = female

fo = Fundamental frequency

m = male

MLU = mean length of utterance

NA = Not Applicable

P = participant or patient

pmh = Patricia Hargrove, blog developer

SLP = speech-language pathologist

 

 

SOURCE: Poore, M. A., & Ferguson, S. H. (2008.) Methodological variables in choral reading. Clinical Linguistics & Phonetics, 22 (1), 13-24.

 

REVIEWER(S): pmh

 

DATE: November 4, 2016

 

ASSIGNED GRADE FOR OVERALL QUALITY: Not graded because this was not an intervention study; nevertheless, it does have clinical implications.

 

TAKE AWAY: The investigators explored prosody of typical adults in a variety of reading contexts (3 scripts and 3 reading conditions.) Compared to Solo reading, Choral reading resulted in smaller fundamental frequency (fo) variability, smaller amplitude variability, and smaller vowel duration variability. Track reading (i.e., in unison with prerecorded scripts) resulted in significantly more vowel errors, suggesting that Track reading might not be a feasible alternative to Choral reading.

 

 

  1. What type of evidence was identified?

                                                                                                           

  • What was the type of design? Prospective Single Group Experiment (exposed to Mmultiple conditions)

 

  • What was the focus of the research? Clinically Related

           

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

 

                                                                                                           

  1. Group membership determination:

                                                                                                           

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

 

 

  1. Were experimental conditions concealed?

                                                                                                           

  • from participants? No

                                                                    

  • from administrators of experimental conditions? No

                                                                    

  • from analyzers/judges? Unclear

                                                                    

 

  1. Were the groups adequately described? Yes

 

–   How many participants were involved in the study?

 

  • total # of Ps:  22 Ps (11 pairs) were in the original group. See question about maintenance below for description of loss of participants (Ps.)
  • # of groups: 1
  • Did the group maintain membership throughout the investigation? No, 6 of the pairs (i.e., 12 Ps) were eliminated from the investigation due to recording and/or interference issues at the time of the recording. Therefore, there were only 5 pairs of Ps resulting in 10 Ps.

 

DESCRIBED OR CONTROLLED CHARACTERISTICS                 

  • age:

     – original group: 18 to 25 years

– final group: not reported

  • gender:

     – original group: 8m; 14f

– final group: 4m; 6f:

  • dialect: South Midland Dialect of American English
  • communication skills: No history of speech, language, or hearing disorders; investigator judged speech to be typical

 

Were the groups similar? NA

                                                         

– Were the communication problems adequately described? Yes

  • disorder type: NA, communication skills of all Ps were within normal limits

 

 

  1. What were the different conditions for this research?

                                                                                                             

  • Subject (Classification) Groups?

                                                               

  • Experimental Conditions? Yes

– type of reading material: poetry, fiction, textbook

– reading condition: solo, track, choral

 

  • Criterion/Descriptive Conditions? No

 

 

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

 

 

  1. Were dependent measures appropriate and meaningful? Yes

 

The dependent measures were

 

  • OUTCOME #1: Fundamental frequency (fo) variability
  • OUTCOME #2: Amplitude variability
  • OUTCOME #3: Vowel duration
  • OUTCOME #4: Number of vowel errors

 

– Outcome #4 (Number of vowel errors) was subjective.

 

Three of the outcomes (see below) were objective:

  • OUTCOME #1: Fundamental frequency (fo) variability
  • OUTCOME #2: Amplitude variability
  • OUTCOME #3: Vowel duration

 

 

  1. Were reliability measures provided?

                                                                                                            

– Interobserver for analyzers? No

 

– Intraobserver for analyzers? Yes

 

  • OUTCOME #3: Vowel duration- Because the measurement of vowel duration required judgment on the part of the analyzers, the investigators provided intraobserver reliability data. The correlation for remeasured vowels was 0.95

 

– Treatment or test administration fidelity for investigators? No

 

 

  1. Description of design:

 

  • Although 22 Ps (11 pairs) initially participated in the investigation, only the data from 10 Ps were analyzed due to technical issues with the recordings.

 

  • All reading were recorded.

 

  • Pairs of Ps elicited the samples by reading scripts in the following order:

– Each speaker in the pair was directed to read silently the 3 scripts (poetry, nonfiction, textbook.) The order of the scripts was counterbalanced.

– First: Solo reading of all designated scripts alone. While separated from his/her experimental partner, each P read his/her scripts alone.

– Second and Third: The order of Track and Choral readings were counterbalanced.

  • TRACK READINIG: Using his/her partner’s Solo reading script as stimuli, P read aloud his/her scripts in unison with the recorded readings of his/her experimental partner.
  • CHORAL READINIG: P read aloud his scripts in unison with the live reading of the same scripts with his/her experimental partner.

 

  • Some data were removed from the investigation:

– Potential outliers were identified for fo variability by highlighting

  • fo more than 2 standard deviations (SD) from the mean

     – The potential outliers were then inspected. If a fo was not continuous with the upper and/or lower limits of the P’s range, it was removed.

 

 

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

 

– Comparisons that were significant (e.g., p ≤ 0.05):

 

  • OUTCOME #1: Fundamental frequency (fo) variability

– fo was significantly more variable in the solo condition

– script type, gender, gender pair, interactions were not associated with significant fo variability

 

  • OUTCOME #2: Amplitude variability

– Amplitude variability was significantly smaller for choral reading compared to solo and track reading

– script type and interactions were not associated with significant amplitude variability

 

  • OUTCOME #3: Vowel duration variability

– Differences among the 3 reading conditions were significantly different

– order of variability from most to least: track, solo, choral

 

  • OUTCOME #4: Number of vowel errors

     – The track condition was associated with significantly more errors than the other 2 conditions.

 

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

 

– Were effect sizes provided? Yes, for some, but not all, comparisons..

 

  • OUTCOME #1: Fundamental frequency (fo) variability;

– Solo condition most variable; eta = 0.83 (strong)

 

  • OUTCOME #2: Amplitude variability

– Amplitude variability least variable in choral reading; eta = 0.73 (strong)

 

  • OUTCOME #3: Vowel duration variability

– Order of variability from most to least: track, solo, choral; eta = 0. 69 (strong)

 

– Were confidence interval (CI) provided? No

 

 

  1. Summary of correlational results:  NA

 

 

  1. Summary of descriptive results: Qualitative research NA (this item is completed only when the investigation was solely or primarily Qualitative in nature.)

 

 

  1. Brief summary of clinically relevant results:

 

  • The fo variability, amplitude variability, vowel duration variability, and vowel errors did not differ in the 3 types of script (poetry, nonfiction, textbook.) The investigators suggested this could be associated with the small N.

 

  • Choral reading appeared to be associated with

– smaller fo variability

– smaller amplitude variability

– smaller vowel duration variability

 

  • Track reading often differed from the other conditions in fo variability and vowel duration variability. Moreover, significantly more errors were noted in the track condition.

 

ASSIGNED GRADE FOR QUALITY OF EXTERNAL EVIDENCE: NA


Flaugnacco et al. (2015)

March 5, 2016

 

 

EBP THERAPY ANALYSIS

Treatment Groups

 

 

Note: Scroll about two-thirds of the way down the page to read the summary of the procedure(s).

 

Key:

C = Clinician

EBP = evidence-based practice

f= female

m = male

MT = music training

NA = not applicable

P = Patient or Participant

pmh = Patricia Hargrove, blog developer

PT = painting training

SLP = speech–language pathologist

 

 

SOURCE:  Flaugnacco, E., Lopez, L., Terribili, C., Montico, M, Zoia, S., Schön, D. (2015). Music training Increases phonological awareness and reading skills in developmental dyslexia: A randomized control trial. PLoS ONE, 10 (9), e0138715. doi:10.1371/ journal.pone.0138715

 

 

REVIEWER(S): pmh

 

DATE: February 29, 2016

 

ASSIGNED GRADE FOR OVERALL QUALITY: B+  (Highest possible grade based on the design was A+.)

 

TAKE AWAY: Italian children who had been diagnosed with dyslexia participated in this randomized control trial investigation the effectiveness of 7 months of Music Training on literacy skills. The results revealed significant improvement in text reading, pseudo-word reading, word reading accuracy, phonemic blending, temporal anisochrony, temporal rise time, rhythm reproduction, tapping reproduction, overall cognitive performance, auditory attention, backward digit recall, and self-esteem.

 

  1. What type of evidence was identified?

                                                                                                           

  • What was the type of evidence? Randomized Clinical/Controlled Trial

                                                                                                           

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

 

                                                                                                           

  1. Group membership determination:

                                                                                                           

  • If there was more than one group, were participants (Ps) randomly assigned to groups? Unclear, the investigators claimed they employed pseudo -randomization on the basis of their baseline scores. There is some acceptance of this procedure in the literature. A more conservative interpretation would not consider quasi-randomization to be true randomization. Nevertheless, the investigators reported that their were no significant differences between the group in the dependent variables or in several characteristics of the Ps prior to intervention.

 

 

  1. Was administration of intervention status concealed?

                                                                                                           

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

                                                                    

 

  1. Were the groups adequately described?

Yes _x__       No ___       Unclear___       Variable _______

 

  • How many Ps were involved in the study?
  • total # of Ps:   48
  • # of groups: 2
  • List names of groups and the # of participants in each group: (

   – Music Training (MT) = 12

– Painting Training (PT) = 12 (2 participants, Ps, dropped out during post testing)

 

  • The following P characteristics were CONTROLLED
  • age: 8 – 11 years
  • cognitive skills: IQ >85
  • residence: Trieste and Rome (Italy):
  • diagnosis: dyslexia
  • language: native speaker of Italian
  • reading: failed 2 of 3 standardized Italian reading tests (accuracy and/or speed)
  • hearing: within normal limits
  • neurological status: within normal limits
  • vision: within normal limits or correct to normal limits
  • speech-language status: excluded developmental speech and language disorders (including using tests of Italian grammar and receptive vocabulary)
  • psycho-social status: excluded several disorders listed in ICD-10 (see 3/17-4/17)

 

  • The following P characteristics were DESCRIBED:
  • age:

MT group = mean age 10 years

     – PT group = mean age 10 years

 

  • gender:

MT group = 71% were male

     – PT group = 77% were male

 

  • handedness:

MT group =  right handed – 92%

     – PT group =  right handed – 86%

 

  • painting practice:

MT group = 0%

     – PT group = 4%

  • music practice:

MT group = 21%

     – PT group = 18%

 

  • educational level of clients:

MT group = median is 5

     – PT group =  median is 5

 

  • educational level of parents:

MT group = mean level for mothers was high school

     – PT group = mean level for mothers was high school

 

  • Were the groups similar before intervention began? Yes

                                                         

  • Were the communication problems adequately described? Yes, the Ps were diagnosed with dyslexia in the absence of developmental speech and language disorders.  

 

 

  1. Was membership in groups maintained throughout the study?

                                                                                                             

  • Did each of the groups maintain at least 80% of their original members? Yes, the MT group maintained 100% and PT group maintained approximately 92%.

                                                               

  • 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? Yes
  • Was there a comparison group? No

 

  • Was the time involved in the foil and the target groups constant? Yes

 

 

  1. Were the outcomes measure appropriate and meaningful? Yes

 

The outcomes were

 

  • OUTCOME #1:   Decreased number of Ps categorized as severely impaired on a task involving the reading of Italian pseudowords (DD-2)
  • OUTCOME #2: Decreased number of Ps categorized as severely impaired on the basis of accuracy of reading text on a standardized Italian reading test
  • OUTCOME #3: Increased speed of reading text on a standardized Italian reading test
  • OUTCOME #4: Decreased number of Ps categorized as severely impaired on the basis of accuracy of reading words on a standardized Italian reading test
  • OUTCOME #5: Increased accuracy of repetition of Italian pseudowords (Promea Battery)
  • OUTCOME #6: Increased accuracy on an Italian phonemic segmentation task
  • OUTCOME #7: Reduced number of seconds involved in an Italian phonemic segmentation task (i.e., increased speed)
  • OUTCOME #8: Increased accuracy on an Italian phonemic blending task
  • OUTCOME #9: Reduced number of seconds involved in an Italian phonemic blending task (i.e., increased speed)
  • OUTCOME #10: Improved performance on a test of temporal anisochrony (i.e., judgment regarding temporal regularity)
  • OUTCOME #11: Improved performance on a test of temporal rise time (i.e., identifying the longest tone of 3)
  • OUTCOME #12: Improved performance on a test of rhythm reproduction represented by tones and durations
  • OUTCOME #13: Improved performance on a test of tapping to the beat of a metronome
  • OUTCOME #14: Improved performance on a task of metrical perception
  • OUTCOME #15: Improved overall cognitive performance on a standardized test
  • OUTCOME #16: Improved digit span on a standardized test
  • OUTCOME #17: Improved auditory attention (BIA Battery)
  • OUTCOME #18: Improved digit span forward
  • OUTCOME #19: Improved digit span backward
  • OUTCOME #20: Improved Arithmetic
  • OUTCOME #21: Improved Block Design
  • OUTCOME #22: Improved Picture Arrangement
  • OUTCOME #23: Improved Vocabulary (comprehension)
  • OUTCOME #24: Improved Similarities
  • OUTCOME #25: Improved self-esteem
  • OUTCOME #26: Improved working memory on WISC

 

All the outcome measures were subjective.

 

None of the outcome measures were objective.

 

 

  1. Were reliability measures provided?

                                                                                                            

  • Interobserver for analyzers? Yes, the investigators reported interobserver reliability for one outcome.

OUTCOME #16: Improved repetition of rhythm represented by tones and durations =   0.89

 

  • Intraobserver for analyzers?

 

– Treatment fidelity for clinicians? Yes, The investigators did not provide treatment fidelity data but they reported that the administrators of the interventions, or clinicians (C), attended intensive training session in the respective interventions, were supervised by a neuropsychologist, and regularly communicated with the other C who was administering the intervention.

 

  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: Decreased number of Ps categorized as severely impaired on a task involving the reading of Italian pseudowords (DD-2)

– MT yielded significantly fewer Ps categorized as severely impaired than PT

     – both the MT and PT groups improved following intervention

 

  • OUTCOME #2: Decreased number of Ps categorized as severely impaired on the basis of accuracy of reading text on a standardized Italian reading test

– MT yielded significantly fewer Ps categorized as severely impaired than PT

 

  • OUTCOME #3: Increased speed of reading text on a standardized Italian reading test

– no significant differences between MT and PT groups following intervention; however,

     – both the MT and PT groups improved following intervention

 

  • OUTCOME #4: Decreased number of Ps categorized as severely impaired on the basis of accuracy of reading words on a standardized Italian reading test

– no significant differences between MT and PT but

     – both the MT and PT groups improved following intervention

 

  • OUTCOME #5: Increased accuracy of repetition of Italian pseudowords (Promea Battery)

– MT significantly better than PT following intervention

 

  • OUTCOME #6: Increased accuracy on an Italian phonemic segmentation task

– no significant differences between MT and PT but

     – both the MT and PT groups improved following intervention

 

  • OUTCOME #7: Reduced number of seconds involved in an Italian phonemic segmentation task (i.e., increased speed)

– no significant differences

 

  • OUTCOME #8: Increased accuracy on an Italian phonemic blending task

– MT significantly better than PT following intervention

 

  • OUTCOME #9: Reduced number of seconds involved in an Italian phonemic blending task (i.e., increased speed)

– no significant differences

 

  • OUTCOME #10: Improved performance on a test of temporal anisochrony (i.e., judgment regarding temporal regularity)

– MT significantly better than PT following intervention

 

  • OUTCOME #11: Improved performance on a test of temporal rise time (i.e., identifying the longest tone of 3

– no significant differences between MT and PT but

     – both the MT and PT groups improved following intervention

 

  • OUTCOME #12: Improved performance on a test of rhythm reproduction represented by tones and durations

– MT significantly better than PT following intervention

 

  • OUTCOME #13: Improved performance on a test of tapping to the beat of a metronome

– no significant differences between MT and PT but

     – both the MT and PT groups improved following intervention

 

  • OUTCOME #14: Improved performance on a task of metrical perception

– no significant differences

 

  • OUTCOME #15: Improved overall cognitive performance on a standardized test

– Following intervention, the Composite score on the WISC was significantly higher for the MT group.

 

  • OUTCOME #16: Improved digit span on a standardized test

– Following intervention, the digit span score on the WISC was significantly higher for the MT group.

 

  • OUTCOME #17: Improved auditory attention (BIA Battery)

– MT significantly better than PT following intervention

 

  • OUTCOME #18: Improved digit span forward

– no significant differences between groups following intervention

     – overall scores did not improve significantly following intervention

 

  • OUTCOME #19: Improved digit span backward

– MT significantly better than PT following intervention

 

  • OUTCOME #20: Improved Arithmetic

– no significant differences between groups following intervention

     – overall scores did not improve significantly following intervention

 

  • OUTCOME #21: Improved Block Design

     – PT significantly better than MT following intervention

  • OUTCOME #22: Improved Picture Arrangement

– no significant differences between groups following intervention

     – overall scores did not improve significantly following intervention

 

  • OUTCOME #23: Improved Vocabulary (comprehension)

– no significant differences between groups following intervention

     – overall scores did not improve significantly following intervention

 

  • OUTCOME #24: Improved Similarities

– no significant differences between groups following intervention

     – overall scores did not improve significantly following intervention

 

  • OUTCOME #25: Improved self-esteem

– no significant difference between groups following intervention but

     – both MT and PT improved significantly following intervention

  • OUTCOME #26: Improved working memory on WISC

– MT significantly better than PT following intervention

 

  • What statistical tests were used to determine significance?
  • Mann-Whitney U
  • Wilcoxon
  • Fisher’s Exact Test

 

  • Were confidence interval (CI) provided? No

 

 

  1. What is the clinical significance

 

– The measures used to describe clinical significance

– the Effect Size derived from Odds Ratio or Interval Data (

 

– Results of EBP testing and the interpretation:

 

  • OUTCOME #1:   Decreased number of Ps categorized as severely impaired on a task involving the reading of Italian pseudowords (DD-2)—Ps in the PT group were 3.7 more times likely to be categorized as severely impaired following treatment

 

  • OUTCOME #2: Decreased number of Ps categorized as severely impaired on the basis of accuracy of reading text on a standardized Italian reading test Ps in the PT group were 3.7 more times likely to be categorized as severely impaired following treatment

 

  • OUTCOME #5: Increased accuracy of repetition of Italian pseudowords (Promea Battery)—small treatment effect in favor of the MT group

 

  • OUTCOME #8: Increased accuracy on an Italian phonemic blending task—small treatment effect in favor of the MT group

 

  • OUTCOME #10: Improved performance on a test of temporal anisochrony (i.e., judgment regarding temporal regularity) —small treatment effect in favor of the MT group

 

  • OUTCOME #12: Improved performance on a test of rhythm reproduction represented by tones and durations—small treatment effect in favor of the MT group

 

  • OUTCOME #15: Improved overall cognitive performance on a standardized test—small treatment effect in favor of the MT group

 

  • OUTCOME #16: Improved digit span on a standardized test—small treatment effect in favor of the MT group

 

  • OUTCOME #17: Improved auditory attention (BIA Battery) —small treatment effect in favor of the MT group

 

  • OUTCOME #19: Improved digit span backward—small treatment effect in favor of the MT group

 

  • OUTCOME #21: Improved Block Design—small treatment effect in favor of the PT group

 

 

  1. Were maintenance data reported? No

 

 

  1. Were generalization data reported? Yes

 

  • Several of the measures could be considered to be generalization data including

–OUTCOME #1 (generalization for both groups): Decreased number of Ps categorized as severely impaired on a task involving the reading of Italian pseudowords (DD-2) Although MT treatment yielded significantly fewer Ps categorized as severely impaired than PT following intervention, both the MT and PT groups improved following intervention

 

–OUTCOME #2 (generalization for both groups): Decreased number of Ps categorized as severely impaired on the basis of accuracy of reading text on a standardized Italian reading test– MT treatment yielded significantly fewer Ps categorized as severely impaired than PT.

 

–OUTCOME #3 (generalization for both groups): Increased speed of reading text on a standardized Italian reading test–Both the MT and PT groups improved following intervention.

 

  • OUTCOME #4 (generalization for both groups): Decreased number of Ps categorized as severely impaired on the basis of accuracy of reading words on a standardized Italian reading test– Both the MT and PT groups improved following intervention

 

  • OUTCOME #5: Increased accuracy of repetition of Italian pseudowords (generalization for both groups): MT performed significantly better than PT following intervention

 

  • OUTCOME #6 (generalization for both groups): Increased accuracy on an Italian phonemic segmentation task — both the MT and PT groups improved following intervention

 

  • OUTCOME #7: Reduced number of seconds involved in an Italian phonemic segmentation task (generalization for both groups)- significant changes were not observed in either group

 

  • OUTCOME #8: Increased accuracy on an Italian phonemic blending task (generalization for both groups): MT performed significantly better than PT following intervention

 

  • OUTCOME #9: Reduced number of seconds involved in an Italian phonemic blending task (generalization for both groups) – significant changes were not observed in either group

 

  • OUTCOME #10: Improved performance on a test of temporal anisochrony (generalization for PT group) – The PT group did not improve significantly on this task

 

  • OUTCOME #11: Improved performance on a test of temporal rise time (generalization for PT group) —PT group improved significantly following intervention

 

  • OUTCOME #12: Improved performance on a test of rhythm reproduction represented by tones and durations (generalization for PT group) — PT did not improve significantly following intervention

 

  • OUTCOME #13: Improved performance on a test of tapping to the beat of a metronome (generalization for PT group)– PT group improved significantly following intervention

 

  • OUTCOME #14: Improved performance on a task of metrical perception (generalization for PT group): – no significant improvement for the PT

 

  • OUTCOME #15: Improved overall cognitive performance on a standardized test (generalization for both groups) – Following intervention, the Composite score on the WISC was significantly higher for the MT group.

 

  • OUTCOME #16: Improved digit span on a standardized test (generalization for both groups)– Following intervention, the digit span score on the WISC was significantly higher for the MT group.

 

  • OUTCOME #17: Improved auditory attention (generalization for PT group) –MT group was significantly better than PT following intervention

 

  • OUTCOME #18: Improved digit span forward (generalization for both groups) – scores did not improve significantly following intervention for either group

 

  • OUTCOME #19: Improved digit span backward (generalization for both groups)– MT significantly better than PT following intervention

 

  • OUTCOME #20: Improved Arithmetic (generalization for both groups)– scores did not improve significantly following intervention

 

  • OUTCOME #21: Improved Block Design (generalization for MT group) – PT significantly better than MT following intervention
  • OUTCOME #22: Improved Picture Arrangement (generalization for both groups): – overall scores did not improve significantly following intervention

 

  • OUTCOME #23: Improved Vocabulary comprehension (generalization for both groups) – scores did not improve significantly following intervention

 

  • OUTCOME #24: Improved Similarities (generalization for both groups) – scores did not improve significantly following intervention

 

  • OUTCOME #25: Improved self-esteem (generalization for both groups)- both MT and PT improved significantly following intervention
  • OUTCOME #26: Improved working memory on WISC (generalization for both groups) – MT significantly better than PT following intervention

 

 

  1. Describe briefly the experimental design of the investigation.

 

  • The investigators also explored whether certain skills predicted other skills. This part of the investigation will not be analyzed or summarized in this review, but the findings are interesting.

 

  • The investigators recruited children who had been diagnosed as dyslexic from Trieste and Rome, Italy.
  • Following the application of the inclusion and exclusion criteria, 48 Ps were assigned to one of the two treatment groups (MT, PT.) The investigators labeled the assignment procedure as quasi-random.

 

  • Prior to intervention, the investigators administered a battery of tests assessing reading, phonological skills, cognitive skills, temporal/rhythmic skills, and self-esteem. (The administration of the pretests to all 48 Ps took approximately 5 weeks.)

 

  • The two interventions lasted the same amount of time. The clinicians (Cs) who administered each intervention had received special training and they were supervised throughout the interventions.

 

  • Following intervention, the investigators administered the same battery of tests assessing reading, phonological skills, cognitive skills, temporal/rhythmic skills, and self-esteem as in the pretest. The administration of the posttests to 46 Ps (2 of the Ps dropped out of the investigation during this time) took approximately 5 weeks.

 

  • The investigators used nonparametric statistics to compare pre and post scores and differences between the two groups (MT, PT) in the changes following intervention.

 

  • The investigators also explored predictors of outcomes but this is neither critiqued or summarized in this review.

 

 

ASSIGNED OVERALL GRADE FOR QUALITY OF EXTERNAL EVIDENCE: B+

 

 

 

SUMMARY OF INTERVENTION

 

PURPOSE: To investigate the effectiveness of music training on the reading skills of children with dyslexia

 

POPULATION: Dyslexia (without comorbid language impairment); Children

 

ELEMENTS OF PROSODY USED AS INTERVENTION (part of independent variable; list only if prosody is being used as a treatment technique with a nonprosodic outcome):   music (rhythm, tempo/timing.)

 

OTHER TARGETS: reading, phonological skills, cognitive skills, temporal/rhythmic skills, and self-esteem.

 

DOSAGE: 2 times a week, group (5-7 Ps) sessions, 1 hour session, 7 weeks for a total of 30 sessions

 

ADMINISTRATOR: teacher trained in MT or PT intervention. The teacher will be will referred to as the clinician (C.)

 

MAJOR COMPONENTS:

 

  • There were 2 interventions: MT and PT.

 

  • In addition to MT or PT intervention, each P received a “ ‘conventional’ rehabilitation program” (p. 8/17) which involved

– daily work at home,

– 20 minutes in length,

– parental supervision, and

– activity forms.

 

MUSIC TRAINING (MT)

 

  • An adaptation of Kodaly and Orff programming targeting rhythm and timing.

 

  • The intervention included

– playing percussion instruments

– producing syllables with specificed rhythm

– music paired with movement

– games involving “sensorimotor synchronization” (8/17)

 

 

PAINTING TRAINING (PT)

 

  • An adaptation of Bruno Munari programming targeting visual-spatial skills, “hand” skills, and creativity.