Kelly (2015)

November 6, 2019

EBP THERAPY ANALYSIS

Treatment Group

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

NA = not applicable

P = Patient or Participant

pmh =  Patricia Hargrove, blog developer

SLP = speech–language pathologist

RtI = Response to Intervention

wcpm =  correctly read words per minute

wpm = words (correct and miscues) per minute

 

SOURCE:  Kelly, M. (2015.)  Implementing Reader’s Theatre as an intervention to improve prosody [PDF file.] Retrieved from https://minds.wisconsin.edu/handle/1793/73984 

 

REVIEWER(S):  pmh

 

DATE: November 5, 2019

 

ASSIGNED GRADE FOR OVERALL QUALITY:  C  The Assigned Grade for Overall Quality is concerned with the quality of the evidence in this investigation supporting the intervention. It is largely based on the design of the investigation and does not represent a judgment about the quality of the intervention.

 

TAKE AWAY: The application of Reader’s Theatre yielded improved reading fluency (number of words read per minute) in elementary school-aged children. The children’s perception of their reading and the participation in work groups also improved. Some of the measures were composite measures in which prosodic behaviors comprised a portion of the score.

 

  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 a treatment group.

 

  1. Was administration of intervention status concealed?
  • from participants?No
  • from teacher? No
  • from analyzers?  No

                                                                    

  1. Were the groups adequately described? No

 

–           How many  Ps were involved in the study?

  • total # of Ps: 11 
  • # of groups:1

 

–  CONTROLLED CHARACTERISTICS

  • educational level of clients: Grade 4 (n = 6); Grade 5 (n = 5) ; all participants (P) received supplemental reading instruction in a Title I classroom..

 

–  DESCRIBED CHARACTERISTICS

  • gender:f = 6; m = 5

 

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

                                                         

4- Were the communication problems adequately described?  No  _x__      Unclear ____, the Ps were reading below the benchmark for their grade level

  • disorder type: reading
  • functional level:

– Benchmark for Grade 4 readers was 105 read words per minute (wpm); the range before intervention was 37-100 wpm.

– Benchmark for Grade 5 readers was 114 read words per minute (wpm); the range before intervention was 59- 86 wpm.

 

  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. Was the group controlled acceptably?  No

 

  1. Were the outcomes measure appropriate and meaningful? Yes

 

–  OUTCOMES

  • OUTCOME #1:To improve scores on the Fluency Self-Assessment Scale
  • OUTCOME #2:To improve scores on the Reader’s Theatre Rubric
  • OUTCOME #3: To increase the benchmark AIMS R-CBM score [used by school district to meet Response to Intervention (RtI) requirements]
  • OUTCOME #4:To meet one’s goal on the Weekly Progress Monitoring Schedule for correctly read words per minute (wcpm)

 

–  All of the outcome 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?

Summary Of Important Results

—  What level of significance was required to claim significance?  NA, the results were presented using descriptive statistics only.

 

NOTE: The author did compare the treatment of Reader’s Theatre plus Read Naturally with the results of treatment of Read Naturally from the previous semester. The Ps performed “slightly better” in the combined treatment  (Reader’s Theatre plus Read Naturally.) This part of the investigation will not be reviewed here as it did not appear to be the major focus.

 

 

PRE, DURING AND POST TREATMENT ONLY ANALYSES

 

NOTE:  The results were presented using descriptive statistics; there were no correlational or inferential analyses.

 

  • OUTCOME #1:To improve scores on the Fluency Self-Assessment Scale

–  Ps’ self-ratings were reported after the 1st, 3rd, and 6thperformances (using different scripts.) The ratings are a composite of each P’s views of his/her performance on expression, volume, phrasing, smoothness, and pace. The highest score was 16.

–  For most Ps, the trend signified improvement from the 1stperformance to the 6thperformance.

 

  • OUTCOME #2:To improve scores on the Reader’s Theatre Rubric

–  Ps’ self-ratings of cooperation and group dynamics were reported after the 1st, 3rd, and 6thperformances (using different scripts.)

–  Five of the 11 Ps perceived that their overall cooperation and the group dynamics improved at least minimally.

 

  • OUTCOME #3: To increase the benchmark AIMS R-CBM score [used by school district to meet Response to Intervention (RtI) requirements]

–  P read three grade level one-minute passages. The median score of the correctly read words plus the errors (miscues) was the benchmark R-CBM score. These data were collected at the end of the Fall Intervention time and at the end of the Winter intervention time.

–  All Ps Benchmark AIMS R-CBM scores improved from the 1sttesting period to the last. The amount of gain varied within the group.

 

  • OUTCOME #4:To meet one’s goal on the Weekly Progress Monitoring Schedule for correctly read words per minute (wcpm)

     –  P read aloud for one minute. The number of correct words (wcpm) and error words were recorded. The results were graphed onto a trend line. These data were collected weekly.

–  By the end of the intervention, 7 of the 11 Ps met their targeted goal

 

–  What was the statistical test used to determine significance?NA, only descriptive statistics are used.

 

–  Were confidence interval (CI) provided?  No

 

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

 

  1. Were maintenance data reported?No

 

  1. Were generalization data reported?Yes
  • Outcomes 3 and 4 were based on cold readings of new scripts. Therefore, they could be considered generalization outcomes.

 

  1. Describe briefly the experimental design of the investigation.

 

  • The investigator was a Title 1 reading specialist.

 

  • She identified 11 children from Grade 4 or 5 to serve as Ps.

 

  • She introduced RT as the days 3 through 6 intervention in a 6-day intervention cycle during the Winter Semester. (Days 1 and 2 remained Read Naturally, a research-based intervention she had administered for 20 years. Read Naturally will not be discussed here. Read Naturally plus another intervention strategy had been used during the Fall Semester.)

 

  • The focus of both interventions was reading fluency.

 

  • The investigator generated data about the effectiveness of RT:

–  Outcomes 1 and 2 (self-evaluations of the Ps) 3 times during the intervention (Scripts 1, 3, 6.)

–  Outcome 3 (AIMS benchmark data) were elicited at the end of Fall Semester and the end of Winter Semester.

–  Outcome 4 (Weekly Progress Monitoring) was collected weekly.

 

  • All data were analyzed descriptively.

 

ASSIGNED OVERALL GRADE FOR QUALITY OF EXTERNAL EVIDENCE:  C

 

SUMMARY OF INTERVENTION

 

PURPOSE: To explore the effectiveness of Reader’s Theatre as a means to improve reading prosody.

 

POPULATION:  literacy problems; children

 

MODALITY TARGETED:  production

 

ELEMENTS/FUNCTIONS OF PROSODY TARGETED:  pace (rate), expression (affective prosody), volume (loudness), phrasing, smoothness (continuity), rhythm

 

OTHER ASPECTS OF LANGUAGE/COMMUNICATION TARGETED:  reading fluency (words read per minute); overall delivery

 

OTHER TARGETS:  cooperation in group, on-task participation

 

DOSAGE:  10 weeks, group intervention, 5 days a week, 30 minute sessions

 

ADMINISTRATOR:  Title I reading teacher

 

MAJOR COMPONENTS:

  • The investigator used 2 interventions during the semester in question:Read Naturally and  Reader’s Theatre (RT). The focus of this review is only RT; Read Naturally will not be described.

 

  • RT involve multiple readings of script by a group of readers to promote reading fluency and prosody (volume, pacing, phrasing, smoothness) that expresses meaning.

 

  • Ps do not memorize the lines, rather they read expressively.

 

  • Ps are assigned scripts which they read among themselves as if they we involved in a conversation.

 

  • The instructor models, instructs, and provides feedback for the Ps. The instructor and the Ps also discuss reading with prosodic expression and reading fluency.

 

  • For Ps who are struggling the instructor also may provide information about

–  “pausing,

– rate,

– stress,

– phrasing, and

–  intonation.” (p. 12)

 

  • The instructor taught RT for 30 minutes a day during “team time”.

 

  • The instructor explained to the Ps that they would practice the scripts and when the script was ready, the group would decide on the audience for their final performance.

 

  • The Ps worked on multiple scripts throughout the semester.

 

  • Reading roles were assigned using the game “Rock, Paper, Scissors”.

 

  • The instructor sent home the scripts for the children to practice.

_____________________________________________________________

 


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.

 

 

————————————————————————————————————

 


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


Eier (2013)

October 31, 2015

CRITIQUE OF UNSUPPORTED PROCEDURAL DESCRIPTIONS

NOTE: Hints for completing this form can be found in “Directions for the Use of Collaboration Forms” section of the Dashboard.

KEY
C = clinician

CI = cochlear implant

G = grad

HL = hearing loss

NA = not applicable

P = patient or participant

pmh = Patricia Hargrove, blog developer

SLP = speech-language pathologist

TITR = Tune in™ to Reading

 

Source: Eier, A. R. (2013). Tune in™ to Reading, an interactive singing program, and children who are deaf or hard of hearing using cochlear implants: Could this program be effective in improving reading fluency. Independent Studies and Capstones. Paper 662. Program in Audiology and Communication Sciences, Washington University School of Medicine (St. Louis, MO.)

Manuscript: http://digitalcommons.wustl.edu/pacs_capstones/662

 

 

Reviewer(s): pmh

 

Date: October 28, 2015

 

Overall Assigned Grade (because there are no supporting data, the highest grade will be F): F

 

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

 

Take Away: This article explored the feasibility of using Tune in™ to Reading (TITR, a music based interactive software program) to treat children with cochlear implants (CI). Although no effectiveness data were offered, the author indicated that TITR may be useful in improving the reading fluency of children with CI because

  • a review of the literature yielded research supporting its effectiveness with children with normal hearing
  • in many cases, the language used in TITR is appropriate for children with hearing loss
  • there is evidence that the interface of the TITR software and CIs can be successful, although some adjustments will be necessary.

 

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

 

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

 

 

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

 

  1. Did the author(s) provide a rationale for components of the intervention? Yes. The author reviewed the literature pertaining to reading fluency and analyzed the software of “Tune in to Reading” (TITR) with respect to

– language level

– feasibility of using the software with cochlear implants (CI)

– ease of use

  1. Description of outcome measures:

 

– Are outcome measures suggested? Yes

 

The outcome measures are.

NOTE: The target behavior of this intervention was improved reading fluency (Outcome #1); the other outcomes are concerned with the author’s analysis of the adequacy of “Tune in to Reading” (TITR.)

  • Outcome #1: Improved reading fluency
  • Outcome #2: Appropriateness of the language level of TITR for children with CI
  • Outcome #3: Feasibility of using TITR software with children with CI
  • Outcome #4: Ease of use of TITR for children with CI

 

  1. Was generalization addressed? No

 

 

  1. Was maintenance addressed? No

 

 

SUMMARY OF INTERVENTION

 

 

PURPOSE: To analyze the potential effectiveness of TITR for improving the reading fluency of children with CI

POPULATION: Hearing Loss, deafness; Children

 

MODALITY TARGETED: production (reading)

 

ELEMENTS OF PROSODY USED AS INTERVENTION (list only if prosody is being used as a treatment technique with a nonprosodic outcome):  music (pitch, rate, rhythm)

OTHER ASPECTS OF LANGUAGE/COMMUNICATION TARGETED: reading fluency

DOSAGE: not applicable (NA)

 

ADMINISTRATOR: A variety of professional educators including teachers, deaf educators, Speech-Language Pathologists (SLPs) could also administer TITR

 

STIMULI: graphic (reading), music (auditory)

 

MAJOR COMPONENTS:

 

  • TITR is an interactive singing-based software program designed to facilitate reading fluency in children who do not have hearing loss (HL) for readers from Grade (G)1 through G8.
  • The major components of TITR are

– The clinician (C, in this case a professional educator) creates an account for the student and assigns a reading level.

– The C assists the student or participant (P) in identifying P’s vocal range.

– P selects a song from the appropriate song-list in the TUNEIN Library. (Appropriateness is determined by reading level and vocal range. The songs from an appropriate song list vary from simple, short or easier, to more complex. The rate of the song as well as the relationship between melody and band components can be adjusted.)

– P listens to the selected song 3 times. The singing and music are accompanied by the lyrics.

– P clicks on each vocabulary word in the lyrics. P then hears the definition of the word and sees a picture.

– P then attempts to sing the song. A red cursor highlights the words to facilitate singing using the appropriate tempo. A blue cursor provides feedback about pitch accuracy.

– Following the completion of each attempted song, P is awarded a star with the color representing an achievement level.

– After singing the song, 5 times the program administers a quiz that assesses:

  • comprehension
  • referential vocabulary
  • inferential vocabulary

– Criteria for at least partial credit for the song is 80% correct on the quiz. Following completion of the quiz, P returns to the song list.

  • The author’s support for TITR for CI users is

– her summarization of research with children without HL who used TITR (or its earlier versions) indicating that TITR was effective.

– most of the lyrics of the songs at the lowest reading level were appropriate for children with HL

– singing using a monotone (frequently observed in children with HL) does not appear to negatively affect progress through the program

– the potential modifications (slowing speed, reducing without instrumental distraction) appeared helpful

– the visual feedback also could help pitch and rhythm of the P.

  • The author’s concerns about TITR for CI users include

– The criteria for awarding the different stars at the end of a song were not clear.

– Less than half of the words in the vocabulary definitions at the lowest level were appropriate for children with HL.

– The phrasing in some of the songs did not represent speech phrasing.

– Although there are 3 options for connecting TITR software with CI, each option is associated with some drawbacks.