Grossman et al. (2010)

December 15, 2016

 

ANALYSIS

Comparison Research  

NOTES:

  • A summary of an intervention is not included in the review because this in not an investigation about intervention. 

KEY: 

ASD = autism spectrum disorders

eta =   partial eta squared

HFA = high-functioning autism

MLU = mean length of utterance

NA = Not Applicable

P = participant or patient

pmh = Patricia Hargrove, blog developer

SLP = speech-language pathologist

TD = typically developing

  

SOURCE: Grossman, R. B., Bemis, R. H., Skwerer, D. P., & Tager-Flusberg, H. (2010.) Lexical and affective prosody in children with high-functioning autism. Journal of Speech, Language, and Hearing Research, 53, 778- 793.

 

REVIEWER(S): pmh

 

DATE: December 7, 2016

 

ASSIGNED GRADE FOR OVERALL QUALITY:  Not graded, this is an investigation of the nature of prosody within a clinical population; it is not an intervention study.

 

TAKE AWAY: This investigation of lexical and affective prosody in children and adolescents with high functioning autism (HFA) comprises 3 experiments: perception of affective prosody, perception of lexical prosody, and production of lexical prosody. The results indicate that children and adolescents with HFA are similar to TD peers with respect to their perception of affective prosody and lexical stress as well in their ability to mark correctly the stressed syllable in compound words (e.g., greenhouse) and noun phrases (green house.) However, the Ps with HFA differed from their TD peers with respect to how they marked the stressed syllable. Specially, the productions of Ps with HFA were of longer duration which was perceived be slower, more labored, containing longer pauses than TD peers.

 

 

  1. What type of evidence was identified?

                                                                                                           

  • What was the type of design? Comparison; Prospective, Nonrandomized Group Design with Controls

 

  • What was the focus of the research? Clinically Related

           

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

 

                                                                                                           

  1. Group membership determination:

                                                                                                           

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

                                                                    

 

  1. Were experimental conditions concealed?

                                                                                                           

  • from participants? No

                                                                    

  • from administrators of experimental conditions? No

                                                                    

  • from analyzers/judges? Unclear

                                                                    

 

  1. Were the groups adequately described? Yes

 

–    How many participants (Ps) were involved in the study?

 

NOTE: The same Ps were involved in all 3 experiments

  • total # of Ps: 31
  • # of groups: 2
  • List names of groups and the number of Ps in each group:

– High-Functioning Autism (HFA) = 16 (except Experiment #3, N = 11 for pitch and intensity analyses

– Typically Developing (TD) = 15 (except Experiment #3, N = 9 for pitch and intensity analyses

 

  • Did all groups maintain membership throughout the investigation? Yes, but data from some Ps were discarded from the pitch and intensity analysis for Experiment #3 due to excessive static on the recordings. This resulted in the following Ns for the 2 groups”

– TD = 9

– HFA = 11

                                                                                

–   CONTROLLED CHARACTERISTICS

                                                                                                                       

  • cognitive skills:

     – HFA = within normal range

     – TD = within normal range

 

  • receptive language:  (performance on the Peabody Picture Vocabulary Test)

     – HFA = within normal range

     – TD = within normal range

 

  • presence of identified genetic disorders: excluded from experiments

 

  • diagnosis of HFA =

     – met criteria in the Diagnostic and Statistical Manual of Mental Disorders; Autism Diagnostic Interview—Revised; Autism Diagnostic Observation Schedule

     – diagnosis noted that the P was in classified as “full range” autism

     – verbal IQ and receive vocabulary were within 2 standard deviations (SD) of the mean but the following challenges still resulted in diagnosis of ASD:

  • social skills
  • communication skills
  • pragmatic skills

     – excluded the following diagnoses:

  • Asperger syndrome
  • Autism, Pervasive Developmental Disorder, not otherwise specified

 

–   DESCRIBED CHARACTERISTICS (* = no significant differences between TD and HFA groups)

 

  • age*:

     HFA = mean – 12;4, range 7;6-17

     TD = mean 12;7, range 7;-18

 

  • gender: Not reported
  • cognitive skills:

HFA =

  • Full range IQ = 106.7 ( mean); 87-123 (range)
  • Verbal IQ* = 101.2 (mean); 83-127 (range)
  • Nonverbal IQ* = 109.6 (mean); 94-127 (range)

     TD =

  • Full range IQ = 108.9 (mean); 87-123 (range)
  • Verbal IQ* = 108.1 (mean); 81-127 (range)
  • Nonverbal IQ* = 106.7 (mean); range 85-116 (range)

 

  • receptive language*: (performance on the Peabody Picture Vocabulary Test)

     HFA = 107.0 (mean); 79-138 (range)

     TD =  111.3 (mean); 79-139 (range)

  • Hearing: Not reported

 

– Were the groups similar? Yes

                                                         

– Were the communication problems adequately described? Unclear.

 

  • disorder type: Ps in the HFA group were described as having social, pragmatic, and communication problems but they were not described. In addition, Ps with HFA were described as “did not at this time exhibit measureable language impairment” (p. 783’)

 

 

NOTE: This study investigated 3 experiments that used the same Ps described in item #4. Items #5 through #13 are presented separately for each of the experiments.

 

EXPERIMENT 1:

Investigation of the perception of affective prosody

 

 

  1. What were the different conditions for this research?

                                                                                                             

  • Subject (Classification) Groups? Yes

HFA

     – TD          

 

  • Experimental Conditions? Yes

 

CONTENT OF STIMULI

– Unfiltered Condition: 6 Sentences produced for each of 3 forms of affective prosody (happy, sad, neutral.) In each case, the content of the sentence and the prosody of the sentence matched the targeted content. For example, happy affective prosody was paired with the following sentence: “When Mike pets the puppy, it’s wagging its tail” (p.792)

– Filtered Condition: The 18 unfiltered sentences were passed through a low-pass filter deleting speech frequencies that resulted in the removal of semantic content but the retention of prosody.

 

EMOTION REPRESENTED ON STIMULI: (p. 781)

– Sad = lower pitch, slower rate, low tone ending

Happy = higher pitch, faster rate, complex tone ending

Neutral = midrange pitch, accent on the main topic, less complex final tone

 

  • Criterion/Descriptive Conditions? No

 

 

  1. Were the groups controlled acceptably? Yes

 

 

  1. Were dependent measures appropriate and meaningful? Yes

 

– OUTCOMES:

 

  • OUTCOME #1: Percentage of correct identifications of depicted affects in unfiltered and filtered sentence stimuli.

 

–   The outcome was subjective.

 

The outcome measures was not objective.

 

 

  1. Were reliability measures provided?

                                                                                                            

  • Interobserver for analyzers? No

 

  • Intraobserver for analyzers? No

 

  • Treatment or test administration fidelity for investigators?

 

 

  1. Description of design:
  • Following a training session that involved only unfiltered sentences, Ps listened to sentences and classified the emotions/affect as happy, sad, or neutral.
  • The validity of prerecorded sentence stimuli wasa ascertained by the independent rating of affect by 10 listeners who were not Ps in the investigation.
  • There were 18 sentences each for the unfiltered and filtered sentences. There were 3 versions of each of the sentence types which difference with respect to the order of sentence. The order of sentences was pseudorandomized and counterbalanced.
  • The verbal stimuli are included in an appendix.
  • Sentences were presented on acomputer via speakers. The filtered sentences were administered first; then the unfiltered sentences were administered.
  • Ps signified their choices by selecting the appropriated button.

 

 

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

 

– Results:

 

  • OUTCOME #1: Percentage of correct identifications of depicted affects in unfiltered and filtered sentence stimuli.
  • performance above chance for
  • filtered task: both TD and HFA
  • unfiltered task: both TD and HFA
  • performance was better on unfiltered than filtered for both TD and HFA
  • performance on neutral sentences was significantly poorer for neutral sentences for both TD and HFA
  • there was not an overall significant difference between TD and HFA groups

 

– The statistical tests used to determine significance included t-test; ANOVA: repeated measure 2 (Group—TD, HFA) x 2 (Task—filtered, unfiltered) x 3 (Emotion—happy, sad, neutral); repeated measure 2 (Group) x 3 (Emotion) for each task

 

– Were effect sizes provided? Yes

 

  • OUTCOME #1: Percentage of correct identifications of depicted affects in unfiltered and filtered sentence stimuli.
  • performance was better on unfiltered than filtered for both TD and HFA;
  • HFA – Cohen’s d = 1.04 (large effect)
  • TD – Cohen’s d = 0.76 (moderate effect)

 

– Were confidence interval (CI) provided? No

 

 

  1. Summary of correlational results: Not Applicable (NA)

 

 

  1. Summary of descriptive results: Qualitative research NA

 

 

  1. Brief summary of clinically relevant results:

 

  • TD and HFA Ps exhibited similar skills in interpreting affective prosody.
  • Both groups had significantly more difficulty on the filtered task than the unfiltered task. However, they still were able to label emotions above chance in the filtered condition. Therefore, both groups make use of semantic information to interpret affect (in addition to prosody.)
  • Both groups found the neutral affect sentences to be more difficult to interpret.

 

 

ASSIGNED GRADE FOR QUALITY OF EXTERNAL EVIDENCE: B

 

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

 

EXPERIMENT 2

Investigate the perception of lexical stress for differentiating noun phrases from compound nouns

 

  1. What were the different conditions for this research?

                                                                                                             

  • Subject (Classification) Groups? Yes

– HFA

     – TD

                                                               

  • Experimental Conditions? Yes

     – Noun Phrases (e.g. green house, wet suit, p. 792)

     – Compound Words (e.g., greenhouse, wetsuit, )

     – Foils (e.g., tree house, headphones, p. 792)

 

  • Criterion/Descriptive Conditions? No

 

 

  1. Were the groups controlled acceptably? Yes

 

 

  1. Were dependent measures appropriate and meaningful? Yes

 

–OUTCOMES:

  • OUTCOME #1: Percentage accuracy of responses to the experimental task

 

– The outcome measure was subjective.

 

 The outcome measure was not objective.

 

 

  1. Were reliability measures provided?

                                                                                                            

  • Interobserver for analyzers? No

 

  • Intraobserver for analyzers? No _

 

  • Treatment or test administration fidelity for investigators? No

 

  • Validity of the stimuli was supported by

AUDITORY STIMULI:

  • The investigators analyzed the experimental auditory stimuli using Praat to insure that the first syllable was stressed in the compound word (e.g., HOTdog) and the second syllable was stressed in the noun phrase (e.g., hot DOG.)
  • The acoustic criteria the investigators used to identify stressing were

         ¶ longer duration

         ¶ higher pitch

         ¶ greater intensity

  • For the foil items (i.e., stimuli produced with equal stress), acoustic analysis of the 3 above features did not reveal differences between the first and second syllable.
  • Ten judges listened to the auditory stimuli to determine which words could be properly identified as noun phrases or compound words.

 

VISUAL STIMULI:

  • The investigators insured that judges could properly link the auditory stimuli with pictures of the targeted words.

 

 

  1. Description of design:
  • The experimental stimuli included auditory and visual stimuli.

– Every experimental word (compound word or noun phrase) was paired with a picture presenting the target word and the opposite stress pattern. For example, for the target “wetsuit,” the investigator presented a picture of a “wet suit” and a picture of a suit that was wet.

–  Eleven foil words (i.e., compound words without corresponding noun phrases) were also presented auditorily and visually throughout the testing. For example, ne picture presented the target word (e.g., rainbow) and one picture presented the picture of a hair bow.

– The verbal stimuli are included in an appendix.

 

  • Prior to the experimental task, investigators administered a brief training task insuring that the Ps were able to press a button signifying their picture choice. Investigators provided corrective feedback to the Ps.

 

  • The Ps listened to prerecorded auditory stimuli of the compound words or noun phrases in isolation (i.e., not in a contextualizing sentence.)

 

 

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

 

– RESULTS:

 

  • OUTCOME #1: Percentage accuracy of responses to the experimental task
  • All Ps from both groups (TD, HFA) performed at the 80% accuracy level on foil stimuli.
  • All Ps from both groups (TD, HFA) performed at the 80% accuracy level for compound word and noun phrase stimuli.
  • Both groups were significantly more accurate on compound word/first syllable stress targets than noun phrase/second syllable stress target.
  • There was no significant differenceS between TD and HFA groups.

 

– The statistical tests used to determine significance included t-test; ANOVA: 2 (Groups: TD, HFA) x 2 (Stress: compound word/first syllable targets, noun phrase/ second syllable targets)

 

–   Were effect sizes provided? Yes

  • OUTCOME #1: Percentage accuracy of responses to the experimental task
  •  Both groups (TD, HFA) were significantly more accurate on compound word/first syllable stress targets than noun phrase/second syllable stress target.

∞ TD Cohen’s d = 0.80 (moderate effect)

∞ HFA Cohen’s d = 1.2 (large effect)

 

 

  1. Summary of correlational results: NA

 

 

  1. Summary of descriptive results: Qualitative research NA

 

 

  1. Brief summary of clinically relevant results:

 

  • HFA and TD groups performed similarly on the task requiring Ps to demonstrate comprehension of compound words (e.g., Yellowstone) compared to noun phrases (yellow stone.) Thus, Ps with HFA and their TD peers are equally competent on this task.

 

 

ASSIGNED GRADE FOR QUALITY OF EXTERNAL EVIDENCE:   B

 

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

 

EXPERIMENT 3

Investigate the production of lexical prosody

 

 

  1. What were the different conditions for this research?

                                                                                                             

  • Subject (Classification) Groups? Yes

HFA

     – TD

                                                               

  • Experimental Conditions? Yes

 

    – Lexical type (compound words/first syllable stress; noun phrases/second syllable stress)

 

  • Criterion/Descriptive Conditions? Yes

 

 

  1. Were the groups controlled acceptably? Yes

 

 

  1. Were dependent measures appropriate and meaningful? Yes

                                                                                                             

–  Outcome measures:

 

  • OUTCOME #1: Mean pitch of productions

 

  • OUTCOME #2: Mean intensity of productions

 

  • OUTCOME #3: Mean whole word duration

 

– The Outcome measures are not subjective.

 

All of the outcome measures are objective.

 

 

  1. Were reliability measures provided?

                                                                                                            

– Interobserver for analyzers? Yes

 

  • OUTCOME #3: Mean whole word duration—The investigators calculated the mean difference in overall duration length for the original analyzer and a second judge using 15% of the samples. The difference was 4 ms which met the investigators 5 ms or less criterion.

 

– Intraobserver for analyzers? No

 

– Treatment or test administration fidelity for investigators? No

 

 

  1. Description of design:

 

  • Experiment 3 was administered after a break following the administration of Experiments 1 and 2.
  • The investigators used the same picture stimuli as Experiment #2 with Experiment #2 always preceding Experiment #3.
  • In this investigation, there were 27 targets: 11 compound word/first syllable stress, 11 noun phrases/second syllable stress, 5 foils.
  • Scripts of the verbal stimuli are included in an appendix.
  • The investigators taught the procedures of Experiment 3 during a brief training session insuring that P clearly understood the procedures.
  • Investigators read a brief narrative designed to elicit the target word while a picture of that word was displayed.
  • Discarded data due to static on the recordings from the 2 groups resulted in reduced Ns for the intensity and pitch analyses to

– TD = 9

– HFA = 11

 

 

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

 

– RESULTS

 

  • OUTCOME #1: Mean pitch of productions

– No significant difference between groups (TD, HFA) on the production of

  • compound word/first syllable stressed targets
  • noun phrase/second syllable stressed targets

 

  • OUTCOME #2: Mean intensity of productions

– No significant difference between groups (TD, HFA) on the production of

  • compound word/first syllable stressed targets
  • noun phrase/second syllable stressed targets

 

  • OUTCOME #3: Mean whole word duration

     Compound words/first syllable stressed words were significantly shorter than noun phases/second syllable stressed word

– HFA group produced significantly longer utterances than the TD group

 

– What were the statistical tests used to determine significance? t-test; ANOVA: one way ANOVA; 2 (Group: HFA, TD) x 2 (Stress: compound word/first syllable stressed, noun phrase/second syllable stressed)

  • Other: (List the test and the associated outcomes)

 

– Were effect sizes provided? Yes.

 

  • OUTCOME #3: Mean whole word duration

     Compound words/first syllable stressed words were significantly shorter than noun phases/second syllable stressed word– eta = 0.53 (large effect)

  • for HFA the effect size was — Cohen’s d = 0.90 (large effect)
  • for TD the effect size was—Cohen’s d = 0.80 (large effect)

 

– HFA group produced significantly longer utterances than the TD group eta = 0.16 (large effect)

  • for compound words/first syllable stressed targets the effect size was –Cohen’s d = 0.82 (large effect)
  • for noun phrases/second syllable stressed targets the effect size was –Cohen’s d = 0.75 (moderate effect)

 

– Were confidence interval (CI) provided? No

 

 

  1. Summary of correlational results: NA

 

 

  1. Summary of descriptive results: Qualitative research NA

 

 

  1. Brief summary of clinically relevant results:

 

  • Ps with HFA were able to differentiate compound words/first syllable stress (e.g., highlight) from noun phrases/second syllable stress (e.g., high light) using duration.

 

  • However, their productions of both types of target words were significantly longer than their TD peers.

 

  • The investigators described their perceptions of Ps with HFA longer productions as being labored and slow with exaggerated pauses between syllables. The TD Ps productions, on the other hand, were perceived to be shorter, not labored, with smoother transitions between syllables.

 

 

ASSIGNED GRADE FOR QUALITY OF EXTERNAL EVIDENCE: __B-___

 


Lenden & Flipsen (2007)

August 26, 2015

NATURE OF PROSODIC DISORDERS

ANALYSIS FORM

 

Key:

 

CA = chronological age

CI = Cochlear Implant

HA = Hearing Age

HI = hearing impaired

NA = not applicable

P = participant

PIA = Post-Implantation Age

pmh = Patricia Hargrove, blog developer

PVSP = Prosody-Voice Screening Profile

 

SOURCE: Lenden, J. M., & Flipsen Jr., P. (2007). Prosody and voice characteristics of children with cochlear implants. Journal of Communication Disorders, 40, 66-81.

 

REVIEWER(S): pmh

 

DATE: August 24, 2015

ASSIGNED GRADE FOR OVERALL QUALITY: C+ (The highest grade for this type of design is C+.)

 

POPULATION: Cochlear Implants, Hearing Impairment; Children

 

PURPOSE: To identify aspects of prosody and voice that are problematic for children with cochlear implants (CI) and developmental trends relevant to prosody and voice.

 

INSIGHTS ABOUT PROSODY:

  • In this longitudinal investigation, the children with CI did not display problems with phrasing and pitch noted in children with hearing impairment (HI). Children with CIs and problems with Phrasing and Pitch might warrant special attention in therapy.
  • Resonance and stress continued to be problematic for most children with CI and did not improve with age. Accordingly, they may be aspects of voice/prosody that clinicians focus attention on in intervention.
  • The investigators noted that the number of participants (Ps) was small and that further research is needed.
  • The investigators recommended that the Prosody-Voice Screening Profile (PVSP) be considered in long-term monitoring of the prosody and voice of children with HI.

 

 

  1. What type of evidence was identified? Longitudinal Research
  1. Group membership determination:
  • If there were groups of participants were members of groups matched? Not applicable (NA.) There was only one group.
  1. Was participants’ communication status concealed?
  • from participants? No

                                                                    

  • from assessment administrators? No

                                                                    

  • from data analyzers? Yes, raters were presented with samples in random order to avoid bias (relative to change over time.)

                                                                    

 

  1. Were the participants adequately described? Yes

How many participants were involved in the study? 6

  • total # of participants: 6
  • was group membership maintained throughout the experiment? Yes
  • # of groups: 1
  • # of participants in the group: 6

 

– The following variables were controlled:

  • hearing status: Prelingually deaf (mean age of identification = 8 months; range 0 to 15 months)
  • time since CI: at least 18 months
  • language modality: spoken language only as primary mode of communication
  • receptive language: Receptive Vocabulary is within 2 standard deviations of the mean for P’s chronological age (CA); Peabody Picture Vocabulary Test III—mean standard score 82.3 months; range 72 months to 99 months

 

– The following variables were controlled described:

  • age at beginning of investigation: mean 5 years; range 3 years, 9 months to 6 years, 2 months
  • gender: 1m; 5f
  • cognitive skills: no known disability
  • mean time (hearing aid use + CI) amplified at the beginning of the investigation: mean 4 years, 4 months; range 2 years, 10 months to 5 years, 3 months
  • age of implantation: mean 28 months; range 20 months to 3 years
  • cause of hearing impairment (HI): unknown (5); partial agenesis of the cochlea (1)
  • physical skills: no known disability
  • emotional status: no known disability
  • implant type: Clarion (2); Nucleus 24 (2); Nucleus 22 (1)
  • intervention: all received prior intervention; oral mode was the focus of the interventions; interventions continued for all participants (Ps) throughout the investigation
  • educational level of clients: all in regular classrooms

 

– Were the communication problems adequately described? No. The investigators were vague about the general level of expressive and receptive language of the Ps but the Ps were capable of some conversational speech.  

 

  1. What were the different conditions for this research?

– Subject (Classification) Groups? Yes. All the Ps all were prelingually deaf.

                                                               

– Experimental Conditions? No

 

– Criterion/Descriptive Conditions? Yes– Ratings of conversational samples on the Prosody-Voice Screening Profile (PVSP).

 

  1. Were the groups controlled acceptably? NA

 

 

  1. Were dependent measures appropriate and meaningful? Yes

– The dependent measures were

  • Dependent Measure #1: Ratings on the Phrasing section of the PVSP
  • Dependent Measure #2: Ratings on the Rate section of the PVSP
  • Dependent Measure #3: Ratings on the Stress section of the PVSP
  • Dependent Measure #4: Ratings on the Loudness section of the PVSP
  • Dependent Measure #5: Ratings on the Pitch section of the PVSP
  • Dependent Measure #6: Ratings on the Laryngeal Quality section of the PVSP
  • Dependent Measure #7: Ratings on the Resonance Quality section of the PVSP
  • Dependent Measure #8: Relationship between measures of the PVSP and 3 age variables: Chronological Ages (CA), Hearing Age (HA), and Post-Implantation Age (PIA)
  • Dependent Measure #9: Changes with age on ratings on the PVSP

All of the dependent measures were subjective.

None of the dependent/ outcome measures were objective.

                                         

 

  1. Were reliability measures provided?

Interobserver for analyzers? No

 

– Intraobserver for analyzer?   Yes

  • Dependent Measure #1: Ratings on the Phrasing section of the PVSP = 100%
  • Dependent Measure #2: Ratings on the Rate section of the PVSP = 92%
  • Dependent Measure #3: Ratings on the Stress section of the PVSP = 83%
  • Dependent Measure #4: Ratings on the Loudness section of the PVSP = 95%
  • Dependent Measure #5: Ratings on the Pitch section of the PVSP = 94%
  • Dependent Measure #6: Ratings on the Laryngeal Quality section of the PVSP = 92%
  • Dependent Measure #7: Ratings on the Resonance Quality section of the PVSP = 85%
  • Overall PVSP score: 92%

Treatment/Procedural fidelity for investigators? No

 

  1. Description of design:
  • This longitudinal investigation involved 6 children with CIs.
  • Spontaneous samples of conversational speech were elicited every 3 months for time ranges varying from 12 to 21 months.
  • The prosody and voice characteristics of the Ps’ speech was determined from the samples that were analyzed using the PVSP.
  • The results were presented primarily using descriptive and correlational statistics as well as descriptions of developmental trends.

 

  1. What were the results of the inferential statistical testing? The only inferential testing mentioned in the manuscript was when correlations were reported for correlations. Those results will be presented in the correlational statistical testing section of this review.

 

 

  1. What were the results of the correlational statistical testing?

 

  • The relationships between measures of the PVSP and 3 age variables (CA, HA, PIA) were explored in 2 ways: (1) by correlating the combined PVSP and age scores of all 6 Ps and (2) ) by correlating the combined PVSP and age scores of only 5 Ps. (One set of P data were omitted because of the possibility of the child being a high performing outlier.)
  • The significant correlations ( p ≤ 0.05) were

–Ratings on the Stress section of the PVSP

  • stress ratings and HA for the 5 member set of Ps: r = 0.354
  • stress ratings and PIA for the 5 member set of Ps: r = 0.341

 

Rating of the Laryngeal Quality section of the PVSP

  • laryngeal quality ratings and CA for all 5 and 6 member sets: for 5 member set r = 0.554 and for 6 member set r = 0.421
  • laryngeal quality ratings and HA for all 5 and 6 member sets: :   for 5 member set r = 0.562 and for 6 member set r = 0.528
  • laryngeal quality ratings and PIA for all 5 and 6 member sets: :   for 5 member set r = 0.571 and for 6 member set r = 0.382

Rating of the Resonance Quality section of the PVSP

  • resonance quality and PIA: for the 5 member set r= 0.335
  • The investigators interpreted the correlations to indicate that at least for Stress, Laryngeal Quality, and Resonance Quality performance tended to improve with age.
  • What was the statistical test used to determine correlation? Not provided

 

  1. What were the results of the descriptive analysis
  • The investigators provided pooled data representing correct scores on the PVSP.
  • In line with the PVSP protocol, they also provided data describing the number of samples (remember each P is represented by multiple samples) in which P’s performance was classified as passed, borderline, or failed.

Dependent Measure #1: Ratings on the Phrasing section of the PVSP: 97% appropriate; 36 Ps passed; 4 borderline; 0 failed

 

Dependent Measure #2: Ratings on the Rate section of the PVSP: 88% appropriate; 22 Ps passed; 13borderline; 5 failed

Dependent Measure #3: Ratings on the Stress section of the PVSP: 48% appropriate; 2 Ps passed; 5 borderline; 33 failed

Dependent Measure #4: Ratings on the Loudness section of the PVSP: 92% appropriate; 32 Ps passed; 2 borderline; 6 failed

Dependent Measure #5: Ratings on the Pitch section of the PVSP: 98% appropriate; 38 Ps passed; 2 borderline; 0 failed

Dependent Measure #6: Ratings on the Laryngeal Quality section of the PVSP: 87% appropriate; 24 Ps passed; 7 borderline; 9 failed

Dependent Measure #7: Ratings on the Resonance Quality section of the PVSP: 10% appropriate; 0 Ps passed; 1 borderline; 39 failed

  • The investigators also described the changes in performance of individuals over time.

Dependent Measure #9: Changes with age on ratings on the PVSP

–   All Ps performed appropriately for the Phrasing and Pitch Sections of the PVSP.

– 4 of the 6 Ps did not improve on the Stress Section of the PVSP with performance remaining unacceptable throughout the investigation. However, 2 of the Ps appeared to improve.

– 5 of the 6 Ps did not evidence problems Loudness and their performance level remained stable. The remaining P did have a reduced score and did improve. The improvement seemed to be more related to the comfort level of the P and it was suspected that the initial poor score was not a problem.

–3 of the 6 Ps produced stable and relatively appropriate Laryngeal Quality during the investigation. One P was unstable at the beginning of the investigation and the other 2 Ps showed a tendency to improve

– 4 of the 6 Ps produced stable but inappropriate Resonance Quality throughout the investigation. One P showed improvement during the investigation. The remaining P started to improve and then performance regressed.


Diehl & Paul (2013)

July 18, 2015

NATURE OF PROSODIC DISORDERS

ANALYSIS FORM

 

Key:

 

ASD = Autism spectrum disorders

CA = chronological age

LD = Learning disability

NA = not applicable

P = participant(s)

PEPS-C = Profiling Elements of Prosodic Systems in Children

pmh = Patricia Hargrove, blog developer

SD = standard deviation

SS = Standard Score

TD = typically developing

 

 

SOURCE: Diehl, J. J., & Paul, R. (2013). Acoustic and perceptual measurements of prosody production on the Profiling Elements of Prosodic Systems in Children by children with autism spectrum disorders. Applied Psycholinguistics, 34, 135-161.

 

REVIEWER(S): pmh

 

DATE: July 11, 2015

ASSIGNED GRADE FOR OVERALL QUALITY: B+ (The highest possible grade, based on the design of the investigation, was B+.)

 

POPULATION: Autism spectrum disorders (ASD); Learning disability (LD)

 

PURPOSE: To investigate the prosody production (and to a lesser extent comprehension) of children with ASD, children with LD, and typically developing (TD) children using acoustic and perceptual measures of prosody.

 

INSIGHTS ABOUT PROSODY:

  • Comparisons of participant (P) groups on the subtests of the Profiling Elements of Prosodic Systems in Children (PEPS-C) revealed that the Ps with ASD and LD struggled with prosodic comprehension of affect, turn ends/terminal contour, and focus/stress but not chunking/phrasing. In addition, Ps with LD struggled with the production of accurate chunking/phrasing. The specific results are listed below:

– For the comprehension of affect subtest, the TD Ps performed significantly better than Ps with ASD or LD.

– For the production of affect subtest, the scores did not differ significantly for the 3 groups (ASD, LD, TD.)

– For the comprehension of turn ends/terminal contour subtest, TD Ps performed significantly better than Ps with ASD or LD.

– For the production of turn ends/terminal contour subtest, the scores did not differ significantly for the 3 groups.

– For the comprehension of chunking/phrasing subtest, the scores did not differ significantly for the 3 groups.

– For the production of chunking/phrasing subtest, the Ps with LD performed significantly more poorly than the Ps with ASD and the TD peers.

– For the comprehension of focus/stress subtest, the TD Ps performed significantly better than Ps with ASD or LD.

– For the production of focus/stress subtest, the scores did not differ significantly for the 3 groups (ASD, LD, TD.)

  • The prosodic productions of the Ps also were measured acoustically.

– As a group, the Ps with ASD displayed significant differences from the TD on the following:

  • longer duration of utterances for affect (conveying dislike) and turn-end/terminal contour tasks.
  • louder intensity for stress/focus task.
  • wider average f0 range for focus/stress task
  • larger SD of f0 during focus/stress task
  • On several expressive prosodic tasks, the Ps with LD produced prosody that differed significantly from the TD peers:
  • lower average f0 for turn ends/terminal contour, chunking/phrasing, and focus/stress tasks.
  • longer duration for turn-end/terminal contour
  • Because the intent of Ps and ASD were regularly interpreted by judges as correct, the findings may be interpreted as indicating that most Ps with ASD or LD can convey meaning using prosody. However, at times their productions are atypical.

 

 

  1. What type of evidence was identified? Prospective, Nonrandomized Group Comparison Design
  1. Group membership determination:

 

  • If there were groups of participants were members of groups matched? Yes

                                                                    

  • The matching strategy involved

The TD group and ASD and LD groups were matched on chronological age (CA).

–  The participants (Ps) with LD and ASD were matched on CA, nonverbal IQ, CELF-4 core, and receptive language scores,

  1. Was participants’ communication status concealed?
  • from participants? No
  • from assessment administrators? No
  • from data analyzers? Unclear

                                                                    

 

  1. Were the groups adequately described? Yes

How many participants were involved in the study?

  • total # of participants: 62
  • was group membership maintained throughout the experiment? Yes
  • # of groups: 3
  • List names of groups:

– TD (Typically developing)

– LD (Learning disability)

– ASD (Autism spectrum disorder)

  • # of participants in each group:

– TD = 22

– LD = 16

– ASD = 24

 

The following variables were CONTROLLED

 

  • neurological status: neurological problems excluded
  • vision: visual loss excluded, if uncorrected
  • hearing: hearing loss excluded
  • diagnosis:

All ASD Ps had been diagnosed with ASD (autism, Asperger’s syndrome, or PPD-NOS);

     – All LD Ps showed no sign of ASD and there were no reports of first degree family members with ASD;

     – For the TD group, the parents reported typical development; there were no reports of first degree family members with ASD or no previous diagnoses of development disability; and TD Ps were in the appropriate grade in school

– The following variables were DESCRIBED

  • age: mean age ASD group = 12.31; mean age LD group = 12.99; mean age TD group = 12.21
  • gender: ASD = 16m, 8f; LD = 12m, 4f; TD = 15m, 7f
  • nonverbal IQ: ASD = 103.61; LD = 96.85 (difference was not significant); TD—not reported
  • core language on CELF-4: ASD = 97.21; LD = 88.94: TD—not reported
  • expressive language on CELF-4: ASD = 100.54; LD = 90.00 (difference was significant); TD not reported
  • receptive language: ASD = 93.67; LD = 88.73; (difference was significant); TD not reported
  • learning disability: based on parent report of the LD group—5 Ps with reading disability, 11 Ps with language-based learning disability
  • Were the communication problems adequately described? Yes

– Communication disorder descriptions:

 

ASD

     – The Standard Score (SS) for the Core CELF-4 for the ASD group

  • ranged from 67-132
  • mean was 97.21

     – The SS for the Receptive Language CELF-4 for the ASD group

  • ranged from 58-121
  • mean was 93.67

– The SS for the Expressive Language CELF-4 for the ASD group

  • ranged from 75-126
  • mean was 100.54
  • This was significantly higher than the LD group.

LD

     – The SS for the Core CELF-4 for the LD group

  • ranged from 60-117
  • mean was 88.94

     – The Standard SS for the Receptive Language CELF-4 for the LD group

  • ranged from 58-119
  • mean was 88.73

– The SS for the Expressive Language CELF-4 for the LD group

  • ranged from 65-114
  • mean was 90.00
  • This was significantly lower than the ASD group.

 

  1. What were the different conditions for this research?

                                                                                                             

– Subject (Classification) Groups? Yes

  • There were 3 subject groups:

     – ASD

     – LD

     – TD

                                                               

– Experimental Conditions? No

 Criterion/Descriptive Conditions? Yes. Performance on the Profiling Elements of Prosodic Systems in Children (PEPS-C)

 

  1. Were the groups controlled acceptably? Yes

 

 

  1. Were dependent measures appropriate and meaningful? Yes

 

The dependent measures were

  • Dependent Measure #1: To comprehend affect signaled by prosody (number correct)

 

  • Dependent Measure #2: To express correctly affect using prosody (number correct perceptually)

 

  • Dependent Measure #3: Expression of prosodic affect of all liking food items as measured by

– average f0

– f0 standard deviation

– f0 variability/range

– intensity of utterance

– duration of utterance

 

  • Dependent Measure #4: Expression of prosodic affect of all not liking food items as measured by

– average f0

– f0 standard deviation

– f0 variability/range

– intensity of utterance

– duration of utterance

 

  • Dependent Measure #5: Expression of prosodic affect of all and correct only liking food items as measured by

– average f0

– f0 standard deviation

– f0 variability/range

– intensity of utterance

– duration of utterance

  • Dependent Measure #6: Expression of prosodic affect of correct not liking food items as measured by

– average f0

– f0 standard deviation

– f0 variability/range

– intensity of utterance

– duration of utterance

 

  • Dependent Measure #7: To comprehend when sentences contained prosody signifying question asking (correct responses)

 

  • Dependent Measure #8: To express statements and questions using prosody (perceptually measured)

 

  • Dependent Measure #9: Prosodic expression of all questions as measured by

– average f0

– f0 standard deviation

– f0 variability/range

– intensity of utterance

– duration of utterance

 

  • Dependent Measure #10: Prosodic expression of correct questions as measured by

– average f0

– f0 standard deviation

– f0 variability/range

– intensity of utterance

– duration of utterance

 

  • Dependent Measure #11: Prosodic expression of all statements as measured by

– average f0

– f0 standard deviation

– f0 variability/range

– intensity of utterance

– duration of utterance

 

  • Dependent Measure #12: Prosodic expression of correct statements as measured by

– average f0

– f0 standard deviation

– f0 variability/range

– intensity of utterance

– duration of utterance

  • Dependent Measure #13: To comprehend prosodic chunking (correct responses)

 

  • Dependent Measure #14: To produce accurate prosodic chunking (correct responses)

 

  • Dependent Measure #15: Prosodic expression of chunking of all subtest items as measured by

– average f0

– f0 standard deviation

– f0 variability/range

– intensity of utterance

– duration of utterance

 

  • Dependent Measure #16: Prosodic expression of chunking of correct subtest items as measured by

– average f0

– f0 standard deviation

– f0 variability/range

– intensity of utterance

– duration of utterance

 

  • Dependent Measure #17: To comprehend prosodic stress/focus (correct responses)

 

  • Dependent Measure #18: To express stress/focus prosodically (correct responses)
  • Dependent Measure #19: Prosodic expression of stress/focus of all subtest items as measured by

– average f0

– f0 standard deviation

– f0 variability/range

– intensity of utterance

– duration of utterance

 

  • Dependent Measure #20: Prosodic expression of stress/focus of correct subtest items as measured by

– average f0

– f0 standard deviation

– f0 variability/range

– intensity of utterance

– duration of utterance

The dependent measures that were subjective were

  • Dependent Measure #1: To comprehend samples of prosodic affect (number correct)
  • Dependent Measure #2: To express correctly affect using prosody (number correct perceptually)
  • Dependent Measure #7: To comprehend when sentences contained prosody signifying question asking (correct responses)
  • Dependent Measure #8: To express statements and questions using prosody (perceptually measured)
  • Dependent Measure #13: To comprehend prosodic chunking (correct responses)
  • Dependent Measure #14: To produce accurate prosodic chunking (correct responses)
  • Dependent Measure #17: To comprehend prosodic stress/focus (correct responses)
  • Dependent Measure #18: To express stress/focus prosodically (correct responses)

–   The dependent/ outcome measures that were objective are

 

  • Dependent Measure #3: Expression of prosodic affect of all liking food items as measured by

– average f0

– f0 standard deviation

– f0 variability/range

– intensity of utterance

– duration of utterance

  • Dependent Measure #4: Expression of prosodic affect of all not liking food items as measured by

– average f0

– f0 standard deviation

– f0 variability/range

– intensity of utterance

– duration of utterance

  • Dependent Measure #5: Expression of prosodic affect of all and correct only liking food items as measured by

– average f0

– f0 standard deviation

– f0 variability/range

– intensity of utterance

– duration of utterance

  • Dependent Measure #6: Expression of prosodic affect of correct not liking food items as measured by

– average f0

– f0 standard deviation

– f0 variability/range

– intensity of utterance

– duration of utterance

  • Dependent Measure #9: Prosodic expression of all questions as measured by

– average f0

– f0 standard deviation

– f0 variability/range

– intensity of utterance

– duration of utterance

  • Dependent Measure #10: Prosodic expression of correct questions as measured by

– average f0

– f0 standard deviation

– f0 variability/range

– intensity of utterance

– duration of utterance

  • Dependent Measure #11: Prosodic expression of all statements as measured by

– average f0

– f0 standard deviation

– f0 variability/range

– intensity of utterance

– duration of utterance

  • Dependent Measure #12: Prosodic expression of correct statements as measured by

– average f0

– f0 standard deviation

– f0 variability/range

– intensity of utterance

– duration of utterance

  • Dependent Measure #15: Prosodic expression of chunking of all subtest items as measured by

– average f0

– f0 standard deviation

– f0 variability/range

– intensity of utterance

– duration of utterance

  • Dependent Measure #16: Prosodic expression of chunking of correct subtest items as measured by

– average f0

– f0 standard deviation

– f0 variability/range

– intensity of utterance

– duration of utterance

  • Dependent Measure #19: Prosodic expression of stress/focus of all subtest items as measured by

– average f0

– f0 variability/range

– f0 standard deviation

– intensity of utterance

– duration of utterance

  • Dependent Measure #20: Prosodic expression of stress/focus of correct subtest items as measured by

– average f0

– f0 standard deviation

– f0 variability/range

– intensity of utterance

– duration of utterance

                                         

 

  1. Were reliability measures provided?

                                                                                                            

– Interobserver for analyzers? Yes

  • Average overall interrater reliability for combined combined Dependent Measures #2 was 0.88. (As a reminder, Dependent Measures #2 is listed below.)

– Dependent Measure #2: To express correctly affect using prosody (number correct perceptually)

 Intraobserver for analyzers? No

 

– Treatment/Procedural fidelity for investigators? No

 

 

  1. Description of design:
  • This investigation involved a prospective, nonrandom comparison design.
  • There were 3 groups of Ps:

– ASD

– LD

– TD

  • All 3 groups were administered the PEPS-C.
  • The dependent measures involved

– perceptual judgments of correction on and production subtests of the PEPS-C

– acoustic analysis of the production subtests.

  • The acoustic analyses comprised:

– average f0

– standard deviation of f0

– f0 range

– utterance duration

– utterance intensity

 

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

– The comparisons are significant presented with p ≤ 0.05.

  • Dependent Measure #1: To comprehend affect using prosody (number correct): TD was significantly better than ASD and LD
  • Dependent Measure #2: To express correctly affect using prosody (number correct perceptually): No significant differences
  • Dependent Measure #3: Expression of prosodic affect of all liking food items as measured by the 5 variables: No significant differences
  • Dependent Measure #4: Expression of prosodic affect of all not liking food items as measured by the 5 variables: No significant differences
  • Dependent Measure #5: Expression of prosodic affect of all and correct liking food items as measured by the 5 variables: No significant differences
  • Dependent Measure #6: Expression of prosodic affect of correct not liking food items as measured by

– average f0

– f0 standard deviation:

– f0 variability/range

– intensity of utterance

– duration of utterance: The ASD group produced significantly longer utterances than the LD group and the TD group.

  • Dependent Measure #7: To comprehend when sentences contained prosody signifying question asking (correct responses): TD was significantly better than ASD and LD
  • Dependent Measure #8: To express statements and questions using prosody (perceptually measured): No significant differences:
  • Dependent Measure #9: Prosodic expression of all questions as measured by

– average f0: The LD group produced significantly lower average f0 and the TD group

– f0 standard deviation:

– f0 variability/range:

– intensity of utterance

– duration of utterance: The Ps with ASD produced significantly longer utterances than the TD peers.

  • Dependent Measure #10: Prosodic expression of correct questions as measured by

– average f0: : The LD group produced significantly lower average f0 and the TD group

– f0 standard deviation:

– f0 variability/range

– intensity of utterance

– duration of utterance

  • Dependent Measure #11: Prosodic expression of all statements as measured by

– average f0

– f0 standard deviation:

– f0 variability/range

– intensity of utterance

– duration of utterance: Ps with ASD produced significantly longer utterances than Ps with LD and those with TD. The Ps with LD produced significantly longer utterances than TD peers.

  • Dependent Measure #12: Prosodic expression of correct statements as measured by

– average f0: The LD group produced significantly lower average f0 and the TD group

– f0 standard deviation:

– f0 variability/range

– intensity of utterance

– duration of utterance: Ps with ASD produced significantly longer utterances than Ps with LD and those with TD. The Ps with LD produced significantly longer utterances than TD peers.

  • Dependent Measure #13: To comprehend prosodic chunking/phrasing (correct responses) No significant differences
  • Dependent Measure #14: To produce accurate prosodic chunking/phasing (correct responses): The Ps with LD displayed significantly lower scores than Ps with ASD and the TD peers.
  • Dependent Measure #15: Prosodic expression of chunking of all subtest items as measured by

– average f0: Ps with LD produced significantly lower f0 than TD peers and Ps with ASD.

– f0 standard deviation

– f0 variability/range

– intensity of utterance

– duration of utterance

  • Dependent Measure #16: Prosodic expression of chunking of correct subtest items as measured by

– average f0: Ps with LD produced significantly lower f0 than TD peers and Ps with ASD.

– f0 standard deviation

– f0 variability/range

– intensity of utterance

– duration of utterance

  • Dependent Measure #17: To comprehend prosodic stress/focus (correct responses): The TD group exhibited significantly higher scores than the ASD and LD groups.
  • Dependent Measure #18: To express stress/focus prosodically (correct responses): No significant differences
  • Dependent Measure #19: Prosodic expression of stress/focus of all subtest items as measured by

– average f0: The LD group was significantly lower than the TD and ASD groups

– f0 standard deviation: The ASD and LD groups were significantly larger than the TF group

– f0 variability/range: Ps with ASD used a significantly wider range than TD.

– intensity of utterance

– duration of utterance

  • Dependent Measure #20: Prosodic expression of stress/focus of correct subtest items as measured by

– average f0: The LD group was significantly lower than the TD and ASD groups

– f0 standard deviation: The f0 SD was significantly smaller for the TD group than for the ASD group.

– f0 variability/range: The range of the ASD group was significantly larger range than the TD group.

– intensity of utterance: The Ps with ASD were significantly louder than the Ps with LD.

– duration of utterance

 

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

–   Were effect sizes provided? Yes. The effect sizes for significant comparisons ranged from 0.05 (small) to 0.25 (large).

– Were confidence intervals (CI) provided? No

 

 

  1. What were the results of the correlational statistical testing? There was no correlational analysis.

 

  1. What were the results of the descriptive analysis? The descriptive analysis was secondary to the inferential analysis.

 


Samuelsson et al. (2011)

June 10, 2015

NATURE OF PROSODIC DISORDERS

ANALYSIS FORM

 

Key:

 

NA = not applicable

P = Participant

pmh = Patricia Hargrove, blog developer

SLI = Specific Language Impairment

TD = Typically Developing

 

 

SOURCE: Samuelsson, C., Reuterskiöld, C., Nettelblatt, U., & Sahlén, B. (2011.) Production and perception of metrical patterns in Swedish children with language impairment. Logopedics Phonatrics Vocology, 36, 1-11.

 

REVIEWER(S): pmh

 

DATE: June 6, 2015

ASSIGNED GRADE FOR OVERALL QUALITY:  B (The highest possible grade based on the design of the investigation was B+.)

 

POPULATION: Specific Language Impairment (SLI), Swedish; Children

 

PURPOSE: To investigate the perception and production of metrical patterns in Swedish children diagnosed with language impairment.

 

INSIGHTS ABOUT PROSODY:

  • Swedish children with SLI more frequently omitted unstressed syllable than TD peers.
  • There may be 3 subgroups of prosody among children with SLI:

– stronger perception/comprehension than production/imitation,

– stronger production/imitation than perception/comprehension, and

– equivalent production/imitation and perception/comprehension.

 

 

  1. What type of evidence was identified? Prospective, Nonrandomized Group Comparison Design
  1. Group membership determination:
  • If there were groups of participants, were members of groups matched? Yes
  • The matching strategy involved selecting participants in the two groups were close in age (preschoolers.)
  1. Was participants’ communication status concealed?
  • from participants? No
  • from assessment administrators? Unclear
  • from data analyzers? Unclear

                                                                    

 

  1. Were the groups/participants adequately described? Yes

How many participants (Ps) were involved in the study?

  • total # of participants: 52
  • was group membership maintained throughout the experiment? Yes
  • # of groups: 2
  • List names of groups: SLI and typically developing (TD)
  • # of participants in each group: SLI = 27 (but see genders- p.4, reported 28 Ps); TD = 25

           

– The following variables controlled:              

  • cognitive skills: at least 78 nonverbal IQ (SLI); teacher reported normal development (TD)
  • language skills: SLI Ps were diagnosed with language impairment by a Swedish speech-language pathologist (SLP)
  • educational level of clients: Preschool
  • hearing: both groups passed a pure tone screening (25dB at 500, 1000, 2000, and 4000 Hz)

– The following variables were described:

  • age: mean age = 4:10 (TD); mean age = 5:4 (SLI)
  • gender: 10f; 18m (SLI); TD not reported

 

– Were the communication problems adequately described? Yes

  • disorder type:

     – 50% of the SLI group was diagnosed with severe language impairment in all domains of language

– 25% of the SLI group was diagnosed with moderate, expressive language impairment, particularly with respect to grammar and phonology

– 25% of the SLI group was diagnosed with mild phonological impairment

 

 

  1. What were the different conditions for this research?
  • Subject (Classification) Groups? Yes, there were 2 groups: SLI and TD
  • Experimental Conditions? No
  • Criterion/Descriptive Conditions? Yes, there were 3 tasks, all of them were in Swedish:
  • Imitation of phrases that differed on the placement of stress on the verb particle or on the prepositional phrase (iambic vs trochaic stress.) The examiner provided pictures to support the different sentences.
  • Comprehension task in which the participant (P) hears a direction and points to the appropriate picture of a set of 3 (2 contrasting sentences and a foil). The directions were identical sentences that differed only in the placement of stress on the verb particle or on the prepositional phrase (iambic vs trochaic stress.)
  • Imitation of phrases with an indefinite article (before the stressed syllable) or a definite form of a noun (after the stressed syllable. This contrasted differed iambic vs trochaic stress. The examiner provided pictures to support the different sentences.

 

  1. Were the groups controlled acceptably? Yes

 

 

  1. Were dependent measures appropriate and meaningful? Yes
  • The dependent measures were

Dependent Measure #1: Overall number of unstressed syllables omitted across all tasks

Dependent Measure #2: Proportion of prestressed syllables omitted in content words versus the proportion of omitted copulas

Dependent Measure #3: Comparing the same morpheme in different positions (stressed versus unstressed) and with different functions (verb particle versus preposition)

Dependent Measure #4: Relative strength of performance on imitated versus comprehension tasks concerned with phrasal stress.

Dependent Measure #5: Performance of Groups from measure 4 on

  • imitation of total unstressed syllables
  • perception of total unstressed syllables
  • imitation of prestressed syllables

Dependent Measure #6: Relationship between linguistic variables and nonverbal IQ among SLI Ps

  • All the dependent measures were subjective:.

 

  • None of the dependent/ outcome measures were objective?

                                         

 

  1. Were reliability measures provided?

 

  • Interobserver for analyzers? Yes. Overall inter-rater reliability for imitated/production tasks was 95%. Differences between raters were resolved by consensus.

 

  •  Intraobserver for analyzers? No

 

  • Treatment/Procedural fidelity for investigators? No

 

 

  1. Description of design:
  • The investigators administered 3 tasks to two groups of Swedish speaking children (SLI and TD groups.)
  • Prior to the administration of the tasks, the SLI Ps had been assessed using the Swedish Test of Language Comprehension, T.R.O.G. (a comprehension test), Lund Test of Phonology and Grammar (expressive), ORIS (oral motor skills), and a test of nonverbal IQ.
  • The 3 tasks were

– Imitation of phrases that differed on the placement of stress on the verb particle or on the prepositional phrase (iambic versus trochaic stress.) The examiner provided pictures to support the different sentences.

– Comprehension task in which the participant (P) hears a direction and points to the appropriate picture of a set of 3 (2 contrasting sentences and a foil). The directions were identical sentences that differed only in the placement of stress on the verb particle or on the prepositional phrase (iambic versus trochaic stress.)

– Imitation of phrases with an indefinite article (before the stressed syllable) or a definite form of a noun (after the stressed syllable. This contrasted differed iambic versus trochaic stress. The examiner provided pictures to support the different sentences.

  • The investigators used inferential (nonparametric) and correlational statistics to analyze the data.

 

  1. What were the results of the inferential statistical testing
  • Significant comparisons are p ≤ 0.05.

Dependent Measure #1: Overall number of unstressed syllables omitted across all tasks- Ps with SLI omitted significantly more unstressed syllables and TD Ps.

Dependent Measure #2: Proportion of prestressed syllables omitted in content words versus the proportion of omitted copulas by SLI group—no significant differences

Dependent Measure #3: Comparing the same morpheme in different positions (stressed versus unstressed) and with different functions (verb particle versus preposition) by the SLI group—no significant difference

Dependent Measure #4: Relative strength of performance on imitated versus comprehension tasks concerned with phrasal stress— not analyzed statistically. See descriptive analysis Item #12 in which 3 groups (A, B, C) of Ps with SLI were identified.

Dependent Measure #5: Performance of Groups from measure 4 (see also item #12) on

  • imitation of total unstressed syllables: Group A significantly poorer than other groups.
  • perception of total unstressed syllables: Group B significantly poorer than other groups.
  • imitation of prestressed syllables: Group A significantly poorer than other groups.

Dependent Measure #6: Relationship between linguistic variables and nonverbal IQ among SLI Ps: This measure was analyzed inferentially and correlationally. See item #11 for the correlational analysis.

     – There were no significant differences among the 3 SLI groups (i.e., Groups A, B, and C) with respect to linguistic and nonlinguistic measure.

– What were the statistical test used to determine significance?

  • Mann-Whitney U
  • Kruskal-Wallis
  • Post-hoc analysis by Siegel and Castellan

 

Were evidence-based measures provided: No

– Were confidence intervals provided? No

 

 

  1. What were the results of the correlational statistical testing?

 

– Correlations that od p ≤ 0.05) are considered significant:

 

  • Dependent Measure #6: Relationship between linguistic variables and nonverbal IQ among SLI Ps: This measure was analyzed inferentially and correlationally. See item #10 for the inferential analysis.

     – Overall SLI (i.e., combined Groups A, B, and C) as well as Groups A and B individually—no significant correlation between perception and imitation of stress patterns

     – For Group C there was a significant correlation between perception and imitation of stress patterns (r = 0.85.)

correlationally. See item #10 for the inferential analysis.

     – Overall SLI (i.e., combined Groups A, B, and C), there were no significant correlations for the number of unstressed free morphemes and oral motor skills.

     – Overall SLI (i.e., combined Groups A, B, and C), there was a significant correlation for the number of unstressed free morphemes and receptive language (r = 0. 37.)

 

  1. What were the results of the descriptive analysis?

Dependent Measure #4: Relative strength of performance on imitated versus comprehension tasks concerned with phrasal stress:

  • The investigators identified 3 subgroups within the SLI group.
  • NOTE : throughout the manuscript the investigator used the term “production” instead of “imitation.” I will continue with the term “imitation” because it is more specific. Also, some of the information provided here was found in the results or discussion section.

– GROUP A: Ps who were stronger on the perception/comprehension tasks than on the imitative task. (Criterion: 2 points better on perception/ comprehension tasks than on the imitation task.) These Ps had problems with all aspects of expressive language performance. This also was the smallest group.

– GROUP B: Ps who were stronger on the imitative task than on the perception/comprehension tasks (Criterion: 2 points better on the imitation task than on the perception/ comprehension tasks.) These Ps had more trouble with overall language comprehension than the other 2 groups.

– GROUP C: Ps whose performance on the perception/comprehension tasks and the imitative task were similar. (Criterion: Scores on the perception/ comprehension tasks and the imitative task were the same or within one point of one another.) Although all these Ps had nonverbal IQs of at least 78, as a group their nonverbal IQs were lower than the o


Ballard et al. (2010b)

June 13, 2014

SECONDARY REVIEW CRITIQUE

 

NOTE: Scroll about two-thirds of the way down the page to access a description of the procedure

 

Source: Ballard, K. J., Varley, R, & Kendall, D. (2010b). Promising approaches to treatment of apraxia of speech: Preliminary evidence and directions for the future. Perspectives on Neurophysiology and Neurogenic Speech and Language Disorders, 20, 87-93.    doi:10.1044/nnsld20.3.87

 

Reviewer(s): pmh

 

Date: June 14, 2014

 

Overall Assigned Grade: D-(The highest possible grade is B, based on the research design.)

 

Level of Evidence: D

Take Away: The authors critiqued three emerging approaches to treating apraxia of speech. This review was concerned only with the approach that used prosody: Rapid Syllable Transition Treatment (ReST).The authors contended that ReST has potential for success with adults with apraxia of speech. The measure that showed improvement was a durational differential of stressed and unstressed syllables in trained and untrained words.

 

What type of secondary review? Narrative Review

 

1. Were the results valid? Yes

a. Was the review based on a clinically sound clinical question? Yes

b. Did the reviewers clearly describe reasonable criteria for inclusion and exclusion of literature in the review (i.e., sources)?

c. The authors did not describe their searching strategy.

d. Did the sources involve only English language publications? Yes

e. Did the sources include unpublished studies? Yes

f. Was the time frame for the publication of the sources sufficient? Yes

g. Did the reviewers identify the level of evidence of the sources? No, but the authors/reviewers focused on the three approaches because of the limited research associated with them.

h. Did the reviewers describe procedures used to evaluate the validity of each of the sources? No

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

j. Did the reviewers or review teams rate the sources independently? No

k. Were interrater reliability data provided? No

l. If the reviewers provided interrater reliability data, list them: Not Applicable

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

n. Were assessments of sources sufficiently reliable? Not Applicable

o. Was the information provided sufficient for the reader to undertake a replication? No

p. Did the sources that were evaluated involve a sufficient number of participants? No, but the authors/reviewers focused on the three approaches because of the limited research associated with them.

q. Were there a sufficient number of sources? No, but the authors/reviewers focused on the three approaches because of the limited research associated with them.

 

2. Description of outcome measures:

• Outcome Associated with the Prosodic Procedure—Rapid Syllable Transition Treatment (ReST)

     – OUTCOME #1: To improve accuracy of duration changes associated with stressed and unstressed syllable in trained and untrained nonsense words with Weak-Strong and Strong-Weak stress pattern

 

 

3. Description of results:

a. What evidence-based practice (EBP) measures were used to represent the magnitude of the treatment/effect size? The authors/reviewers did not provide EBP data.

 

b. Summarize overall findings of the secondary review:

  • The authors/reviewers reported on a procedure that targets lexical stress and articulatory accuracy for children with Childhood Apraxia of Speech (CAS). Seven children with CAS in two investigators improved their ability to produce durational changes for Weak and Strong syllables in trained and untrained multisyllables nonsense words. The authors contended that these findings suggest a feasible intervention for adults with apraxia of speech.

 

c. Were the results precise? Unclear

d. 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? Not Applicable

e. Were the results of individual studies clearly displayed/presented? Yes

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

g. Were the results in the same direction? Yes

h. Did a forest plot indicate homogeneity? Not Applicable

i. Was heterogeneity of results explored? No

j. Were the findings reasonable in view of the current literature? Yes

k. Were negative outcomes noted? No

           

 

4. Were maintenance data reported?No

 

 

5. Were generalization data reported? Yes. Changes in trained and untrained multisyllable nonsense words were reported.

 

 

SUMMARY OF INTERVENTION

 

Population: Apraxia of speech, Adults

 

Prosodic Targets: lexical stress

 

Nonprosodic Targets: articulatory accuracy (the authors/reviewers did not describe results for this target)

 

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

 

Description of Procedure—Rapid Syllable Transition Treatment (ReST)

  • The focus of treatment is the production of multisyllable words, targeting accurate lexical stress and articulation.

• Stimuli are multisyllable nonsense words (nonsense strings) with Weak-Strong (WS) and Strong-Weak (SW) stress patterns.

• The following procedures are incorporated into ReST:

– complex targets (number of syllables, number of different speech sounds)

– varied targets

– high intensity practice

– presentation of targets in random order

– limited feedback on accuracy

 

Evidence Supporting Procedure

• 7 children with CAS (across 2 investigations) improved their ability to modulate duration in Weak and Strong syllable in trained and untrained multisyllable nonsense words.

 

Evidence Contraindicating Procedure

  • The authors/reviewers described the support as preliminary. There was

– a small number of investigations (2)

– a small number of participants (7 participants with impairment)

– the participants were children with CAS


Russell (2010)

September 16, 2013

 

EBP THERAPY ANALYSIS

Single Subject Designs

 

SOURCE:  Russell, S., Laures-Gore, J., & Patel, R.  (2010).  Treating expressive aprosodia:  A case study.  Journal of Medical Speech-Language Pathology, 18 (4), 115-120.

 

REVIEWER(S):  pmh

 

DATE:   07. 07.12

 

ASSIGNED OVERALL GRADE:  D+  (This is the highest grade that can be awarded to a case study.)

 

TAKE AWAY:  Limited support from a case study for this imitative 6 step approach in improving the production of contrastive stress.

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

2.  Quality of evidence:

a.  What type of evidence was identified?  Case Study: Description with Pre and Post Test Results

b.   What was the level of evidence?  Level = D+

 

3.  Was phase of treatment concealed?

a.  from participants?  No

b.  from clinicians?

c.  from data analyzers?

4. Were the participants adequately described?  Yes

a.  How many participants were involved in the study?  1

b.  The following characteristics/variables were described:

•  age:  46 years

•  gender:  m

•  cognitive skills:  independent function

•  educational level:  high school

•  handedness:  left

•  medications:  none

•  depression:  no

c.  Were the communication problems adequately described?  Inconsistent

•  The disorder type was expressive aposodia.

 

5.  Was membership in treatment maintained throughout the study? Not applicable

 

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

a.  Were baseline data collected on all behaviors?  Yes, but there was only one baseline session.

b.  Did probes include untrained data?  No

c.  Did probes include trained data?  Yes

d.  Was the data collection continuous?  Yes

 

7.  Were the outcomes measure appropriate and meaningful?  Yes

a.  The outcomes were

•  OUTCOME #1:  Peak Fo associated with stressed/unstressed targets

•  OUTCOME #2:  Peak intensity associated with stressed/unstressed targets

•  OUTCOME #3:  Word duration associated with stressed/unstressed targets

•  OUTCOME #4:  Fo range associated with sentences with happy, sad, and angry emotions

•  OUTCOME #5:  Listeners’ judgments of the location of the stressed word in an utterance.

•  OUTCOME #6:  Listeners’ identification of the emotional intent (happy, sad, angry) of an utterance.

 

b.  The subjective  outcome measures are

•  OUTCOME #5:  Listeners’ judgments of the location of the stressed word in an utterance.

•  OUTCOME #6:  Listeners’ identification of the emotional intent (happy, sad, angry) of an utterance.

 

c.  The subjective outcome measures are

•  OUTCOME #1:  Peak Fo associated with stressed/unstressed targets

•  OUTCOME #2:  Peak intensity associated with stressed/unstressed targets

•  OUTCOME #3:  Word duration associated with stressed/unstressed targets

•  OUTCOME #4:  Fo range associated with sentences with happy, sad, and angry emotions

 

d.  None of the outcome measures are associated with reliability data. However, the investigators provided data for segmentation of acoustic measures (r = .94).

8.  Did the target behavior improve when it was treated?

•  OUTCOME #1:  Peak Fo associated with stressed/unstressed targets—Yes, moderate

•  OUTCOME #2:  Peak intensity associated with stressed/unstressed targets—Yes, limited

•  OUTCOME #3:  Word duration associated with stressed/unstressed targets—No, ineffective

•  OUTCOME #4:  Fo range associated with sentences with happy, sad, and angry emotions—No, ineffective

•  OUTCOME #5:  Listeners’ judgments of the location of the stressed word in an utterance—Yes, strong

•  OUTCOME #6:  Listeners’ identification of the emotional intent (happy, sad, angry) of an utterance—No, ineffective

9.  Baseline information:  Was baseline low and stable?  NA—only single baseline session

10.  What was the magnitude of the treatment effect?  NA

 

11.  Was information about treatment fidelity adequate?  Not Provided

12.  Was maintenance information provided?  Yes, the investigators provided a follow up session after treatment.  Ps did not maintain progress. The time between time between last session and follow up was not clear.

SUMMARY OF INTERVENTION PROCEDURES

PURPOSE:  to investigate the effectiveness of the imitative version of Rosenbek’s 6 step continuum in improving the expressive aprosodia.

POPULATION:  expressive aprosodia as the result of bilateral strokes

 

MODALITY:  expressive

 

ELEMENTS OF PROSODY TARGETED:  contrastive stress, affective prosody

DOSAGE:  9 sessions in 14 weeks

 

ADMINISTRATOR:  SLP

 

STIMULI:  not described but see Rosenbek et al. (2006)

GOAL ATTACK STRATEGY:  vertical

 

MAJOR COMPONENTS:  not described but see Rosenbek et al. (2006)


Pennington et al. (2006)

September 3, 2013

EBP THERAPY ANALYSIS for

Single Subject Designs

 

SOURCE:  Pennington, L., Smallman, C., & Farrier, F. (2006). Intensive dysarthria therapy for older children with cerebral palsy:  Findings from six cases.  Child Language Teaching and Therapy, 22, 255-273.

 

REVIEWER(S):  pmh

 

DATE:  7.13.13

ASSIGNED OVERALL GRADE:  D- (Due to level of evidence, the highest possible grade was D+.)

 

TAKE AWAY:  These 6 case studies indicate that a systems approach to improving the speech of 10-18 year olds with cerebral palsy may have potential to improve intelligibility of single words but not connected speech. The investigators described the procedures in only general terms.

 

1.  What was the focus of the researchClinical Research

 

2.  What type of evidence was identified?                              

a.  What  type of single subject design was used?  Case StudiesDescription with Pre and Post Test Results

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

                                                                                                           

3.  Was phase of treatment concealed?                                             

a.  from participants?  No                             

b.  from clinicians?  No                                 

c.  from data analyzers?  Yes

 

4.  Were the participants adequately described?  Yes

a.  How many participants were involved in the study?  6      

4b.  Were the following characteristics/variables actively controlled or described?

CONTROLLED

•  age: 10 years or older (10-18 years, mean = 15 years)

•  diagnosis:  mild to severe dysarthria associated with cerebral palsy

•  education of participant:  in a single special school in the UK

DESCRIBED

•  gender:  4f, 2m

•  cognitive skills:  4 WNL, 2 moderate learning difficulty

•  description of cerebral palsy:  5 quadriplegia, 1 hemiplegia

•  expressive language:  all spoke in sentence; usually simple sentence structures

•  receptive language:  at least 8.5 years on the Test of Receptive Grammar

                                                 

c.  Were the communication problems adequately described?  Yes

•  The disorder type: dysarthria

•  Other aspects of communication that were described:

–  intelligibility:  impaired

–  type of dysarthria:    3 spastic, 3 mixed

–  severity of dysarthria:  1 mild, 3 moderate, 2 severe

–  presence of apraxia:  1 yes, 5 no

–  prosodic characteristics:  3 slow speech, 6 low pitch, 2 reduced volume, 3  monotone, 1 variable volume, 2 narrow pitch range

                                                                                                                       

5.  Was membership in treatment maintained throughout the study?  Yes. Initially a seventh participant was identified but was excluded from this report due to severe hearing loss and presence of a cochlear implant.

a.  If there was more than one participant, did at least 80% of the participants remain in the study?  Yes

b.  Were any data removed from the study?  No 

 

6.  Did the design include appropriate controls? No, these were case studies, 

a.  Were preintervention data collected on all behaviors?  No. Participant satisfaction (Outcome #3) was not pretested but Outcomes #1 and 2 were pretested.

b.  Did probes/intervention data include untrained data?  Yes

c.  Did probes/intervention data include trained data?  No

d.  Was the data collection continuous?  No

e.  Were different treatment counterbalanced or randomized?  Not Applicable

 

7.  Were the outcomes measure appropriate and meaningful?  Yes

a.  The outcomes were:

SPEECH MEASURES

  OUTCOME #1:  Improved single word intelligibility on the Children’s Speech Intelligibility Measure (CSIM)

  OUTCOME #2:  Improved intelligibility of connected speech describing pictures of Renfrew’s Bus Story

SATISFACTION  MEASURE:

  OUTCOME #3:  Positive participant perception of intervention

  OUCOME #4:  Improve breath control for speech.  (Specific data were not provided for this outcome. Therefore, it will not be discussed further.)

b.  All the outcomes were subjective.

c.  None of the outcomes were objective.

d.  None of the outcome measures were supported with reliability data. Investigators noted that there was not good agreement among judges but did not provide supporting data.

 

8.  Results:

a.  Did the target behavior improve when it was treated?  Inconsistent, but even when there were notable difference, none of them were statistically different.

b.   The overall quality of improvement was

•  NOTE: Comparisons were for preintervention (Pre; 3 days of data collection, 3 judges), 1 week post intervention preintervention (Post1; 3 days of data collection, 3 judges), 7 weeks post intervention preintervention (Post7) 3 days of data collection, 3 judges)*

SPEECH MEASURES

OUTCOME #1:  Improved single word intelligibility on the Children’s Speech Intelligibility Measure (CSIM)

•  Pre vs Post1:  1P (slight); 3P (moderate);  1P (strong); 1P (contraindicated)

 Pre vs. Post7:  3P (slight); 1P  (strong); 2P (ineffective)  

OUTCOME #2:  Improved intelligibility of connected speech describing pictures of Renfrew’s Bus Story

•  Pre vs Post1:  3P (moderate); 2P (ineffective); 1P (contraindicated)

 Pre vs. Post7:  1P (slight); 4P (ineffective); 1P (contraindicated)

SATISFACTION  MEASURE:

OUTCOME #3:  Positive participant perception of intervention–  Investigators only provided descriptions of Ps’ responses following intervention.   Overall, Ps’ claimed that they thought the intervention was useful and indicated they would participate again.  The Ps offered concerns about dosage.

9.  Description of baseline:

a.  Were baseline data provided?  No

 

10.  What was the magnitude of the treatment effect?  NA

 

11.  Was information about treatment fidelity adequate?  No

 

12.  Were maintenance data reported?  Yes. The investigators administered post testing 1 week after treatment and 7 weeks after treatment. No significant differences were noted compared to pretesting. Descriptively, 4 Ps were notably better at the 7 week follow up for single words (Outcome #1) and one P appeared to be notably better in the 7 week follow up for connected speech (Outcome #2).

 

13.  Were generalization data reported?  No

 

OVERALL RATING OF THE QUALITY OF SUPPORT FOR THE INTERVENTION:  D-

 

SUMMARY OF INTERVENTION

 

PURPOSE:  To provide initial support for a systems approach for improving the intelligibility of children with cerebral palsy.

POPULATION:  dysarthria associated with cerebral palsy

 

MODALITY TARGETED:  Expression

 

ELEMENTS OF PROSODY USED AS INTERVENTION:  stress, loudness

 

OTHER ASPECTS OF LANGUAGE/COMMUNICATION TARGETED:  intelligibility, breath control for speech

DOSAGE:  5 days a week, 5 weeks, 20-30 minute sessions  (for students the number of sessions attended ranged from 15-22)

 

ADMINISTRATOR:  2 SLP students trained to administer the systems approach.  SLP students alternated in serving as Clinician or Assistant in sessions.

 

MAJOR COMPONENTS:

 

TECHNIQUES:  modeling, reinforcement, specific exercises (practiced 10 times in a block, criterion 9 correct in 3 successive blocks), explanation

STEPS:

1.  C described and discussed with P the importance of optimal breathing and posture/seating.

2.  Using 2 types of simple sentences, C instructed P to being exhaling as he/she initially vocalized at the beginning of the sentence. (There were 5 activities with the purpose of using breath control to modify loudness and mark stress in phrases.)

3. Step 2 was repeated but the target was using breath control to modify loudness and mark stress in connected speech (picture description, picture sequences, story telling).  Four activities were associated with this step.

NOTE:  None of the Ps completed the program in the prescribed timeline.


Samuelsson (2010)

August 29, 2013

Single Subject Research

Source: Samuelsson, C. (2010) Prosody intervention for children. In H. Roddam & J. Skeat (eds.) Embedding evidence-based practice in speech and language therapy: International examples (pp. 189-194). Chichester, UK: Wiley-Blackwell .

 

Reviewer(s):   pmh

 

Date:  8.16.13

 

Overall Assigned Grade:  C (The brevity of chapter resulted in the omission of much information.)

Level of Evidence:  A-

 

Take Away:  This very brief chapter consists of a description of a strategy for decision-making about prosodic intervention in a context of having little or no evidence supporting a particular approach. A brief presentation of a single subject experimental design study was provided illustrating the process.

 

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

 

2.  What type of evidence was identified?                              

a.  What  type of single subject design was used?  Single Subject Experimental Design with Specific Client  – Multiple Baseline       

b.  What was the level of support associated with the type of evidence?  Level = A-       

                                                                                                           

3.  Was phase of treatment concealed?

a.  from participants?  No

b.  from clinicians?  No

c.  from data analyzers?  No

 

4.  Were the participants adequately described?  Yes

a.  How many participants were involved in the study? 1

b.  The following characteristics were described

•  age:  4 years

•  gender:  m

•  expressive language:  WNL

•  receptive language:  WNL

•  Language:  Swedish

c.  Were the communication problems adequately described?  Yes          

•  The disorder types were  phonological disorder, prosodic disorder

•  Other aspects of communication were

–  problems with prosodic production at the word level, phase level, and discourse level on an instrument designed to assess Swedish prosody.

  –  prosodic perception was stronger than prosodic production 

                                                                                                                       

5.  Was membership in treatment maintained throughout the study? Not applicable

a.  If there was more than one participant, did at least 80% of the participants remain in the study?  Not  applicable

b.  Were any data removed from the study?  No. Data were not removed. However, due to the brief nature of the chapter, only summary statements were made. No specific data were reported.

 

6.  Did the design include appropriate controls?  Unclear. This was only a brief presentation.

a.  Were baseline/preintervention data collected on all behaviors?  Yes

b.  Did probes/intervention data include untrained data?  Yes

c.  Did probes/intervention data include trained data?  No

d.  Was the data collection continuous?  No

 

7.  Were the outcomes measure appropriate and meaningful?  Yes

a.  The outcomes were

  OUTCOME #1:  To improve prosody at the word level on a specific assessment instrument

  OUTCOME #2:  To improve prosody at the phrase level on a specific assessment instrument

  OUTCOME #3:  To improve prosody at the discourse level on a specific assessment instrument

b.  All of the outcomes were subjective.

c.  None of the outcomes were objective.

d.  None of the outcomes were associated with reliability data.

 

8.  Results:

a.  Did the target behavior improve when it was treated?  Yes. No specific data were reported. The characterizations were descriptive and provided in the prose of the chapter.

b.  The  overall quality of improvement was

OUTCOME #1:  To improve prosody at the word level on a specific assessment instrument  Effective

OUTCOME #2:  To improve prosody at the phrase level on a specific assessment instrument  Effective

OUTCOME #3:  To improve prosody at the discourse level on a specific assessment instrument  Slight improvement

9.  Description of baseline:

 

a.  Were baseline data provided? Yes

  OUTCOME #1:  To improve prosody at the word level on a specific assessment instrument:  3 times over 9 weeks

OUTCOME #2:  To improve prosody at the phrase level on a specific assessment instrument:  3 times over 9 weeks

OUTCOME #3:  To improve prosody at the discourse level on a specific assessment instrument:  3 times over 9 weeks

(continue numbering as needed)

 b.  Was baseline low and stable?

NOTE:  Data were not provided, but in the prose, the investigator described nature of baseline data.  The investigator described the prosodic problems as stable over the baseline period.

10.  What was the magnitude of the treatment effect?  NA

 

11.  Was information about treatment fidelity adequate?  Not Provided

 

12.  Were maintenance data reported?  Yes. Follow up administration of the assessment instrument revealed that the results were stable with some slight improvement.

 

13.  Were generalization data reported?  No. However, the assessment instrument involved word, phrase, and discourse contexts.

 

OVERALL RATING OF THE QUALITY OF SUPPORT FOR THE INTERVENTION: C

 

 

SUMMARY OF INTERVENTION

 

PURPOSE:  To investigate the effectiveness of a prosodic intervention designed to improve the prosodic skills of a child who speaks Swedish

POPULATION:  phonological disorder, prosodic disorder (Swedish)

 

MODALITY TARGETED:  comprehension and production

 

ELEMENTS/FUNCTIONS OF PROSODY TARGETED: lexical stress, phrasal stress, intonation

DOSAGE:  6 one-hour sessions plus homework

 

ADMINISTRATOR:  SLP and family

 

STIMULI:  auditory and visual

 

MAJOR COMPONENTS:

•  Basic Goal:  improve prosody at the word, phase, and discourse level

•  Intermediate Goal:  to produce prosodic contrasts at the word, phrase, and discourse level

WORD LEVEL

•  This was the main focus of intervention.

•  Intervention involved perception and production. Because P had stronger perception, perception was used to facilitate production.

•  C presented P with minimal pairs in Swedish. The two Swedish words differed in pitch direction (tonal word accent) and/or stress.  (The investigator provided illustrations of Swedish minimal pairs.)

PHRASAL LEVEL

•  Target: phrasal stress and intonation of real and nonsense sentence

•  P imitated C’s production of a real or nonsense sentences

DISCOURSE LEVEL
•  C recorded P’s discourse.

•  P listened to the recordings focusing on prosody.

•  It is assumed P discussed his production of prosody.

 


Rosenbek et al. (1974)

August 4, 2013

 

EBP THERAPY ANALYSIS for

Single Subject Designs

 

SOURCE:  Rosenbek, J., Hansen, R., Baughman, C. H., & Lemme, M. (1974). Treatment of developmental apraxia of speech: A case study. Language, Speech, and Hearing Services in Schools, 5, 13-22.

 

REVIEWER(S):  pmh

 

DATE:  7.21.13

ASSIGNED OVERALL GRADE:  D+  (this is the highest grade possible because of the case study design)

 

TAKE AWAY:  This case study provides limited evidence that an intervention program for childhood apraxia of speech that incorporated selected aspects of prosody (i.e., rate, stress) has potential for improving speech.

 

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

                                                                                                           

2.  What type of evidence was identified?                              

a.  What  type of single subject design was used?  Case Studies – Program Description with Case Illustration

b.  What was the level of support associated with the type of evidence? 

Level =  D                                                        

                                                                                                           

3.  Was phase of treatment concealed?

a.  from participants?  No

b.  from clinicians?  No

c.  from data analyzers?  Variable

 

4.  Were the participants adequately described?  Yes

a.  How many participants were involved in the study?  1

b.  The following characteristics were  described

•  age: 9 years

•  gender:  f

•  cognitive skills:  WNL but severe academic problems

•  hearing:   WNL

•  expressive language:  impaired

•  receptive language:  WNL

•  MLU:  sentences average 2-3 words                

•  educational level of participant: in second grade

•  prior therapy:  6 years

•  auditory discrimination:  WNL

c.  Were the communication problems adequately described?  Yes

•  The disorder types were  oral apraxia and developmental apraxia of speech (childhood apraxia of speech)

•  Other aspects of communication that were described:

–  intelligibility:  poor

–  articulation:  poor performance on Templin-Darley Test of Articulation; better in isolated words than in connected speech

–  stimulability:   most sounds were stimulable

–  expressive language:  sentences average 2-3 words; the following tended to be omitted:  articles, prepositions, verb forms

–  motor speech skills:  articulatory groping; difficulty initiating speech

–  auditory memory:  some depression but insufficient to explain communication problems

–  expressive-receptive language gap:  present

                                                                                                                       

5.  Was membership in treatment maintained throughout the study?  Not applicable

 

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

a.  Were baseline/preintervention data collected on all behaviors?  No, data were not collected for ALL the outcomes but it was collected for one outcome–/r/ production (Outcome #1).

b.  Did probes/intervention data include untrained data?  Yes

c.  Did probes/intervention data include trained data?  No

d.  Was the data collection continuous?  Yes, for Outcome #1

e.  Were different treatment counterbalanced or randomized? Not Applicable

 

7.  Were the outcomes measure appropriate and meaningful?  Yes

a.  The outcomes were

  OUTCOME #1:  To increase the number of correct productions of /r/ in a 20 item speaking task.

  OUTCOME #2:  To increase intelligibility rating in spontaneous conversation

b.  All the outcomes were subjective.

c.  None of the outcomes were objective.

d.  None of the outcome measures were accompanied by reliability data that are reliable:  none

 

8.  Results:

a.  Did the target behavior improve when it was treated?  Yes

b.  The overall quality of improvement for each of the outcomes was  

   OUTCOME #1:  To increase the number of correct productions of /r/ in a 20 item speaking task– strong

OUTCOME #2:  To increase intelligibility rating in spontaneous conversation– moderate

9.  Description of baseline:

a.  Were baseline data provided? Inconsistent, the first data point for Outcome #1 could be considered a baseline because the probe was administered before the sessions as were probes before each session.  For Outcome #2, spontaneous samples only were elicited before the first session, midway through the 22 sessions, and at the end of treatment. 

•  The number of data points for Outcome #1 was

    OUTCOME #1:  To increase the number of correct productions of /r/ in a 20 item speaking task— 1

b.  Was baseline low and stable?

  OUTCOME #1:  To increase the number of correct productions of /r/ in a 20 item speaking task—NA, only one baseline session.

c.  What was the percentage of nonoverlapping data (PND)?

NOTE:  The reviewer calculated PND

  OUTCOME #1:  To increase the number of correct productions of /r/ in a 20 item speaking task—95%

d.  Does inspection of data suggest that the treatment was effective?         

OUTCOME #1:  To increase the number of correct productions of /r/ in a 20 item speaking task—highly effective

 

10.  What was the magnitude of the treatment effect?  NA

 

11.  Was information about treatment fidelity adequate?  Not Provided

 

12.  Were maintenance data reported?  No

13.  Were generalization data reported? Yes. The second outcome was concerned with the intelligibility of speech in conversation and can be considered to be indicative of generalization. There was a

 

OVERALL RATING OF THE QUALITY OF SUPPORT FOR THE INTERVENTION:  __D+_____

 

SUMMARY OF INTERVENTION

 

PURPOSE:  To describe procedures for treating childhood apraxia of speech and provide an illustrative case study.

POPULATION:  childhood apraxia of speech

 

MODALITY TARGETED:  expression

 

ELEMENTS OF PROSODY USED AS INTERVENTION:  rate, prolongation, pause, sentence stress

 

 

OTHER ASPECTS OF LANGUAGE/COMMUNICATION TARGETED:  /r/ production, intelligibility

DOSAGE:  22 sessions over 3 months

 

ADMINISTRATOR:  SLP

 

STIMULI:  auditory, gesture, visual/written cues,

 

MAJOR COMPONENTS:

STEP 1:  In spaced drills, C taught P compensatory and facilitating behaviors such as

•  reduce speaking rate by prolonging vowels and continuant consonants

•  pause between syllables of multisyllabic words

•  add a schwa to consonant clusters

•  produce utterances with equal and even stress

A.  P produced target utterances using compensations. The utterances were controlled by type and complexity

•  type: sentences with carrier phrases and a target word (e.g., I see a ___), functional phrases (e.g., phone numbers, addresses), lists that were functional in school (e.g., days of the week, counting)

•  complexity:  utterances with ordered with the following considerations—

–  visible sounds before nonvisible sounds

–  distance between sounds in words with sounds closer to one another being targeted prior to words with sounds further apart.

•  C provided tangible reinforcement for correct attempts.

B.  C guided P’s arm to swing in a semicircle for each syllable of the targeted utterance (alternate motions could be using a finger to trace a pattern or squeezing a bean bag.)

C.  C provided P with written cues to encourage the production of the facilitators.  For example, with the utterance written on a card, the C included a symbol (e.g., U) under each syllable. The same symbol was used to cue the addition of the schwa between the sounds in a consonant cluster in a word such as ‘blue.’  (NOTE:  The investigators reported that this appeared to be very helpful.)

D.  C recorded P’s responses and worked with P to establish the skill of self-monitoring.

STEP 2:  Accurate production of sounds from the /r/ family.

— C reinforced P for correct behaviors.

— Order of targets was

•  monosyllable words with or without consonant clusters  (from 2nd grade reader)

•  multisyllabic words  (from 2nd grade reader)

•  phrases and sentences (C created and from 2nd grade reader)

The following were the criteria for a correct response:

•  correct production of /r/

•  slow speaking rate

•  equal and even stress

•  addition of schwa to consonant clusters

A.  C presented written words or phrases containing /r/ with visual cues from P’s 2nd grade reader.

B.  C first requested P to imitate target words/phrases and then to produce them spontaneously. C modeled and required P to accompany productions with swinging arm movements or with other rhythmic movements.

STEP 3:  Application of “chew” procedures

A.  To facilitate slow rate production, P directed C to produce target sentences as if she were chewing like a cow.

NOTE:  The stress compensations involved atypical stress patterns (equal and even stress).


Kollman (1991)

June 23, 2013

EBP THERAPY ANALYSIS for

Single Subject Designs

 

SOURCE:  Kollman, P. A. (1991). Modifying the prosody of a child with impaired phonology. (Unpublished Master’s Thesis). Kansas State University, Manhattan, Kansas

 

REVIEWER(S):  pmh

 

DATE:  6.07.13

ASSIGNED OVERALL GRADE:  A-

 

TAKE AWAY:  This replication of Hargrove et al. (1989) supports and extends the findings of the original paper. The multiple baseline single subject experimental design study determined that the procedure was successful in improving the use of contrastive stress on words in the subject and object position of sentences, although acquisition of stress on verbs was less successful. These findings were similar to the original study. The investigator also presented data indicating positive results for generalization (speaker, lexical items, location, intelligibility, phonological errors) and follow-up sessions.

https://clinicalprosody.wordpress.com/2013/06/23/krauss-galloway-1982/

 

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

 

2.  What type of evidence was identified?                              

a.  What  type of single subject design was used?  Single Subject Experimental Design with Specific Client – Multiple Baseline        

b.  What was the level of support associated with the type of evidence? 

Level =  A-                                                       

                                                                                                           

3.  Was phase of treatment concealed?                                 

a.  from participants?  No

b.  from clinicians?  No

c.  from data analyzers?  No

 

4.  Were the participants adequately described?  Yes

a.  How many participants were involved in the study? 1

b.  The following characteristics were described:

•  age:  4 years, 10 month

•  gender:  m

c.  Were the communication problems adequately described? Yes

•  The disorder type was phonological impairment   

Other aspects of communication that were described:

•  Intelligibility:

– initial evaluation:   73% known context; 50% unknown context;

– after adenoid removal:  highly intelligible, interpretable only in context

– after 6 week intervention:  still highly unintelligible, more difficult to understand than expected based on phonological improvement, especially in conversation

•  Prosody:

after adenoid removal:  primary stress on each work, perceived to be speaking one word at a time; excessive use of rising terminal contour;

– after 6 weeks of phonological intervention:  complex pitch changes. Infrequent falling terminal contour, excessive rate, excessive loudness

•  Overall language skills:

at first evaluation 5-11 month delay in semantics, syntax, vocabulary; – after removal of adenoids–receptive vocabulary, pragmatics, hearing WNL

•  Voice quality:  

– initially extremely hypernasal;

– after adenoid removal—improved markedly

•  Phonology:

PRIOR TO INITIAL (6 WEEK PHONOLOGICAL) INTERVENTION DISPLAYED

     –  consonant sequence reduction

     –  consonant postvocalic singleton omissions

     –  strident deficiency

     –  velar obstruent deficiency

     –  liquid deficiency

     –  glide deficiency

     –  glottal replacement

     –  epenthesis

     –  stopping

      –  gliding

     –  vowelization

     –  affrication

     –  deaffrication

     –  depalatization

     –  alveolar assimilation

     –  prevocalic voicing

     –  postvocalic voicing

AFTER INITIAL (6 WEEK) PHONOLOGICAL INTERVENTION

•  made rapid progress in phonological treatment

     –  but highly unintelligible in connected speech

•  Khan-Lewis Phonological Analysis

     –  composite score:  26  (CA equivalent = 3 years, 3 months

     –  simplification rating:  4

     –  simplification interpretation:   excessive use of phonological processes for CA

     –  use of phonological processes:   

        •  excessive  use—palatal fronting, liquid simplification

        •  moderate use—cluster simplification, syllable reduction, deletion of final consonants, stridency deletion, deaffrication

        •  average use—stopping of fricatives and affricatives, consonant harmony

                                                                                                                       

5.  Was membership in treatment maintained throughout the study?  Not applicable           

a.  If there was more than one participant, did at least 80% of the participants remain in the study?  Not  applicable

b.  Were any data removed from the study?  No

 

6.  Did the design include appropriate controls?  Yes

a.  Were baseline/preintervention data collected on all behaviors?  Yes

b.  Did probes/intervention data include untrained data?  Yes

c.  Did probes/intervention data include trained data?  Yes.  The home probes included some trained data.

d.  Was the data collection continuous?  Yes for treatment sessions, the investigator noted that probes were administered after each session.  However, home probes were administered on nontreatment days so they would not be continuous.

e.  Were different treatment counterbalanced or randomized?  Not Applicable 

 

7.  Were the outcomes measure appropriate and meaningful? Yes

a.  The outcomes were

TREATMENT OUTCOMES

  OUTCOME #1:  To produce an elicited sentence structure (SUBJECT + [is] + verb + ing + the + object) with primary stress on the subject and a falling terminal contour immediately after the treatment session.

  OUTCOME #2:  To produce an elicited sentence structure (subject + [is] + VERB + ing + the + object) with primary stress on the verb and a falling terminal contour immediately after the treatment session.

  OUTCOME #3:  To produce an elicited sentence structure (subject + [is] + verb + ing + the + OBJECT) with primary stress on the object and a falling terminal contour immediately after the treatment session.

GENERALIZATION OUTCOMES

  OUTCOME #4:  To produce an elicited sentence structure (SUBJECT + [is] + verb + ing + the + object) with primary stress on the subject and a falling terminal contour at home on nontreatment weekdays.

  OUTCOME #5:  To produce an elicited sentence structure (subject + [is] + VERB + ing + the + object) with primary stress on the verb and a falling terminal contour at home on nontreatment weekdays.

  OUTCOME #6:  To produce an elicited sentence structure (subject + [is] + verb + ing + the + OBJECT) with primary stress on the object and a falling terminal contour at home on nontreatment weekdays.

OUTCOME #7:  To improve phonological status (composite score, simplification rating, simplification interpretation, use of phonological processes on Khan-Lewis Phonological Analysis) from preintervention to post intervention

OUTCOME #8:  To increase intelligibility (percent consonants correct, PCC) in spontaneous speech from preintervention to post intervention.

b.  All the outcomes were subjective.

c.  List numbers of the outcomes that are objective:  none

7d.  List the number of the outcome measures that are reliable:  Outcomes #1-6

7e.  List the data supporting reliability of each outcome measure; the numbers should match item 7a.

INTERVENTION OUTCOMES

OUTCOME #1:  To produce an elicited sentence structure (SUBJECT + [is] + verb + ing + the + object) with primary stress on the subject and a falling terminal contour immediately after the treatment session.  Interobserver reliability:  85.7%

OUTCOME #2:  To produce an elicited sentence structure (subject + [is] + VERB + ing + the + object) with primary stress on the verb and a falling terminal contour immediately after the treatment session.  Interobserver reliability:  90.3%

OUTCOME #3:  To produce an elicited sentence structure (subject + [is] + verb + ing + the + OBJECT) with primary stress on the object and a falling terminal contour immediately after the treatment session.  Interobserver reliability:   95.2%

GENERALIZATION OUTCOMES

OUTCOME #4:  To produce an elicited sentence structure (SUBJECT + [is] + verb + ing + the + object) with primary stress on the subject and a falling terminal contour at home on nontreatment weekdays.  Interobserver reliability:  85.7%

OUTCOME #5:  To produce an elicited sentence structure (subject + [is] + VERB + ing + the + object) with primary stress on the verb and a falling terminal contour at home on nontreatment weekdays.  Interobserver reliability:  90.4%

OUTCOME #6:  To produce an elicited sentence structure (subject + [is] + verb + ing + the + OBJECT) with primary stress on the object and a falling terminal contour at home on nontreatment weekdays.  Interobserver reliability:  90.4%

 

8.  Results:

a.  Did the target behavior improve when it was treated?  Yes

b.  The overall quality of improvement for each of the objectives was match the numbers in item 7a.)

TREATMENT OUTCOMES

OUTCOME #1:  To produce an elicited sentence structure (SUBJECT + [is] + verb + ing + the + object) with primary stress on the subject and a falling terminal contour immediately after the treatment session.  Strong

OUTCOME #2:  To produce an elicited sentence structure (subject + [is] + VERB + ing + the + object) with primary stress on the verb and a falling terminal contour immediately after the treatment session.  Moderate

OUTCOME #3:  To produce an elicited sentence structure (subject + [is] + verb + ing + the + OBJECT) with primary stress on the object and a falling terminal contour immediately after the treatment session.  Moderate

GENERALIZATION OUTCOMES

OUTCOME #4:  To produce an elicited sentence structure (SUBJECT + [is] + verb + ing + the + object) with primary stress on the subject and a falling terminal contour at home on nontreatment weekdays.  Strong

OUTCOME #5:  To produce an elicited sentence structure (subject + [is] + VERB + ing + the + object) with primary stress on the verb and a falling terminal contour at home on nontreatment weekdays.  Limited

OUTCOME #6:  To produce an elicited sentence structure (subject + [is] + verb + ing + the + OBJECT) with primary stress on the object and a falling terminal contour at home on nontreatment weekdays.  Ineffective

OUTCOME #7:  To improve phonological status (composite score, simplification rating, simplification interpretation, use of phonological processes on Khan-Lewis Phonological Analysis) from preintervention to post intervention Strong

OUTCOME #8:  To increase intelligibility (percent consonants correct, PCC) in spontaneous speech from preintervention to post intervention.  Moderate

9.  Description of baseline:

a.  Were baseline data provided?  Yes

 

TREATMENT OUTCOMES

  OUTCOME #1:  To produce an elicited sentence structure (SUBJECT + [is] + verb + ing + the + object) with primary stress on the subject and a falling terminal contour immediately after the treatment session.  3 sessions

OUTCOME #2:  To produce an elicited sentence structure (subject + [is] + VERB + ing + the + object) with primary stress on the verb and a falling terminal contour immediately after the treatment session.  8 sessions

OUTCOME #3:  To produce an elicited sentence structure (subject + [is] + verb + ing + the + OBJECT) with primary stress on the object and a falling terminal contour immediately after the treatment session.  14 sessions

GENERALIZATION OUTCOMES

OUTCOME #4:  To produce an elicited sentence structure (SUBJECT + [is] + verb + ing + the + object) with primary stress on the subject and a falling terminal contour at home on nontreatment weekdays.   4 sessions

OUTCOME #5:  To produce an elicited sentence structure (subject + [is] + VERB + ing + the + object) with primary stress on the verb and a falling terminal contour at home on nontreatment weekdays.  9 sessions

OUTCOME #6:  To produce an elicited sentence structure (subject + [is] + verb + ing + the + OBJECT) with primary stress on the object and a falling terminal contour at home on nontreatment weekdays.  12 sessions

OUTCOME #7:  To improve phonological status (composite score, simplification rating, simplification interpretation, use of phonological processes on Khan-Lewis Phonological Analysis) from preintervention to post intervention  Not applicable

OUTCOME #8:  To increase intelligibility (percent consonants correct, PCC) in spontaneous speech from preintervention to post intervention.  Not applicable

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

For Outcomes #1-6 (the only applicable outcomes), for the most part, baselines were low and stable.

c.  What was the percentage of nonoverlapping data (PND)?  (The numbers should match the numbers in item 7a.  Note if there are insufficient data to calculate PND.)  Data for Outcomes #1-6 were abstracted from a figure by the reviewer.

  TREATMENT OUTCOMES

  OUTCOME #1:  To produce an elicited sentence structure (SUBJECT + [is] + verb + ing + the + object) with primary stress on the subject and a falling terminal contour immediately after the treatment session.  40%

OUTCOME #2:  To produce an elicited sentence structure (subject + [is] + VERB + ing + the + object) with primary stress on the verb and a falling terminal contour immediately after the treatment session.  67%

OUTCOME #3:  To produce an elicited sentence structure (subject + [is] + verb + ing + the + OBJECT) with primary stress on the object and a falling terminal contour immediately after the treatment session.  80%

GENERALIZATION OUTCOMES

OUTCOME #4:  To produce an elicited sentence structure (SUBJECT + [is] + verb + ing + the + object) with primary stress on the subject and a falling terminal contour at home on nontreatment weekdays.  75%

OUTCOME #5:  To produce an elicited sentence structure (subject + [is] + VERB + ing + the + object) with primary stress on the verb and a falling terminal contour at home on nontreatment weekdays.  67%

OUTCOME #6:  To produce an elicited sentence structure (subject + [is] + verb + ing + the + OBJECT) with primary stress on the object and a falling terminal contour at home on nontreatment weekdays.  0%

OUTCOME #7:  To improve phonological status (composite score, simplification rating, simplification interpretation, use of phonological processes on Khan-Lewis Phonological Analysis) from preintervention to post intervention  Not applicable

OUTCOME #8:  To increase intelligibility (percent consonants correct, PCC) in spontaneous speech from preintervention to post intervention.  Not applicable

 

d.  Does inspection of data suggest that the treatment was effective (i.e., interpretation of PND based on Schlosser & Wendt, 2008):

TREATMENT OUTCOMES

  OUTCOME #1:  To produce an elicited sentence structure (SUBJECT + [is] + verb + ing + the + object) with primary stress on the subject and a falling terminal contour immediately after the treatment session.  Ineffective

OUTCOME #2:  To produce an elicited sentence structure (subject + [is] + VERB + ing + the + object) with primary stress on the verb and a falling terminal contour immediately after the treatment session.  Fairly effective

OUTCOME #3:  To produce an elicited sentence structure (subject + [is] + verb + ing + the + OBJECT) with primary stress on the object and a falling terminal contour immediately after the treatment session.  Fairly effective

GENERALIZATION OUTCOMES

OUTCOME #4:  To produce an elicited sentence structure (SUBJECT + [is] + verb + ing + the + object) with primary stress on the subject and a falling terminal contour at home on nontreatment weekdays.  Fairly effective

OUTCOME #5:  To produce an elicited sentence structure (subject + [is] + VERB + ing + the + object) with primary stress on the verb and a falling terminal contour at home on nontreatment weekdays.  Fairly effective

OUTCOME #6:  To produce an elicited sentence structure (subject + [is] + verb + ing + the + OBJECT) with primary stress on the object and a falling terminal contour at home on nontreatment weekdays.  Ineffective

OUTCOME #7:  To improve phonological status (composite score, simplification rating, simplification interpretation, use of phonological processes on Khan-Lewis Phonological Analysis) from preintervention to post intervention  Not applicable

OUTCOME #8:  To increase intelligibility (percent consonants correct, PCC) in spontaneous speech from preintervention to post intervention.  Not applicable

 

10.  What was the magnitude of the treatment effect?  NA

 

11.  Was information about treatment fidelity adequate?  Yes. On page 24,the investigator noted that reliability was measured for treatment  fidelity and for judging correctness of P’s production.  The interobserver reliability was reported to be 90%.  It is not clear if this represents one type of reliability or overall reliability.  The averages for judging correctness are reported to be 90.6% (clinic) and 88.8% (home). (Overall reliability for these two is 89.7%.)

 

12.  Were maintenance data reported?  Yes.   Two types of follow-up data were collected. For Subject (Outcomes #1, 4) and Verb (Outcomes #2, 5), follow-up data consisted of (1) data sessions after the training sessions for the outcome were completed and (2) three follow up sessions approximately 2 months after the completion of the study. Both types of data indicated that the Ps maintained at least some progress.  For the Object (Outcomes #3, 6,  only the 2 months post intervention data were collected.  Again, P maintained some progress.

 

13.  Were generalization data reported? Yes. There were 2 types of generalization data:

1.  generalization from the clinic to the home (different location, clinician, time of day, objects)

2.  generalization from prosodic behaviors to nonprosodic behaviors (segmental phonology, intelligibility)

Both sets of data support generalization claims.

 

OVERALL RATING OF THE QUALITY OF SUPPORT FOR THE INTERVENTION:  ___A-____

 

SUMMARY OF INTERVENTION

PURPOSE:  To replicate and extend Hargrove et al. (1989)

POPULATION:  phonological impairment

 ODALITY TARGETED:  expression

ELEMENTS/FUNCTIONS OF PROSODY TARGETED:  stress-emphatic/contrastive; stress—sentence/phrasal;  intonation-terminal contour; overall intonation contour

OTHER ASPECTS OF LANGUAGE/COMMUNICATION TARGETED:  intelligibility (PCC); phonological status

DOSAGE:  30-40 minute treatment sessions, followed by 15 minute probes, 3 times a week, 8 weeks

ADMINISTRATOR:  SLI

STIMULI:  small dolls, toys, or objects; auditory stimuli; visual/kinesthetic cues

GOAL ATTACK STRATEGY: vertical

MAJOR COMPONENTS:

 Pretreatment task:

•  C taught P proper names for each of the dolls and objects involved in treatment and probes.

Intervention session:

     Parts:  Each session consisted of a treatment and probe part.  The probe always occurred after the treatment.

     Treatment Phases:  Because this investigation involved a multiple baseline design there were 3 phases.   Each phase lasted 6 sessions or until P’s performance during the probe for the target was 85% correct or better.  There were 3 treatment phases:

•  Subject

•  Verb + ing

•  Object

Home Probes:  To measure generalization, on nontreatment week days, a different clinician administered probes in P’s home, during a different time of day, with primarily different objects.

Treatment Procedures:

•  C enacted a scene using toys that could be described by a Subject + [is] + Verb+ing + Object sentence (e.g., Bo is holding the hat.)

•  C asks a question in which one part of the sentence is incorrect  (e.g., Is Pam holding the hat?)

•  The C’s incorrect query was tied to the Treatment Phase.  Thus, during the Subject Phase, C only produced the wrong subject in the questions; during the Verb+ ing Phase, C only the wrong verb; and so forth.

•  P’s targeted response consisted of the production of a Subject + [is] + Verb+ing + Object sentence in which the “error” word from C’s production is contradicted using emphatic stress (No, BO is holding the hat.), no stressing on function words and +ing,  using a falling terminal contour. NOTE: “is” was not required,

•  If P was correct, C provided verbal and tangible reinforcement.

•  If P was incorrect, C used, at her discretion, a variety of techniques to elicit the correct response  (explanation, modeling, hand cues) imitation requests, and redirection.