JCPSLP vol 19 no 3 2017 low res. pdf

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JCPSLP Volume 19, Number 3 2017 165
Ayer, A., Yalınçetin, B., Aydınlı, E., Sevilmiş, S., Ulaş,
H., Binbay, T., Akdede, B. B., & Alptekin, K. (2016).
Formal thought disorder in first-episode psychosis.
Comprehensive Psychiatry , 70, 209–215. doi:10.1016/j.
comppsych.2016.08.005
Bambini,V., Arcara, G., Bechi, M., Buonocore, M.,
Cavallaro, R., & Bosia, M. (2016). The communicative
impairment as a core feature of schizophrenia: Frequency
of pragmatic deficit, cognitive substrates, and relation
with quality of life. Comprehensive psychiatry, 71, 106–0.
doi:10.1016/j.comppsych.2016.08.012
up assessments at 3 and 6 months post intervention to
establish retention of skills. With the necessary consent
in place, Ellie is hoping to document Mark’s response to
intervention in the form of a single case design and submit
for publication in order to add to the evidence base.
References
Arntzen, E., Tonnessen, I. R., & Brouwer, G. (2006).
Reducing aberrant verbal behaviour by building a repertoire
of rational verbal behavior. Behavioral Interventions, 21,
177–193. doi:10.1002/bin.220
Table 1. Critical appraisal of Joyal et al. (2016)
Joyal M., Bonneau, A., & Fecteau, S. (2016). Speech and language therapies to improve pragmatics and discourse skills in patients
with schizophrenia. Psychiatry Research, 240, 88–95.
Question Y/N Comments
1. Did the review
address a clearly
formulated
question?
Y A clinical question is clearly stated, but the wording of it is potentially misleading. The question aims to
“identify the importance of speech and language therapy (SLT) as part of rehabilitation curriculum for
patients with schizophrenia”; however, the review considers interventions targeting a range of cognitive
parameters which happen to include areas of speech or language, not necessarily conducted by a speech
and language therapist/speech-language pathologist.
2. Did the authors
look for the right
type of papers?
Y Articles reporting original data were included, regardless of the type of study. No randomised control trials
were available for inclusion. Four articles reported outcomes of single case studies.
3. Do you think all
the important,
relevant studies
were included?
Unsure Difficult to answer given the possible ambiguity of the question. Whether the selected articles actually
address the clinical question depends on how the term “speech and language therapy” is defined. Articles
that were discarded based on exclusion criteria are not listed, though Ellie is aware at least one additional
article (Arntzen et al., 2006) that appears to match the inclusion criteria but was not included in the review.
4. Did the review’s
authors do
enough to assess
the quality of the
included studies?
N The authors did not include a measure of quality (e.g., PEDro scale) for any of the studies. Given that there
were three single case studies included and no randomised control trials, a qualitative score would have
provided more information about the level of validity of the selected studies.
5. If the results of
the review have
been combined,
was it reasonable
to do so?
N/A Results have not been combined as the authors recognised that the broad term “speech and language
therapies” could refer to a variety of different aspects of communication that cannot be compared (e.g.,
speech versus language versus pragmatics). Therefore, results have been divided into three main categories
(see below).
6. What are the
overall results of
the review?
Results are mixed and multifaceted because the authors examined three key areas of each intervention:
1. Therapeutic approach → The most common approach was “operant conditioning” which presented mixed results.
2. Speech and language abilities → The authors report that “pragmatics and discourse skills” can be successfully
targeted and that improvements can be “retained over time”. With only 5/12 studies targeting these areas including
follow-up measures post study, further evidence is needed to substantiate that claim.
3. Therapy setting → Mixed results. Benefits were reported for both individual and group therapy settings but without
enough data to draw any solid conclusions.
7. How precise are
the results?
Effect sizes (Glass’s delta) are provided for 6 studies but no confidence intervals are provided. Only 6 /18 studies
provided quantitative data (means and standard deviations), thus meta-analysis of the studies is not possible.
8. Can the results
be applied to the
local population?
Y Yes, because studies included participants over the age of 18 with a diagnosis of schizophrenia.
9. Were all important
outcomes
considered?
N According to the authors, 9/18 studies had no follow-up measure, so it is unclear whether positive results
were consistently maintained post intervention. Authors state pragmatic and discursive skills can be
successfully targeted and maintained, but only 5/12 studies targeting these areas had follow-up post study.
10. Are the benefits
worth the harms
and costs?
Unsure There is no perceived harm to receiving speech and language therapy intervention; however, further
research is needed regarding the financial cost and potential benefits.
Summary Low-level systematic review due to paucity of high-level and/or quantitative studies, so unable to do meta-analysis. The
heterogeneity of the speech and language therapy areas being studied and the different design and methods of each
study make comparison between studies difficult. For single case studies and small cohort studies, the authors did not
provide a measure of research quality.