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Treatment of Underlying Forms: A Bayesian Meta-Analysis of the Effects of Treatment and Person-Related Variables on Treatment Response.

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Title: Treatment of Underlying Forms: A Bayesian Meta-Analysis of the Effects of Treatment and Person-Related Variables on Treatment Response.
Authors: Swiderski, Alexander M.1,2,3 aswiderski@pitt.edu, Quique, Yina M.4, Dickey, Michael Walsh1,2,3, Hula, William D.1,3
Source: Journal of Speech, Language & Hearing Research. Nov2021, Vol. 64 Issue 11, p4308-4328. 21p. 7 Charts, 3 Graphs.
Subject Terms: *Sentences (Grammar), *Aphasia, *Comprehension, *Speech therapy, *Vocabulary, *Evaluation, Deep structure (Linguistics), Aphasic persons, Treatment effectiveness, Online information services, Meta-analysis, Time, Systematic reviews, Severity of illness index, Time series analysis, Descriptive statistics, Statistical models, MEDLINE, Dose-response relationship in biochemistry
Abstract: Purpose: This meta-analysis synthesizes published studies using "treatment of underlying forms" (TUF) for sentencelevel deficits in people with aphasia (PWA). The study aims were to examine group-level evidence for TUF efficacy, to characterize the effects of treatment-related variables (sentence structural family and complexity; treatment dose) in relation to the Complexity Account of Treatment Efficacy (CATE) hypothesis, and to examine the effects of person-level variables (aphasia severity, sentence comprehension impairment, and time postonset of aphasia) on TUF response. Method: Data from 13 single-subject, multiple-baseline TUF studies, including 46 PWA, were analyzed. Bayesian generalized linear mixed-effects interrupted time series models were used to assess the effect of treatment-related variables on probe accuracy during baseline and treatment. The moderating influence of person-level variables on TUF response was also investigated. Results: The results provide group-level evidence for TUF efficacy demonstrating increased probe accuracy during treatment compared with baseline phases. Greater amounts of TUF were associated with larger increases in accuracy, with greater gains for treated than untreated sentences. The findings revealed generalization effects for sentences that were of the same family but less complex than treated sentences. Aphasia severity may moderate TUF response, with people with milder aphasia demonstrating greater gains compared with people with more severe aphasia. Sentence comprehension performance did not moderate TUF response. Greater time postonset of aphasia was associated with smaller improvements for treated sentences but not for untreated sentences. Conclusions: Our results provide generalizable group-level evidence of TUF efficacy. Treatment and generalization responses were consistent with the CATE hypothesis. Model results also identified person-level moderators of TUF (aphasia severity, time postonset of aphasia) and preliminary estimates of the effects of varying amounts of TUF for treated and untreated sentences. Taken together, these findings add to the TUF evidence and may guide future TUF treatment-candidate selection. [ABSTRACT FROM AUTHOR]
Copyright of Journal of Speech, Language & Hearing Research is the property of American Speech-Language-Hearing Association and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Education Research Complete
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  Data: Treatment of Underlying Forms: A Bayesian Meta-Analysis of the Effects of Treatment and Person-Related Variables on Treatment Response.
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  Data: <searchLink fieldCode="AR" term="%22Swiderski%2C+Alexander+M%2E%22">Swiderski, Alexander M.</searchLink><relatesTo>1,2,3</relatesTo><i> aswiderski@pitt.edu</i><br /><searchLink fieldCode="AR" term="%22Quique%2C+Yina+M%2E%22">Quique, Yina M.</searchLink><relatesTo>4</relatesTo><br /><searchLink fieldCode="AR" term="%22Dickey%2C+Michael+Walsh%22">Dickey, Michael Walsh</searchLink><relatesTo>1,2,3</relatesTo><br /><searchLink fieldCode="AR" term="%22Hula%2C+William+D%2E%22">Hula, William D.</searchLink><relatesTo>1,3</relatesTo>
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  Data: <searchLink fieldCode="JN" term="%22Journal+of+Speech%2C+Language+%26+Hearing+Research%22">Journal of Speech, Language & Hearing Research</searchLink>. Nov2021, Vol. 64 Issue 11, p4308-4328. 21p. 7 Charts, 3 Graphs.
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  Data: *<searchLink fieldCode="DE" term="%22Sentences+%28Grammar%29%22">Sentences (Grammar)</searchLink><br />*<searchLink fieldCode="DE" term="%22Aphasia%22">Aphasia</searchLink><br />*<searchLink fieldCode="DE" term="%22Comprehension%22">Comprehension</searchLink><br />*<searchLink fieldCode="DE" term="%22Speech+therapy%22">Speech therapy</searchLink><br />*<searchLink fieldCode="DE" term="%22Vocabulary%22">Vocabulary</searchLink><br />*<searchLink fieldCode="DE" term="%22Evaluation%22">Evaluation</searchLink><br /><searchLink fieldCode="DE" term="%22Deep+structure+%28Linguistics%29%22">Deep structure (Linguistics)</searchLink><br /><searchLink fieldCode="DE" term="%22Aphasic+persons%22">Aphasic persons</searchLink><br /><searchLink fieldCode="DE" term="%22Treatment+effectiveness%22">Treatment effectiveness</searchLink><br /><searchLink fieldCode="DE" term="%22Online+information+services%22">Online information services</searchLink><br /><searchLink fieldCode="DE" term="%22Meta-analysis%22">Meta-analysis</searchLink><br /><searchLink fieldCode="DE" term="%22Time%22">Time</searchLink><br /><searchLink fieldCode="DE" term="%22Systematic+reviews%22">Systematic reviews</searchLink><br /><searchLink fieldCode="DE" term="%22Severity+of+illness+index%22">Severity of illness index</searchLink><br /><searchLink fieldCode="DE" term="%22Time+series+analysis%22">Time series analysis</searchLink><br /><searchLink fieldCode="DE" term="%22Descriptive+statistics%22">Descriptive statistics</searchLink><br /><searchLink fieldCode="DE" term="%22Statistical+models%22">Statistical models</searchLink><br /><searchLink fieldCode="DE" term="%22MEDLINE%22">MEDLINE</searchLink><br /><searchLink fieldCode="DE" term="%22Dose-response+relationship+in+biochemistry%22">Dose-response relationship in biochemistry</searchLink>
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  Group: Ab
  Data: Purpose: This meta-analysis synthesizes published studies using "treatment of underlying forms" (TUF) for sentencelevel deficits in people with aphasia (PWA). The study aims were to examine group-level evidence for TUF efficacy, to characterize the effects of treatment-related variables (sentence structural family and complexity; treatment dose) in relation to the Complexity Account of Treatment Efficacy (CATE) hypothesis, and to examine the effects of person-level variables (aphasia severity, sentence comprehension impairment, and time postonset of aphasia) on TUF response. Method: Data from 13 single-subject, multiple-baseline TUF studies, including 46 PWA, were analyzed. Bayesian generalized linear mixed-effects interrupted time series models were used to assess the effect of treatment-related variables on probe accuracy during baseline and treatment. The moderating influence of person-level variables on TUF response was also investigated. Results: The results provide group-level evidence for TUF efficacy demonstrating increased probe accuracy during treatment compared with baseline phases. Greater amounts of TUF were associated with larger increases in accuracy, with greater gains for treated than untreated sentences. The findings revealed generalization effects for sentences that were of the same family but less complex than treated sentences. Aphasia severity may moderate TUF response, with people with milder aphasia demonstrating greater gains compared with people with more severe aphasia. Sentence comprehension performance did not moderate TUF response. Greater time postonset of aphasia was associated with smaller improvements for treated sentences but not for untreated sentences. Conclusions: Our results provide generalizable group-level evidence of TUF efficacy. Treatment and generalization responses were consistent with the CATE hypothesis. Model results also identified person-level moderators of TUF (aphasia severity, time postonset of aphasia) and preliminary estimates of the effects of varying amounts of TUF for treated and untreated sentences. Taken together, these findings add to the TUF evidence and may guide future TUF treatment-candidate selection. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Journal of Speech, Language & Hearing Research is the property of American Speech-Language-Hearing Association and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=ehh&AN=153519502
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        Value: 10.1044/2021_JSLHR-21-00131
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      – Code: eng
        Text: English
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      – SubjectFull: Aphasia
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      – SubjectFull: Comprehension
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      – SubjectFull: Dose-response relationship in biochemistry
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      – TitleFull: Treatment of Underlying Forms: A Bayesian Meta-Analysis of the Effects of Treatment and Person-Related Variables on Treatment Response.
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              Text: Nov2021
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