Date of Award

12-2016

Degree Type

Selective Evidence-Based Medicine Review

Degree Name

Master of Science in Health Sciences - Physician Assistant

Department

Physician Assistant Studies

Department Chair

John Cavenagh, MBA, PhD, PA-C

Abstract

Objective: The objective of this EBM review was to determine if increasing speech production & language acquisition through therapies which emphasized speech therapy, would improve verbal communication skills in autistic individuals.

Study Design: Three RCTs selected due to relevance to the proposed question and fulfillment of the requirement of measuring POEMs.

Data Sources: All articles were published in peer-reviewed journals via PubMed.

Outcome Measures: The Preschool Language Scale 4 and Comprehensive Assessment of Spoken Language was measured pre-intervention and 12 months later. The verbal production evaluation scale which measured phonology, pragmatics, prosody, and sematic features. The number of verbal attempts, correct words used (list of target words assessed at baseline and beginning of each treatment week for reassessment).

Results: The results from Casenhiser et al. demonstrated that language development improved with the intervention group (MEHRIT therapy). The mean changes from pretest was 0.61 w/SD of 0.32.1 Post treatment was a mean of 0.72 w/SD of 0.39. The MEHRIT group had p=0.038.1 Lim et al. examined the speech therapy group to a music therapy group and control. The change in score of speech production pre-post test was a mean of +65.33, SD 56.89. Comparing speech vs control had a mean difference of 64.405, SD 12.973. When comparing speech to no treatment the p value was <0.001 indicating large effect of speech treatment. When comparing speech pretest and post-test the p value was <0.001. Sandiford et al. evaluated melodic based communication/speech therapy vs. traditional speech therapy. It was determined that both improved their social skills through F score. Number of verbal attempts for both groups had F=6.9 and F=4.1 for number of correct words. The p value for number of verbal attempts was p<0.001 and p<0.04 for number of correct words.

Conclusions: Although inconclusive, there was improvement in communication skills gained through the 3 RCTs above suggesting that early intervention and speech therapy is critical to development.

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