A Systematic Review of Prosody Implementation by Speech-Language Pathologists in Therapeutic Interaction

Abstract

Background: Prosody (intonation, pitch, stress, rhythm, speech rate) plays a dual role in speech-language therapy: as both an intervention target and a therapeutic communication tool. Objectives: This study aimed to systematically analyze the implementation of prosody by speech-language pathologists (SLPs) in therapeutic interactions, encompassing clinical practices, barriers, and psychological factors. Methods: A systematic literature review (SLR) was conducted following PRISMA 2020 guidelines, searching PubMed, Scopus, CINAHL, PsycINFO, and ASHAWire for studies published between 2015 and 2026. Of 1,240 identified articles, 7 studies met the inclusion criteria. Results: Thematic synthesis revealed four main themes: low frequency of prosody assessment (only 18–23% of SLPs routinely assessed prosody); primary barriers including lack of formal training (74%), knowledge deficits (67%), and unavailability of practical assessment tools (72–82%); psychological factors positively correlated with clinical practice frequency; and a consistent implementation gap across countries (USA, France, India, Germany). Conclusion: This study recommends integrating prosody as a core competency in SLP curricula and developing practical, validated prosody assessment tools.

Keywords: Prosody, Speech-Language Pathologist, Speech Therapist, Therapeutic Interaction, Systematic Review.