Speech Intervention via Telepractice for Children with Repaired Cleft Palate : Randomized Controlled Trial and Assessment of Speech Production and Perception Skills

通过远程练习对腭裂修复儿童进行言语干预：言语产生和感知技能的随机对照试验和评估

• 批准号: 10280767
• 负责人: Sue Ann Soyoung Lee
• 金额: $ 39.92万
• 依托单位: TEXAS TECH UNIVERSITY HEALTH SCIS CENTER
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-09 至 2023-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10280767
• 关键词: Acoustics; Adopted; Affect; Agreement; Articulation; Auditory; Behavior; Behavior Therapy; Behavioral; COVID-19 pandemic; Characteristics; Child; Cleft Palate; Clinical; Clinical Trials; Communication; Computer software; Custom; Data; Data Management Resources; Development; Disabled Children; Disabled Persons; Education; Effectiveness; Emotional; Ensure; Evaluation; Genetic Transcription; Goals; Healthcare; Individual; Intervention; Intervention Studies; Judgment; Language; Literature; Manuals; Measures; Methodology; Methods; Mission; Modeling; Monitor; Mouth Diseases; National Institute of Dental and Craniofacial Research; Output; Parents; Pathologist; Patients; Pattern; Perception; Pharyngeal structure; Phase; Physiological; Play; Population; Process; Production; Protocols documentation; Randomized; Randomized Controlled Trials; Recording of previous events; Reporting; Research; Role; Safety; Sample Size; School Teachers; School-Age Population; Schools; Self-control as a personality trait; Service delivery model; Services; Severities; Social Distance; Speech; Speech Disorders; Speech Perception; Stimulus; Strategic Planning; Technology; Testing; Therapeutic; Time; Treatment Efficacy; Treatment Protocols; Treatment outcome; U-Series Cooperative Agreements; United States; United States National Institutes of Health; acoustic imaging; base; clinically significant; control trial; craniofacial disorder; efficacy research; efficacy study; efficacy testing; evidence base; executive function; experimental study; functional outcomes; glottis; health care service; improved; innovation; instrumentation; intervention program; language impairment; operation; programs; public education; repaired; rural area; service delivery; skills; social; social interventions; software development; treatment effect; trial comparing; trial design; underserved rural area; urban area

PROJECT SUMMARY/ABSTRACT Although the Individuals with Disabilities Education Act (IDEA) ensures that all children with disabilities are provided with appropriate public education, there is an increasing inequity in the provision of speech- language services across the U.S. due to the critical shortage of speech-language pathologists (SLPs) in public school settings. Telepractice is one way to mitigate the shortage issue. Currently available telepractice studies have been conducted with small sample sizes and varying methodological rigor. In particular, to date no treatment efficacy studies via telepractice have been conducted on children with a history of cleft palate (CP). Children with repaired CP often develop compensatory articulation patterns which are not common in children with speech disorders. It is imperative to identify whether telepractice is efficacious for children with repaired CP to treat compensatory articulation. In evaluation of compensatory articulation errors, two major limitations exist in the current literature. First, these errors are mainly examined based on the listener's auditory-perceptual judgement without instrumental analysis; second, how speech perception plays a role in production of compensatory articulation has not been fully investigated although ample evidence suggests interplay between perception and production skills. As a Phase I randomized controlled trial (RCT), this proposal responds to the NIDCR Behavioral Social Intervention Clinical Trial Planning & Implementation Cooperative Agreement (UG3/UH3). This proposal fits with NIDCR's Strategic Plan in that it aims to develop and test an effective behavioral intervention for children with oral and craniofacial disorders. Our aim during the UG3 one-year planning period is to (1) finalize the intervention protocols, (2) develop the Manual of Operations, (3) develop custom software for the data management system, and (4) stimuli and software development for the speech perception experiment in order to complete an unbiased RCT design for the UH3 phase. Our primary aims during the UH3 phase are (Aim 1) to establish the efficacy of telepractice speech intervention for children with repaired CP, and (Aim 2) to quantitatively define compensatory articulation errors using instrumentation analyses, and (Aim 3) to determine speech perception deficits in children with CP. This research will be clinically significant because Aim 1 will assist clinicians to make evidence-based decisions to adopt a telepractice service delivery model to treat children with repaired CP. Aims 2-3 will provide important clinical rationales to evaluate speech production using instrumental analyses and to identify speech perception deficits when clinicians treat children with CP. The importance of this study is highlighted by the current COVID-19 pandemic. The associated social-distancing restrictions have been imposed upon school teachers and SLPs to adopt telepractice while continuing to provide educational and therapeutic services. Thus, the results of the proposed study will meet an increasing demand for telepractice efficacy studies for children with speech disorders.

项目摘要/摘要 尽管《残疾人教育法案》（思想）确保所有残疾儿童 提供了适当的公共教育，在提供言论的情况下越来越不平等 - 由于语音语言病理学家（SLP）的严重短缺，美国各地的语言服务 学校设置。远程治疗是减轻短缺问题的一种方法。目前可用的远程治疗研究 已经以较小的样本量和不同的方法论严格进行。特别是迄今为止尚未 通过远程治疗的治疗功效研究已经针对具有left裂病史（CP）的儿童进行了。 维修CP的儿童通常会出现补偿性发音模式，这些模式在儿童中并不常见 言语障碍。必须确定远程治疗是否对修复CP的儿童有效 治疗补偿性表达。在评估补偿性发音错误时，存在两个主要局限性 在当前的文献中。首先，这些错误主要根据听众的听觉检查进行检查 没有器乐分析的判断；第二，语音感知如何在生产中发挥作用 尽管有足够的证据表明相互作用 感知和生产技巧。 作为I期随机对照试验（RCT），该建议对NIDCR行为社会做出响应 干预临床试验计划与实施合作协议（UG3/UH3）。该提议适合 NIDCR的战略计划是为了开发和测试 口腔和颅面疾病。我们在UG3一年计划期间的目标是（1）完成干预措施 协议，（2）制定操作手册，（3）为数据管理系统开发自定义软件， （4）语音感知实验的刺激和软件开发，以完成公正 UH3阶段的RCT设计。我们在UH3阶段的主要目的是（目标1）确定 修复CP的儿童和（AIM 2）定义补偿性的远程疗法语音干预 使用仪器分析的发音错误，（目标3）确定儿童的语音感知缺陷 与CP。这项研究将在临床上具有重要意义，因为AIM 1将帮助临床医生进行基于证据的 决定采用远程治疗服务交付模型来治疗修复CP的儿童。目标2-3将提供 重要的临床原理，以使用仪器分析评估语音产生并确定语音 当临床医生治疗CP儿童时，感知赤字。这项研究的重要性由 当前的COVID-19大流行。相关的社交限制已在学校施加 教师和SLP在继续提供教育和治疗服务的同时，采用远程疗法。因此， 拟议的研究结果将满足对儿童远程疗效研究的需求不断增长 言语障碍。