Identifying and Treating Childhood Apraxia of Speech in Minimally Verbal Children with Autism

识别和治疗很少言语的自闭症儿童的儿童期言语失用症

基本信息

批准号：
10382142
负责人：
KAREN V CHENAUSKY
金额：
$ 3.32万
依托单位：
MGH INSTITUTE OF HEALTH PROFESSIONS
依托单位国家：
美国
项目类别：
财政年份：
2019
资助国家：
美国
起止时间：
2019-09-01 至 2021-11-30
项目状态：
已结题

项目摘要

Although one in four children with autism remain minimally verbal past age five, we do not know all the factors that limit spoken language in these minimally verbal children with autism. One powerful contributor may be a concomitant motor speech disorder, Childhood Apraxia of Speech (CAS). CAS is an impairment in the ability to plan and sequence for speech, which renders speech inconsistent and imprecise. But because producing intelligible speech is a prerequisite to acquiring spoken language, there is an urgent need to understand how CAS may affect speech movements and intelligibility in minimally verbal children with autism, and to develop interventions that incorporate strategies to address CAS, when present. This project proposes three studies to investigate the relationship between CAS and speech in minimally verbal children with autism and CAS. First, we compare a group of 11 minimally verbal children with autism who meet criteria for CAS to a group of 11 who do not meet criteria for CAS. We hypothesize that facial movement tracking, a non-invasive method to investigate speech motor function, will reveal that the +CAS group show lower movement consistency and precision than the –CAS group. Next, we investigate the relationship of clinical signs of CAS to speech movement parameters and to intelligibility. We hypothesize that more severe CAS predicts lower movement consistency and precision, and lower intelligibility, in an additional group of 22 minimally verbal children with autism+CAS. Finally, we use the previous investigations to inform treatment for a group of 20 minimally verbal children with autism+CAS. First we identify the speech movements for each child that are both disordered and degrade intelligibility,. Then, we create a set of mono- and bisyllabic stimuli involving these movements and train participants on a subset of them in a series of single-subject experiments. Treatment will involve principles of motor learning (massed and distributed practice) and dynamic cueing, which have been shown to be effective for treating CAS. Both perceptual (intelligibility-based) and objective (movement-based) outcome measures will demonstrate the extent to which this targeted treatment improves speech production in these children. The findings will inform clinical practice for minimally verbal children with autism and lead to the development of novel interventions for this severely affected population.

尽管四分之一的自闭症儿童过去五岁的言语仍然很少，但我们并不了解在这些自闭症的最低言语儿童中限制口语的因素。一个强大的贡献者可能是一种伴随的运动言语障碍，儿童言语失用（CAS）。 CAS 是计划和序列序列的损害，这使语音不一致并暗示。但是因为发表可理解的演讲是获取口语的先决条件语言，迫切需要了解CAS如何影响语音运动和对自闭症自闭症的最低言语儿童的清晰性，并制定结合的干预措施在场时解决CA的策略。该项目提出了三项研究，以调查 CAS与言语中的CAS与自闭症和CAS的言语之间的关系。首先，我们比较一组11个最小口头的自闭症儿童，他们符合CAS的标准与一群 11谁不符合CAS的标准。我们假设面部运动跟踪是一种无创的调查语音运动功能的方法，将揭示 +CAS组显示较低运动一致性和精度比–CAS组。接下来，我们研究临床体征的关系 CAS到语音运动参数和清晰度。我们假设更严重的CAS 预测较低的运动一致性和精确度，并降低了一组 22个自闭症+CAS的最小口头儿童。最后，我们使用以前的调查通知一组20个自闭症+CAS的最小口头儿童的治疗。首先，我们确定演讲每个既无序和降解智力的孩子的运动。然后，我们创建一个集合单声道和双音节刺激涉及这些运动，并在其中的一部分上训练参与者在一系列单个受试者实验中。治疗将涉及运动学习原理（群众）和分布式实践）和动态提示，这些提示已被证明有效治疗 CAS。感知（基于清晰度）和客观（基于运动）的结果度量都将证明该靶向治疗在多大程度上改善了这些治疗的言语产生孩子们。这些发现将为有自闭症的最低言语儿童提供临床实践，并导致针对这一受到严重影响的人群的新干预措施的发展。