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.

项目概要/摘要 尽管《残疾人教育法》(IDEA) 确保所有残疾儿童 提供适当的公共教育，但在提供言论方面存在着日益不平等的现象 由于公共场合言语语言病理学家（SLP）严重短缺，美国各地的语言服务受到影响 学校设置。远程医疗是缓解短缺问题的一种方法。目前可用的远程治疗研究 已经以小样本量和不同的方法严格性进行了。特别是，迄今为止还没有 通过远程治疗对有腭裂 (CP) 病史的儿童进行了治疗效果研究。 脑瘫修复后的儿童通常会出现代偿性发音模式，这在儿童中并不常见 患有言语障碍。确定远程治疗对于脑瘫修复儿童是否有效至关重要 来治疗代偿性关节。在评估代偿性关节误差时，存在两个主要局限性 在当前的文献中。首先，这些错误主要是根据听者的听觉感知来检查的。 没有仪器分析的判断；第二，言语感知如何在生产中发挥作用 尽管大量证据表明代偿性关节之间存在相互作用，但尚未得到充分研究 感知能力和制作能力。 作为 I 期随机对照试验 (RCT)，该提案响应了 NIDCR 行为社会研究 干预临床试验规划和实施合作协议（UG3/UH3）。该提案符合 NIDCR 的战略计划旨在为患有以下疾病的儿童制定和测试有效的行为干预措施： 口腔和颅面疾病。我们在 UG3 一年规划期间的目标是 (1) 最终确定干预措施 协议，(2) 开发操作手册，(3) 为数据管理系统开发定制软件， (4) 语音感知实验的刺激和软件开发，以完成无偏见的实验 UH3 阶段的 RCT 设计。我们在 UH3 阶段的主要目标是（目标 1）确定 对脑瘫修复儿童进行远程言语干预（目标 2）定量定义补偿 使用仪器分析确定发音错误，以及（目标 3）确定儿童的言语感知缺陷 与CP。这项研究将具有临床意义，因为目标 1 将帮助临床医生做出基于证据的研究 决定采用远程医疗服务提供模式来治疗脑瘫修复儿童。目标 2-3 将提供 使用仪器分析评估言语产生和识别言语的重要临床原理 临床医生治疗脑瘫儿童时存在感知缺陷。这项研究的重要性通过 当前的 COVID-19 大流行。学校已实施相关的社交距离限制 教师和 SLP 采用远程医疗，同时继续提供教育和治疗服务。因此， 拟议研究的结果将满足儿童远程治疗功效研究日益增长的需求 患有言语障碍。