Testing the efficacy of a novel intervention for minimally verbal children with

测试一种新颖的干预措施对语言能力极差的儿童的有效性

• 批准号: 8426946
• 负责人: GOTTFRIED SCHLAUG
• 金额: $ 37.76万
• 依托单位: BOSTON UNIVERSITY (CHARLES RIVER CAMPUS)
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-09-04 至 2017-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8426946
• 关键词: Affect; Aftercare; Architecture; Area; Auditory; Behavioral; Brain; Brain imaging; Brain region; Characteristics; Child; Cognitive; Communication; Communication impairment; Complement; Data; Educational Intervention; Fiber; Frequencies; Hand; Individual; Inferior frontal gyrus; Instruction; Intervention; Laboratories; Language; Lead; Left; Maps; Measures; Methods; Motor; Motor Activity; Movement; Music; Oral; Outcome; Output; Parietal; Pathway interactions; Play; Production; Randomized Clinical Trials; Randomized Controlled Trials; Relative (related person); Reporting; Role; Speech; Speech Sound; Superior temporal gyrus; Techniques; Therapeutic; Time; Training; Treatment outcome; auditory feedback; base; behavior measurement; comparative efficacy; design; efficacy testing; improved; innovation; joint attention; melodic intonation therapy; neuroimaging; neuromechanism; novel; phrases; preference; relating to nervous system; response; skills; sound; success; treatment effect

Although up to 30% of individuals with ASD are minimally verbal, extremely few interventions can reliably produce significant improvements in speech output. Recently, our laboratory has developed Auditory-Motor Mapping Training (AMMT), a novel intonation-based intervention, which aims to facilitate speech output in minimally verbal children with ASD. This intervention involves the mapping of sounds to oral articulatory actions through intonation and bimanual motor activities. AMMT is built upon the musical strengths and preferences that have been observed in these children. Furthermore, associating sounds with actions engages an auditory-motor network of brain regions important for speech that has been reported to be dysfunctional in ASD. The overall aim of the study is to compare the efficacy of AMMT to that of a control therapy (CT) in facilitating speech output in a randomized controlled trial (RCT). To examine whether the core components of AMMT are responsible for the treatment effects, CT will omit the intonation and motor components. The accuracy of each child's speech output will be assessed multiple times before, during, and after treatment by independent coders. Our overall aim will also be complemented by two additional aims, in which we will examine whether frequency of AMMT affects treatment outcome, and whether pre-existing variability in language-related pathways and functional connections correlate with outcome, and is changed after treatment. Based on our preliminary data, we hypothesize that: (1) compared to CT, AMMT will result in significantly greater improvements in the accuracy of consonant and vowel productions, with generalization to items that are not trained during the therapy,and more appropriate words after therapy, (2) greater improvements will be observed in individuals who undergo higher frequency (compared to lower frequency) of AMMT, (3) baseline behavioral measures (e.g., cognitive, speech praxis, joint attention abilities) will be related to the degree of speech improvements in both AMMT and CT, and (4) the degree of variability infunctional and structural brain connections will be related to AMMT treatment outcome, and (5) intensive AMMT treatment will lead to increased functional connections in the auditory-motor network. By using a combination of behavioral and brain imaging measures, the proposed study will examine the efficacy of a novel intervention, and enhance our understanding of the underlying neural mechanisms that underlie the therapy effects.

尽管高达30％的ASD患者的口头是最少的，但很少有干预措施可可靠地改善语音输出。最近，我们的实验室开发了一种基于语调的新干预措施（AMMT）的听觉运动映射培训（AMMT），旨在促进具有ASD的最小口头儿童的语音输出。这种干预涉及将声音映射到口头发音 通过语调和双人运动活动的行动。 AMMT建立在这些孩子中观察到的音乐优势和偏好之上。此外，将声音与动作相关联使大脑区域的听觉运动网络与言语重要性相关联，据报道在ASD中具有功能失调。该研究的总体目的是将AMMT与对照疗法（CT）的功效进行比较，在随机对照试验（RCT）中促进语音输出中的功效。为了检查AMMT的核心成分是否负责治疗效果，CT将省略语调和运动成分。在独立编码人员治疗之前，期间和之后，将多次评估每个孩子的语音输出的准确性。我们的总体目标还将得到两个附加目标的补充，在这些目标中，我们将检查AMMT的频率是否影响治疗结果，以及与语言相关途径的预先存在变异性和功能连接是否与结果相关，并且在治疗后会更改。根据我们的初步数据，我们假设：（1）与CT相比，AMMT将显着提高辅音和元音生产的准确性，并且对治疗期间未接受培训的项目以及治疗后更合适的单词的概括，（2）在频率较低的个人中会发现更大的改善（比较较低的频率）（比较较低的频率（比较）（比较）（比较）（比较）（比较）（比较）（比较）（比较）（比较）（比较）（比较）（相比）） AMMT，（3）基线行为措施（例如，认知，语音实践，关注能力）将与AMMT和CT的语音改善程度有关，以及（4）变异性象征和结构性脑连接的程度将与AMMT治疗结果相关，以及（5）强度的AMMT治疗将导致强度的效果连接范围。通过使用行为和脑成像措施的结合，拟议的研究将检查新干预的疗效，并增强我们对构成治疗效果的潜在神经机制的理解。