Communication Development in Children with Cerebral Palsy

脑瘫儿童的沟通发展

• 批准号: 8271458
• 负责人: Katherine C Hustad
• 金额: $ 35.21万
• 依托单位: UNIVERSITY OF WISCONSIN-MADISON
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-06-01 至 2013-06-06
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8271458
• 关键词: 4 year old; Accounting; Age; American; Brain imaging; Cerebral Palsy; Characteristics; Child; Classification; Clinical; Cognition; Cognitive; Communication; Cross-Sectional Studies; Data; Development; Diagnosis; Dysarthria; Epilepsy; Growth; Growth and Development function; Individual; Intervention; Language; Lead; Learning Disabilities; Life; Mental Retardation; Methodology; Motivation; Motor; Movement Disorders; Nature; Outcome; Pattern; Population; Prevalence; Production; Research; Sampling; Spastic; Speech; Speech Development; Speech Disorders; Subgroup; Time; United States; Validation; Work; base; cohort; communication theory; disability; innovation; motor impairment; neuropathology; outcome forecast; public health relevance; skills; theories; tool

DESCRIPTION (provided by applicant): Cerebral palsy (CP) is regarded as the most common cause of severe motor disability in children (1); approximately 10,000 new cases are diagnosed each year in the United States (2). Although motor impairment is the primary defining feature of CP, other disabilities such as mental retardation, seizure disorder, and learning disabilities often co-occur (3-5). Research suggests that 60% of children with CP have communication problems (6); however, the exact nature of these problems has never been comprehensively examined. Existing research has emphasized differentiation of speech features based on the nature of the gross motor movement disorder (7-12) (i.e. athetoid vs. spastic). Language and cognitive variables have been controlled in these studies by including only those with "normal" abilities. Because learning disabilities and mental retardation frequently accompany CP, a true account of communication must include simultaneous quantification of speech, language, and cognitive abilities. There have been significant advances in the study of gross motor development (13-17), fine motor development (18-21), and brain imaging findings in children with CP (5, 6, 22-25). However, the lack of data regarding communication and its development has prohibited a thorough understanding of the constellations of and inter-relations among deficits that accompany CP. Using a multidimensional theoretical perspective, this project will quantify longitudinal development of speech, language, and cognition at 6 month intervals over a period of 4 years. A cohort of 80 children with CP and 17 typically developing children, who are 2-4 years of age at the onset of the study, will be followed. Hypotheses are: 1.) there are identifiable and longitudinally stable communication-based subgroups within the population of children who have CP; and 2.) these subgroups are loosely related to gross motor, fine motor, and brain imaging findings for these same children. Specific aims that target these hypotheses are to: a.) establish subgroups of children with CP on the basis of cross sectional communication (speech, language, and cognition) profiles (Aim 1); b.) quantify developmental changes in speech, language, and cognitive abilities and determine the stability of communication subgroup membership over time in young children with CP (Aim 2); c.) identify the extent to which gross and fine motor classifications are associated with communication subgroup membership (Aim 3); and d.) characterize structural neuro-anatomical involvement and determine how patterns of neuropathology are associated with communication subgroup membership (Aim 4). Results will inform an initial theory of communication development in children with CP that emphasizes the inter-relations among speech, language, and cognition. The longitudinal methodology will enable development of growth curves for individual children and for the putative communication subgroups. Results will have direct clinical implications for communication intervention and will also advance the broader theoretical understanding of CP, where classification of speech and language problems has been identified as a high priority (3, 26). PUBLIC HEALTH RELEVANCE: Cerebral palsy (CP) is the most common cause of severe motor disability in children; approximately 800,000 Americans are living with CP. Most children with CP have communication problems, but very little is known about the specific nature of these problems. This research will examine communication development over time in children with CP and will identify communication-based subgroups of children who have similar kinds of problems. Results will lead to a better understanding of communication prognoses and ultimately may lead to interventions that enhance communication outcomes in children with CP.

描述（由申请人提供）：脑瘫（CP）被认为是儿童严重运动残疾的最常见原因（1）；在美国，每年约有10,000例新病例被诊断出（2）。尽管运动障碍是CP的主要定义特征，但其他残疾（例如智力低下，癫痫发作障碍和学习障碍）通常会同时发生（3-5）。研究表明，有60％的CP儿童存在沟通问题（6）；但是，这些问题的确切性质从未经过全面检查。现有的研究强调了基于总体运动运动障碍的性质（7-12）的性质（即无动物与痉挛）的性质的分化。在这些研究中，仅包括具有“正常”能力的人，语言和认知变量已经受到控制。由于学习障碍和智力低下经常伴随着CP，因此对沟通的真实描述必须包括同时量化语音，语言和认知能力。在CP儿童（5、6、22-25）的研究中，总体运动发育（13-17），精细运动发育（18-21）和大脑成像发现方面取得了重大进展。但是，缺乏有关通信及其发展的数据，禁止对CP伴随的缺陷之间的关系和相互关系的星座有深入的了解。使用多维理论观点，该项目将在4年的时间内以6个月的间隔量化语音，语言和认知的纵向发展。在研究开始时，将有80名CP和17名儿童组成2-4岁的儿童。假设是：1。）在患有CP的儿童人群中，有可识别且纵向稳定的基于沟通的亚组；和2.）这些亚组与这些儿童的总体运动，精细运动和大脑成像发现密切相关。针对这些假设的具体目的是：a。）基于横截面沟通（语音，语言和认知）概况建立CP儿童的子组（AIM 1）； b。）量化语音，语言和认知能力的发展变化，并确定CP年幼儿童的交流子组成员的稳定性（AIM 2）； c。）确定与通信亚组成员资格相关的总体和精细运动分类的程度（AIM 3）；和d。）表征结构神经 - 动物学的参与，并确定神经病理学模式与通信亚组成员资格如何相关（AIM 4）。结果将为患有CP儿童的交流发展理论提供介绍，该理论强调语音，语言和认知之间的相互关系。纵向方法论将使个别儿童和推定的交流子组的增长曲线发展。结果将对交流干预具有直接的临床意义，并且还将提高对CP的更广泛的理论理解，在这种情况下，语音和语言问题的分类已被确定为高优先级（3，26）。公共卫生相关性：脑瘫（CP）是儿童严重运动残疾的最常见原因；大约有80万美国人生活在CP。大多数患有CP的孩子都有沟通问题，但是对这些问题的特定性质知之甚少。这项研究将检查CP儿童的沟通发展，并将确定具有类似问题的儿童的基于沟通的子组。结果将使人们更好地了解沟通预后，并最终可能导致干预措施，从而增强CP儿童的沟通结果。