Communication Development in Children with Cerebral Palsy

脑瘫儿童的沟通发展

基本信息

批准号：
8676772
负责人：
Katherine C Hustad
金额：
$ 57.12万
依托单位：
UNIVERSITY OF WISCONSIN-MADISON
依托单位国家：
美国
项目类别：
财政年份：
2008
资助国家：
美国
起止时间：
2008-06-07 至 2018-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8676772
关键词：
10 year old 2 year old 6 year old Address Advanced Development Affect Age Area Behavioral Cereals Cerebral Palsy Child Childhood Classification Clinical Cognition Cognitive Cognitive deficits Communication Communication impairment Complex Cues Data Data Collection Databases Development Developmental Disabilities Dysarthria Foundations Funding Future Goals Growth Impaired cognition Impairment Intervention Intervention Studies Investigation Joints Language Language Development Language Disorders Lead Life Longitudinal Studies Measures Modeling Motor Nature Outcome Process Production Relative (related person)Research Resources Speech Speech Development Speech Intelligibility Speech Therapy Testing Time Treatment Efficacy Validation Work base disability evidence base functional outcomes language comprehension motor control motor impairment outcome forecast programs prospective public health relevance therapy development tool

项目摘要

DESCRIPTION (provided by applicant): Cerebral palsy (CP) is the most common cause of severe motor impairment in children, affecting 3 per 1000 in the US and internationally. CP has a profound detrimental impact on all aspects of life. Motor impairment is the primary defining feature, but co-occurring developmental disabilities are frequent and lead to a complex array of problems. Approximately 60% of children with CP have some type of communication disorder, however the specific nature of the communication problems in children with CP and how these problems change with development is virtually unknown. Treatment studies are extremely limited, and the evidence base is poor. Creation of research-based tools for classifying speech and language problems in CP and controlled intervention studies are priority areas. In the previous funding cycle, we developed a model for classifying speech and language impairments in children with CP. Our model comprises 4 broad classification groups distinguished on the presence of speech motor involvement with or without the presence of language/cognitive involvement. A key finding is that children with CP show early speech and language development trajectories that are specific to classification groups. This has critical implications for understanding how deficits in language/cognition and speech production interact during development, and for intervention. Age-stratified prospective longitudinal data on children with CP beyond the age of 6 years are not available; thus, rates and limits of change are unknown. This critical barrier impedes our capacity to predict outcomes and develop interventions that optimize speech and language abilities. Our long-term goal is to generate a theoretically driven, data-based longitudinal model of speech and language development in CP that can be used to predict outcomes, test interventions, and guide treatment decisions. The proposed research will extend the longitudinal window of investigation of speech and language development through the age of 10 years in 100 children with CP who we have been following for the past 4 years. Specific aims of the proposed study are: 1.) To quantify longitudinal change in speech and language development and determine stability of classification group membership; 2.) To identify early predictors of later speech intelligibility and classification group membership; and 3.) To test the effects of behavioral speech interventions on intelligibility. Results will have diect clinical implications for communication intervention and will also advance the broader theoretical understanding of CP. The proposed work will validate a longitudinal classification model for communication in children with CP and quantify rates and limits of change of targeted speech and language variables through the age of 10 years. Results will enable us to predict the relative communication abilities of children later in childhood based on data collected earlier in life, and explore the potential benefit of behavioral speech interventions. This will lay a critica foundation for future studies that address behavioral speech and language intervention in the context of developmental trajectories to maximize functional outcomes.

描述（由申请人提供）：脑瘫 (CP) 是儿童严重运动障碍的最常见原因，在美国和国际上每 1000 人中就有 3 人受到影响。 CP 对生活的各个方面都有深远的有害影响。运动障碍是主要的定义特征，但同时发生的发育障碍也很常见，并会导致一系列复杂的问题。大约 60% 的 CP 儿童存在某种类型的沟通障碍，但 CP 儿童沟通问题的具体性质以及这些问题如何随着发育而变化几乎是未知的。治疗研究极其有限，证据基础也很差。创建基于研究的工具来对 CP 中的言语和语言问题进行分类以及受控干预研究是优先领域。在上一个资助周期中，我们开发了一个对脑瘫儿童言语和语言障碍进行分类的模型。我们的模型包括 4 个广泛的分类组，根据是否存在语言/认知参与来区分言语运动参与。一项重要发现是，患有脑瘫的儿童表现出特定于分类群体的早期言语和语言发展轨迹。这具有重要意义用于了解语言/认知和言语产生的缺陷在发育过程中如何相互作用，并进行干预。目前尚无 6 岁以上 CP 儿童的年龄分层前瞻性纵向数据；因此，变化的速率和限度是未知的。这一关键障碍阻碍了我们预测结果和制定优化言语和语言能力的干预措施的能力。我们的长期目标是生成一个理论驱动的、基于数据的 CP 言语和语言发展纵向模型，可用于预测结果、测试干预措施并指导治疗决策。拟议的研究将把言语和语言发展的纵向调查窗口延长至 100 名 CP 儿童的 10 岁，我们在过去 4 年里一直在跟踪这些儿童。本研究的具体目标是： 1.) 量化语音和语言发展的纵向变化并确定分类组成员的稳定性； 2.) 识别后期语音清晰度和分类组成员资格的早期预测因子； 3.) 测试行为言语干预对清晰度的影响。结果将对沟通干预产生直接的临床意义，也将促进对脑瘫的更广泛的理论理解。拟议的工作将验证 CP 儿童沟通的纵向分类模型，并量化 10 岁时目标言语和语言变量的变化率和限制。结果将使我们能够根据生命早期收集的数据来预测儿童后期的相对沟通能力，并探索行为言语干预的潜在好处。这将为未来的研究奠定关键基础，这些研究在发展轨迹的背景下解决行为言语和语言干预，以最大限度地提高功能结果。