Addressing Structural Disparities for Children with Early Communication Disorders (ASCEND)

解决早期沟通障碍儿童的结构性差异 (ASCEND)

• 批准号: 10723478
• 负责人: Lauren M. Cycyk
• 金额: $ 11.7万
• 依托单位: OREGON HEALTH & SCIENCE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-06-01 至 2027-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10723478
• 关键词: Address; Administrator; Adult; Advocate; Affect; Age; Attitude; Behavioral; Belief; Big Data; Caring; Characteristics; Child; Child Care; Child Support; Child health equity; Childhood; Clinical; Color; Communication; Communication impairment; Communities; Complex; Consensus; Criminal Justice; Data; Development; Disabled Persons; Discrimination; Disparity; Early Intervention; Early identification; Early treatment; Education; Eligibility Determination; Emotional; Equity; Ethnic Origin; Evaluation; Evidence based intervention; Exclusion; Face; Family; Family Characteristics; Focus Groups; Foundations; Funding; Goals; Health; Health Care Costs; Health Disparities Research; Health Services Accessibility; Home; Human; Individual; Information Systems; Intervention; Interview; Language; Language Disorders; Leadership; Linguistics; Locales; Mental Health; Methods; Minority Groups; National Institute on Deafness and Other Communication Disorders; Organizational Policy; Outcome; Parents; Pathologist; Personal Satisfaction; Policies; Population; Poverty; Poverty Areas; Primary Care Physician; Process; Provider; Race; Recommendation; Regulation; Reproducibility; Research; Resources; Risk; Rural; School-Age Population; Services; Source; Specialist; Speech; Speech Disorders; Structural Racism; Structure; Surveys; Symptoms; System; Techniques; US State; Variant; autism spectrum disorder; child services; children of color; community-level factor; disability; early childhood; early satiety; experience; health disparity; health inequalities; hearing impairment; improved; improved outcome; inequitable distribution; innovation; marginalized population; member; physical conditioning; policy recommendation; programs; provider intervention; rural area; rural poverty; service intervention; service providers; social; stakeholder perspectives; structural determinants

PROJECT ABSTRACT Communication disorders (CDs), including primary developmental speech and language disorders, autism spectrum disorder, and hearing impairment, are the most prevalent disabilities in early childhood. Early identification and treatment of CDs supports children's short- and long-term social, emotional, behavioral, academic, mental, and physical health outcomes and reduces educational, criminal justice, and health care costs. Yet, children from racial, ethnic, and/or linguistic minority populations, including those living in rural areas and/or in poverty, do not receive timely access to high-quality CD care. While long-standing structural inequities in health and educational settings underlie these disparities, specific sources of SRD that impact children of Color across the CD referral, identification, and treatment process, are unknown. In partnership with five US states and diverse stakeholders, we will undertake the first comprehensive multi-state analysis of structural racism and discrimination (SRD) in the primary system of early identification and treatment for CDs: the Individuals with Disabilities Education Act Part C Early Intervention (EI) system. The goal of this study is to lay the foundation for evidence-based interventions that improve health equity for children of Color with CDs age 0-3. To do so, this study applies a health disparities framework to precisely detect, understand, and develop solutions that address sources of SRD in EI at the individual, organizational, and community levels. In Aim 1, we will leverage 5 states' EI data systems to identify distributional inequities in EI referral, evaluation, eligibility, and service allocation outcomes according to child intersecting identities, indicators of community resources and opportunities, and EI process features. In Aim 2, we will contextualize distributional inequities identified in Aim 1 through focus groups with parents of children of Color with CDs, surveys of key professionals providing CD care in EI (i.e., pediatric primary care physicians, speech-language pathologists, EI developmental specialists), and interviews with EI administrative leadership. In Aim 3, we will use Nominal Group Technique, a stakeholder consensus process, to generate and prioritize practice and policy recommendations to disrupt SRD for children with CDs. Advisors, including parents of children of Color with CDs, adults with disabilities, EI providers, parent disability advocates, EI administrators, and scholars of Color and/or with disabilities, will inform all aspects of the study. This project will ultimately result in a set of comprehensive, stakeholder-informed, data-driven, and feasible recommendations to improve equity in early CD care for the 1 in 5 children of Color affected by early CDs.

项目摘要 沟通障碍（CD），包括主要的发展语音和语言障碍，自闭症 频谱障碍和听力障碍是幼儿期最普遍的残疾。早期的 CD的识别和治疗支持儿童的短期和长期社会，情感，行为， 学术，心理和身体健康成果，减少教育，刑事司法和医疗保健 费用。然而，来自种族，种族和/或语言少数群体的孩子，包括居住在农村的人 区域和/或贫困，无法及时获得高质量的CD护理。虽然长期存在 卫生和教育环境中的不平等是这些差异的基础，这是SRD的特定来源 在CD转介，识别和治疗过程中有色的孩子尚不清楚。合伙 我们将拥有五个美国的各种利益相关者，我们将承担第一个全面的多国家 在早期识别的主要系统中对结构种族主义和歧视（SRD）的分析 CD的治疗：《残疾人教育法》第C部分早期干预（EI）系统。 这项研究的目的是为改善健康公平的循证干预措施奠定基础 CDS年龄为0-3的有色孩子。为此，本研究将健康差异框架应用于 检测，理解和开发解决方案，以解决个人，组织，组织中的EI中的SRD来源 和社区层面。在AIM 1中，我们将利用5个州的EI数据系统来确定分配不平等 EI转介，评估，资格和服务分配结果，根据儿童相交身份， 社区资源和机会的指标以及EI流程功能。在AIM 2中，我们将背景化 AIM 1中通过与有色孩子的父母与CD的父母一起确定的分配不平等， 在EI中提供CD护理的主要专业人员的调查（即儿科初级保健医生，语音语言 病理学家，EI发展专家），以及对EI行政领导的访谈。在AIM 3中，我们将 使用名义组技术（利益相关者共识过程）来生成和优先级练习和 为CD儿童中断SRD的政策建议。顾问，包括有色子女的父母 与CD，残疾成年人，EI提供者，父母残疾倡导者，EI管理员和学者 颜色和/或残疾人将为研究的各个方面提供信息。该项目最终将导致一组 全面，利益相关者信息，数据驱动和可行的建议，以提高公平性 早期CD护理受早期CD影响的五分之一的颜色儿童。