An Exploratory Model of Early Speech Intervention for Children with Cleft Palate

腭裂儿童早期言语干预的探索模型

• 批准号: 7659922
• 负责人: Nancy J. Scherer
• 金额: $ 19.09万
• 依托单位: EAST TENNESSEE STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-07-17 至 2011-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7659922
• 关键词: Address; Aftercare; Age-Months; Behavior; Child; Classification; Cleaved cell; Cleft Lip; Cleft Palate; Clinic; Cognitive; Communities; Control Groups; Development; Early treatment; Educational process of instructing; Effectiveness; Effectiveness of Interventions; Equipment and supply inventories; Hearing; Home environment; Impairment; Intervention; Investigation; Joints; Language; Language Delays; Language Development; Maintenance; Manuals; Measures; Methods; Modeling; Operative Surgical Procedures; Outcome; Palate; Parents; Pattern; Pilot Projects; Play; Prevention; Principal Investigator; Procedures; Production; Protocols documentation; Randomized; Relative (related person); Research; Risk; Speech; Speech Sound; Testing; Time; Training; Treatment Efficacy; Vocabulary; base; design; evidence base; follow-up; group intervention; intervention program; phonology; prevent; public health relevance; repaired; sound; speech accuracy; theories; treatment effect; treatment strategy

DESCRIPTION (provided by applicant): Young children with cleft lip and/or palate are at risk for speech and language delays associated with structural deficits despite early surgical repair. This study proposes to evaluate the effectiveness of an early intervention to facilitate speech and vocabulary development and prevent the habituation of compensatory articulation use. This exploratory investigation consists of a pilot study to operationalize intervention components of an EMT (Enhanced Milieu Teaching) intervention with and without a phonological recasting emphasis (PE) and a randomized group study to compare the optimal combination of EMT/PE (determined in the pilot) to a traditional articulation therapy performed in the community. The pilot study will examine 4 children, 18-24 months of age, in a multiple baseline design. Following refinement of the procedures in the pilot study, a group study will examine the effectiveness of this intervention in 2 groups of children with clefts, 18-24 months of age, randomly assigned to a treatment (14 children) or community-based control group (CBI) (14 children). Specific aims of the group study includes: (1) examining the effects of a naturalistic vocabulary intervention to promote change in the sound inventories, speech accuracy and use of compensatory articulation for the children in the EMT/PE intervention group compared with the children in a control group, (2) comparing the effects of the EMT/PE intervention on the generalization of speech production changes to home use in the treatment and control groups, and (3) to determine if changes in vocabulary, sound inventory, speech sound accuracy and use of compensatory articulation are maintained 3 months after the conclusion of the treatment. The children will receive a comprehensive speech, language, hearing and cognitive assessment at the beginning of the study, and 3 and 6 months later, corresponding to the beginning, immediately following treatment and a 3 month follow-up. PUBLIC HEALTH RELEVANCE: This project examines treatment efficacy of an early intervention model for children with cleft lip and/or palate that promotes early normalization of speech and language development and prevention of compensatory articulation patterns. The intervention optimizes methods for promoting treatment generalization and maintenance through a collaborative parent-clinician implemented intervention delivered across clinic and home settings. This model will be compared to a traditional articulation treatment provided in the community.

描述（由申请人提供）：尽管进行了早期手术修复，患有唇裂和/或腭裂的幼儿仍面临与结构缺陷相关的言语和语言发育迟缓的风险。本研究旨在评估早期干预对于促进言语和词汇发展并防止补偿性发音使用习惯的有效性。这项探索性调查包括一项试点研究，旨在实施有或没有语音重铸重点 (PE) 的 EMT（增强环境教学）干预措施的干预组成部分，以及一项随机分组研究，以比较 EMT/PE 的最佳组合（在试点中确定） ）到在社区进行的传统关节治疗。该试点研究将采用多基线设计对 4 名 18-24 个月大的儿童进行检查。在完善试点研究的程序后，一项小组研究将检查该干预措施对 2 组 18-24 个月大的唇腭裂儿童的有效性，这些儿童被随机分配到治疗组（14 名儿童）或社区对照组（CBI）（14 名儿童）。小组研究的具体目标包括：(1) 与对照组儿童相比，检查自然主义词汇干预对促进 EMT/PE 干预组儿童的声音库存、言语准确性和补偿性发音的变化的影响。对照组，(2) 比较 EMT/PE 干预对治疗组和对照组家庭使用言语产生变化的影响，以及 (3) 确定词汇量、声音库存、言语声音准确性和使用代偿性关节治疗结束后维持3个月。孩子们将在研究开始时以及3个月和6个月后接受全面的言语、语言、听力和认知评估，对应于开始、治疗后立即进行以及3个月的随访。公共健康相关性：该项目研究了唇裂和/或腭裂儿童的早期干预模型的治疗效果，该模型促进言语和语言发展的早期正常化并预防补偿性发音模式。该干预措施通过家长与临床医生合作在诊所和家庭环境中实施的干预措施，优化了促进治疗泛化和维持的方法。该模型将与社区提供的传统关节治疗进行比较。