Technology-assisted language intervention for children who are deaf/hard-of-hearing (TALI)

针对聋哑/听力障碍儿童的技术辅助语言干预 (TALI)

• 批准号: 10599981
• 负责人: Jareen Meinzen-Derr
• 金额: $ 59.67万
• 依托单位: CINCINNATI CHILDRENS HOSP MED CTR
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-04-20 至 2025-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10599981
• 关键词: Academic achievement; Address; Adherence; Adult; Age; Area; Auditory; Augmentative and Alternative Communication; Caregivers; Child; Child Development; Clinical Trials Design; Cognitive; Colorado; Communication; Complex; Computer software; Coupled; Data; Decision Making; Development; Diagnosis; Disadvantaged; Early identification; Educational process of instructing; Effectiveness; Effectiveness of Interventions; Emerging Technologies; Evidence based intervention; Family; Feedback; Future; Goals; Home; Human; Infant; Intervention; Language; Language Delays; Language Development; Language Disorders; Language Therapy; Measures; Medical center; Modeling; Monitor; National Institute on Deafness and Other Communication Disorders; Outcome; Outcome Measure; Outcome Study; Outcomes Research; Parents; Pediatric Hospitals; Population; Problem behavior; Psychology; Public Health; Randomized; Randomized, Controlled Trials; Reproducibility; Research Design; Research Support; Risk; Sampling; Semantics; Severities; Site; Social Behavior; Social Functioning; Speech; Standardization; Strategic Planning; Techniques; Technology; Testing; Visual; Work; behavioral outcome; care delivery; childhood hearing loss; cognitive ability; deaf; design; effective therapy; effectiveness testing; evidence base; falls; hard of hearing; hearing impairment; improved; improved outcome; innovation; intervention program; language outcome; multidisciplinary; post intervention; primary outcome; programs; randomized trial; recruit; skills; social; standard care; syntax; tool; treatment as usual

PROJECT SUMMARY Upon diagnosis of hearing loss, parents/caregivers of children who are deaf/hard-of-hearing (DHH) make decisions around numerous approaches to language and communication development. Despite strong efforts to improve long-term outcomes, DHH children continue to fall short of age-appropriate language levels, placing them at risk for reduced academic achievement, behavioral problems, and poor social abilities that persist into adulthood. The lack of research supporting innovative intervention strategies leaves a gaping hole in our ability to fully support DHH children. Thus, we are unable to provide families with the quality information regarding intervention options. Evidence supports augmentative and alternative communication (AAC) for enhancing language development, yet technology-based AAC has not been applied or effectively studied in DHH children. To address the substantial and pervasive language deficits among DHH children that have persisted despite advances in amplification technology and early identification, we designed a technology-assisted language intervention (TALI) that incorporates high-tech AAC into speech-language therapy as a language teaching tool specifically adapted for DHH children. Our central hypothesis is that DHH children who participate in the TALI will have greater gains in spoken language outcomes compared to DHH children who receive treatment-as-usual (TAU) speech-language therapy. In a small randomized trial to test the effectiveness of the TALI, our preliminary data show that the TALI significantly improves spoken language outcomes for DHH children and is more effective than TAU. However, there remains a need to (a) provide evidence for reproducibility and generalizability in a larger population and (b) understand the TALI effectiveness on additional language outcome measures. We propose a randomized controlled trial of 114 DHH children at 2 recruitment sites (Cincinnati Children’s Hospital Medical Center and Children’s Hospital of Colorado). Children will be randomized to either receive 24 weeks of the TALI or 24 weeks TAU therapy. We will expand our current work to include additional language outcomes, creating a more complete picture of the effectiveness of the proposed intervention. We will test our central hypothesis through the following specific aims: (1) Compare spoken (expressive) language outcomes in DHH children and participating in the TALI with those participating in TAU therapy; (2) Compare language outcomes measured on standardized assessments between children who are DHH participating in the TALI with those participating in TAU; (3) Evaluate whether the benefits of the TALI on language outcomes is maintained 6 months post-intervention. Primary outcomes include syntax, semantics and discourse collected from language samples measured every 6 weeks and receptive/expressive standardized language scores measured pre and post intervention. AAC use will be monitored to measure adherence to the TALI while at home. This project directly aligns with NIDCD’s strategic plan’s overarching goal of improving outcomes in human communication.

项目摘要 诊断出听力损失后，聋哑/听力障碍（DHH）的父母/照顾者使 关于语言和沟通发展的多种方法的决定。尽管做出了巨大的努力 为了改善长期结局，DHH儿童继续不适合年龄的语言水平 他们有降低学术成就，行为问题和社会能力不佳的风险 成年。缺乏支持创新干预策略的研究在我们的 能够完全支持DHH儿童。那就是我们无法为家庭提供质量信息 考虑干预选择。证据支持增强和替代交流（AAC） 增强语言发展，但基于技术的AAC尚未应用或有效地研究 DHH的孩子。解决有实质和普遍的语言在DHH儿童中定义的 我们设计了一个技术辅助的语言干预（TALI），将高科技AAC纳入语音语言疗法中 专门针对DHH儿童的语言教学工具。我们的中心假设是DHH的孩子 与DHH儿童相比 接受治疗态度（TAU）语音语言疗法。在一项小型随机试验中，以测试 塔利的有效性，我们的初步数据表明，塔利大大改善了口语 DHH儿童的结果比Tau更有效。但是，仍然需要（a）提供 较大人群中可重复性和概括性的证据，（b）了解塔利 对其他语言结果指标的有效性。我们提出了一个随机对照试验114 DHH在2个招聘场所（辛辛那提儿童医院医疗中心和儿童医院的儿童 科罗拉多州）。儿童将随机接受24周的TALI或24周tau治疗。我们 将扩大我们当前的工作，包括其他语言成果，创建更完整的图片 拟议干预的有效性。我们将通过以下特定测试中心假设 目的：（1）比较DHH儿童中的口语（表现力）语言结果，并与 参加tau疗法的人； （2）比较在标准化评估中衡量的语言结果 在DHH参加TALI的孩子与参加Tau的孩子之间； （3）评估是否 塔利对语言结果的好处是在干预后6个月维持的。主要结果 包括每6周测量的语言样本收集的语法，语义和话语 干预前后测量的接受/表达标准化语言得分。 AAC使用将是 受到监测以测量在家中对塔利的依从性。该项目直接与NIDCD的策略保持一致 计划的总体目标是改善人类交流中的成果。