Early Augmentative and Alternative Communication (AAC) Intervention Delivered via Hybrid Telehealth

通过混合远程医疗提供早期增强和替代沟通 (AAC) 干预

• 批准号: 10601100
• 负责人: Emily Dayle Quinn
• 金额: $ 19.25万
• 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: 2022-04-04 至 2025-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10601100
• 关键词: Address; Adherence; Adoption; Augmentative and Alternative Communication; Behavior; Caregiver support; Caregivers; Child; Child Language; Clinical Trials; Communication; Communication impairment; Comprehension; Data; Development; Educational Activities; Educational process of instructing; Experimental Designs; Exposure to; Family; Future; Geography; Goals; Home; Hybrids; Instruction; Intellectual functioning disability; Intervention; Interview; Language; Language Development; Language Therapy; Learning; Methods; Modeling; Modification; National Institute on Deafness and Other Communication Disorders; Nursery Schools; Outcome; Parents; Participant; Pathologist; Persons; Population; Preparation; Procedures; Qualitative Methods; Questionnaires; Research; Research Priority; Service delivery model; Speech; Testing; Text Messaging; Toddler; Transportation; Visual; Vocabulary; Work; acceptability and feasibility; clinical practice; community based treatment; critical period; design; effective intervention; effectiveness/implementation trial; elementary school; experience; experimental study; implementation science; implementation strategy; improved; innovation; intervention effect; language impairment; language outcome; literacy; novel; pilot test; post intervention; preference; primary outcome; secondary outcome; service delivery; skills; social; telehealth; therapy design; therapy development; treatment adherence; underserved community

PROJECT SUMMARY Augmentative and Alternative Communication (AAC) intervention can increase language, literacy, social, and adaptive skills for children with severe communication impairments. However, AAC is underutilized in speech- language therapy for toddlers with intellectual and developmental disabilities (IDD). Hybrid telehealth models can transform the delivery of early AAC interventions by expanding access to speech-language pathologists (SLPs) with AAC expertise and reducing geographic and transportation barriers in underserved communities. The purpose of this proposal is to develop and pilot test a hybrid telehealth AAC intervention for toddlers with IDD and their families. We employ an implementation science approach, using systematic qualitative methods to identify caregiver and SLP preferences and single-case experimental design methods to assess the feasibility of the AAC intervention. The central hypothesis is that the intervention will improve caregivers’ use of AAC strategies, which will lead to increases in children’s expressive communication skills. Three specific aims are proposed. Aim 1: Determine stakeholders’ preferences and needs for two key AAC intervention components: (a) service delivery and (b) strategies to enhance treatment adherence. We will conduct interviews with caregivers and SLPs to assess their needs and preferences regarding the intervention. Interview findings will inform initial modifications to the service delivery model and treatment adherence strategies investigated in Aims 2 and 3. Aim 2: Develop an AAC intervention through iterative testing cycles. We will conduct six multiple baseline designs across behaviors to refine the AAC intervention and demonstrate preliminary efficacy using an in-person service delivery. Findings from this study will inform adaptations for a hybrid telehealth delivery of the AAC intervention, involving both in-person and telehealth sessions evaluated in Aim 3. Aim 3: Conduct a pilot test of a hybrid telehealth AAC intervention. We will pilot test the hybrid telehealth AAC intervention using a combination multiple-probe design across participants and behaviors. Nine parent-child dyads will receive 24 intervention sessions, eight sessions provided to families in-person, and 16 provided via telehealth. The primary outcome is caregivers’ use of AAC intervention strategies, and the secondary outcome is child communication acts. This proposal is innovative because it uses implementation science methods to develop a novel hybrid telehealth AAC intervention that is feasible, acceptable, and appropriate for its end-users, increasing the likelihood of widescale adoption in routine clinical practice. The project is significant because it addresses a critical need for early AAC language interventions designed for home use. Our expected outcomes are to have developed the AAC intervention and implementation strategies in preparation for an R01 application to conduct a large-scale clinical trial.

项目摘要 增强和替代性交流（AAC）干预可以提高语言，识字，社会和 严重沟通障碍儿童的适应性技能。但是，AAC在言语中不足 - 具有智力和发育障碍的幼儿的语言疗法（IDD）。混合远程医疗模型 可以通过扩展对语音语言病理学家的访问来改变早期AAC干预措施的交付 （SLP）具有AAC专业知识，并减少了服务不足的社区的地理和运输障碍。 该建议的目的是开发和试点测试幼儿的混合远程医疗AAC干预 与IDD及其家人。我们使用系统的定性采用实施科学方法 识别护理人员和SLP偏好以及单案实验设计方法评估的方法 AAC干预的可行性。中心假设是干预将改善照顾者的 使用AAC策略，这将导致儿童表现力的沟通技巧提高。三 提出了具体目标。目标1：确定利益相关者对两个关键AAC的偏好和需求 干预组件：（a）服务提供和（b）增强治疗依从性的策略。我们 将对护理人员和SLP进行采访，以评估他们的需求和偏好 干涉。访谈结果将为服务提供模型和治疗的初步修改提供信息 目标2和3中调查的依从性策略。目标2：通过迭代制定AAC干预 测试周期。我们将跨行为进行六种多个基线设计，以完善AAC干预 并使用面对面的服务提供初步效率。这项研究的发现将告知 改编AAC干预的混合远程医疗交付，涉及面对面和远程医疗 AIM 3中评估的会议。AIM3：对混合远程医疗AAC干预进行试点测试。我们将 试点测试混合远程医疗AAC干预使用参与者的组合多探针设计 和行为。九个亲子二元组将接受24次干预课程，提供8次会议 面对面的家庭，通过远程医疗提供了16个。主要结果是护理人员使用AAC干预 策略，次要结果是儿童沟通行为。该提议具有创新性，因为它 使用实施科学方法来开发一种新型的混合远程医疗AAC干预措施 可行，可接受且适合其最终用户，增加了广泛采用的可能性 常规临床实践。该项目很重要，因为它解决了早期AAC的关键需求 为家庭使用而设计的语言干预措施。我们的预期结果是开发了AAC 干预和实施策略，以准备R01应用程序进行大规模进行 临床试验。