Treatment of Speech Disorders in Children with Down Syndrome

唐氏综合症儿童言语障碍的治疗

• 批准号: 7319806
• 负责人: Stephen Mark Camarata
• 金额: $ 40.61万
• 依托单位: VANDERBILT UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-09-01 至 2010-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7319806
• 关键词: Address; Adolescence; Adolescent; Adult; Affect; Aftercare; Area; Auditory; Birds; Characteristics; Child; Clinical Trials; Cognitive; Competence; Condition; Data; Development; Disease regression; Down Syndrome; Elements; Funding; Growth; Heterogeneity; Impairment; Incidence; Individual; Individual Differences; Intervention; Investigation; Joints; Knowledge; Language; Learning; Life; Literature; Measures; Mediating; Methods; Modeling; Motor; Motor Skills; Neurologic; Outcome; Outcome Measure; Phase; Placement; Population; Procedures; Production; Public Health; Purpose; Rain; Randomized; Rate; Recruitment Activity; Relative (related person); Reporting; Research; Research Personnel; Role; Sampling; Social Development; Speech; Speech Development; Speech Disorders; Speech Sound; Speech Therapy; Staging; Suggestion; System; Testing; Training; Week; base; design; experience; follow-up; improved; knowledge base; phonology; programs; response; skills; sound; speech accuracy; speech processing; syntax; therapy design; treatment effect

DESCRIPTION (provided by applicant): A major developmental challenge for children with Down Syndrome (DS) is generating comprehensible and accurate speech within the context of a dynamic, maturing system, which is mediated by input from immature, dynamic speech processing ability. It is perhaps not surprising that the development of speech often goes awry in DS, with speech disorder being a relatively high incidence condition that typically persists through adolescence into adulthood and is often a life-long disabling characteristic of DS. Because of this, it is important to develop more effective treatments that improve two key elements of speech disorders: Speech-comprehensibility and speech accuracy. In addition, because children with DS display considerable heterogeneity in abilities that affect differential response to speech treatment methods, it is important to examine the relationship between particular pretreatment skills as potential predictors or moderators of growth and differential response to treatment for speech-comprehensibility and speech accuracy. The purpose of this project is to examine the relationship between pretreatment levels of: Cognitive ability, speech-motor ability, degree of speech accuracy in elicited and spontaneous contexts, degree of speech- comprehensibility in spontaneous contexts, EEG/ERP measures of auditory differentiation of phonemes and (a) growth in levels of speech-comprehensibility and speech accuracy within children with DS who experienced speech therapy and (b) differential response to two types of speech treatment designed to increase levels of speech accuracy and speech comprehensibility in these children. Sixty children with DS who all have severe speech disorders at pretreatment will be recruited in this project. At entry into the study, auditory differentiation of phonemes will be measured using PCA and ICA methods, as will levels of speech accuracy and speech comprehensibility. The children with DS will then be randomly assigned to one of two treatments designed to improve speech skills: Phonological Knowledge Recast (PKR) treatment or Articulatory Training (AT) treatment. These children will receive treatment in a 1:1 format for 60 minutes/session, 2/week for 6 months. Speech-comprehensibility and speech accuracy will be subsequently tested again using the spontaneous sampling methods: a) twice during the treatment phase, b) immediately after treatment, and c) at two follow-up periods. All EEG/ERP measures, standardized test measures, speech-motor measures, and measures of speech accuracy, and speech-comprehensibility will also be repeated at the last period. Multiple regression, multivariate permutation tests, and growth curve analyses will be used to test the research questions. Five years of funding are requested. Relevance of this research to public health: People with DS often have difficulty developing accurate and comprehensible speech, which in turn has detrimental impacts on language, educational and social development. This project is designed to develop more effective treatments for speech disorders in DS.

描述（由申请人提供）：唐氏综合症 (DS) 儿童的一个主要发展挑战是在动态、成熟的系统环境中生成可理解且准确的语音，该系统是由不成熟的动态语音处理能力的输入介导的。 DS 中言语发育经常出现问题也许并不奇怪，言语障碍是一种相对较高的发病率，通常会从青春期一直持续到成年期，并且往往是 DS 的终生残疾特征。因此，开发更有效的治疗方法来改善言语障碍的两个关键要素：言语理解性和言语准确性非常重要。此外，由于患有 DS 的儿童在影响对言语治疗方法差异反应的能力方面表现出相当大的异质性，因此检查特定预处理技能作为生长的潜在预测因素或调节因素与对言语可理解性和言语治疗的差异反应之间的关系非常重要准确性。该项目的目的是检查预处理水平之间的关系：认知能力、言语运动能力、诱发和自发情境中的言语准确性程度、自发情境中的言语可理解性程度、听觉区分的脑电图/ERP测量音素和（a）经历过言语治疗的 DS 儿童的言语理解性和言语准确性水平的增长，以及（b）对旨在提高这些儿童的言语准确性和言语理解性水平的两种类型言语治疗的不同反应 孩子们。该项目将招募 60 名在治疗前均患有严重言语障碍的 DS 儿童。在进入研究时，将使用 PCA 和 ICA 方法测量音素的听觉分化，以及语音准确性和语音可理解性水平。然后，患有 DS 的儿童将被随机分配接受两种旨在提高言语技能的治疗方法之一：语音知识重铸 (PKR) 治疗或发音训练 (AT) 治疗。这些儿童将接受 1:1 的治疗，每次 60 分钟，每周 2 次，持续 6 个月。随后将使用自发抽样方法再次测试言语可理解性和言语准确性：a）在治疗阶段两次，b）治疗后立即测试，c）在两个后续阶段。所有 EEG/ERP 测量、标准化测试测量、言语运动测量、言语准确性和言语可理解性测量也将在最后一个阶段重复。多元回归、多元排列检验和增长曲线分析将用于测试研究问题。要求提供五年的资金。这项研究与公共卫生的相关性：患有 DS 的人通常难以发展准确和可理解的言语，这反过来又对语言、教育和社会发展产生不利影响。该项目旨在开发更有效的 DS 言语障碍治疗方法。