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: 7849882
• 负责人: Stephen Mark Camarata
• 金额: $ 18.92万
• 依托单位: VANDERBILT 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/7849882
• 关键词: Address; Adolescence; Adolescent; Adult; Affect; Aftercare; Area; Auditory; Birds; Characteristics; Child; Clinical Trials; Cognitive; Competence; Data; Development; 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; Population; Procedures; Production; Public Health; Rain; Randomized; 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; base; design; effective therapy; experience; follow-up; improved; knowledge base; phonology; post intervention; programs; response; skills; sound; speech accuracy; speech processing; standardize measure; 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）：唐氏综合症儿童（DS）的一个重大发展挑战正在在动态，成熟系统的背景下生成可理解和准确的语音，这是由未成熟，动态语音处理能力的输入所介导的。言语的发展经常在DS中出现问题，这也许并不奇怪，言语障碍是一种相对较高的发病率状况，通常在青春期一直持续到成年，并且通常是DS的终生残疾特征。因此，重要的是要开发更有效的治疗方法，以改善语音障碍的两个关键要素：语音的理解性和语音准确性。此外，由于具有DS的儿童在影响对语音治疗方法的差异反应的能力上表现出相当大的异质性，因此重要的是要研究特定的预处理技能作为潜在的预测因素或生长的潜在预测因素和对言语不理解性和语音准确性的治疗反应的差异反应。该项目的目的是检查预处理水平之间的关系：认知能力，语音运动能力，引发和自发背景的语音准确性，自发上下文中的语音程度，EEG/ERP的脑音/ERP测量，听觉差异的衡量和（音素的听觉差异）以及语音差异和（a）在言语中的表达方式和（a）在言语中的成长和（a）在言语中的差异和（a）在经历了跨度差异和（a）在跨越言语的差异和（a），以及跨度差异的措施，以及在跨度范围内经历过dds的措施，以及（a）在跨度差异的范围内，以及（a），与DDS的跨度差异（a”旨在提高这些儿童的语音准确性和语音可理解的水平。该项目将招募60名在预处理中患有严重言语障碍的DS儿童。进入研究时，将使用PCA和ICA方法来测量音素的听觉差异，语音准确性和语音可理解的水平也是如此。然后，患有DS的儿童将被随机分配给旨在提高语音技能的两种治疗方法之一：语音知识重铸（PKR）治疗或关节培训（AT）治疗。这些孩子将以1：1的格式接受60分钟/疗程的治疗，2/周，持续6个月。语音的理解性和语音准确性随后将使用自发抽样方法再次测试：a）在治疗阶段两次，b）立即治疗后，c）在两个随访期间。所有EEG/ERP的测量，标准化的测试措施，语音运动量度以及语音准确性的度量以及语音的理解性也将在最后一个时期重复。多元回归，多元置换测试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：DS患者通常难以发展准确且可理解的语音，这反过来又对语言，教育和社会发展产生了不利影响。该项目旨在为DS中的语音障碍开发更有效的治疗方法。