Developing a caregiver-administered word learning treatment for children with Developmental Language Disorder (DLD)

项目总结 将最佳实践纳入日常临床实践平均需要17年时间。这 研究与实践之间的差距令人震惊，是改善个人生活的主要障碍 沟通障碍。一个关键的研究到实践的障碍是大多数临床研究是在 学术环境，而不是在日常环境中。这导致了基于证据的程序，而不是 在现实世界中是可行的。这个K18奖项的目标是提高候选人的实施技能 科学(促进将循证实践融入日常环境的方法研究) 并将她的研究转移到缩小研究与实践的差距上。在培训目标方面，应聘者 将完成实施科学的在线研究生证书，并将与导师和 Juniper Gardens儿童计划的同事们，以获得领导高质量社区的技能- 从事实施研究。在研究方面，患有发育性语言障碍的儿童 学习困难(DLD)的人学习新单词的速度比同龄人慢，这使他们面临学习失败的风险。读书是一种 向患有DLD的儿童教授新单词的有效方法，并有可能扩展以满足迫切的需求 在这个小组中持续学习单词。具体地说，培训照顾者(例如，父母)教书的计划 通过书籍阅读和每月提供一套生词读本和教材具有潜力 具有成本效益和深远的好处：照顾者可以定期教他们的孩子新单词。 拟议的初步临床试验向这一长期目标迈出了第一步，开发了一名护理员- 针对有DLD风险的学龄前儿童进行读书治疗。40名儿童患有 DLD和他们的照顾者将分三个阶段参加暑期阅读计划：(1)为期4周 向他们提供带有突出显示的词汇和阅读日志的书籍的时期(基线 记录典型阅读和教学行为的阶段)；(2)为期4周的培训， 支持、书籍和教材(实施阶段)；(3)为期4周 书籍和教材，以检查他们继续计划的能力(可持续发展阶段)。目标1 和2确定照顾者是否增加治疗剂量(在治疗期间教单词的次数 阅读)和剂量频率(一本书被阅读的次数)在实施和维持中 相对于基线。AIM 3将使用调查、访谈和实地笔记来确定照顾者发现的是什么 治疗容易或困难，特别是在剂量和剂量频率方面。目标4将决定 儿童单词学习是否因照顾者剂量和/或剂量频率而异。这项研究推进了我们的 了解治疗的哪些方面(剂量或剂量频率)对照顾者来说最难 实施。这将提高我们有效培训和支持照顾者进行治疗的能力， 让我们更接近于为DLD儿童创造一种可扩展的、有效的单词学习疗法。

PROJECT SUMMARY It takes an average of 17 years for best practices to be incorporated into everyday clinical practice. This research-to-practice gap is shocking and is a major barrier to improving the lives of individuals with communication disorders. One critical research-to-practice barrier is that most clinical research is done in academic settings, rather than in everyday settings. This has led to evidence-based procedures that are not feasible in the real word. The goal of this K18 award is to improve the candidate's skills in implementation science (the study of methods to promote the integration of evidence-based practices into everyday settings) and move her research into closing the research-to-practice gap. In terms of training objectives, the candidate will complete an online graduate certificate in implementation science and will work with mentors and colleagues at the Juniper Gardens Children's Project to gain skills in conducting high quality community- engaged implementation research. In terms of research, children with Developmental Language Disorder (DLD) are slower to learn new words than their peers, placing them at risk for school failure. Book reading is an effective way to teach new words to children with DLD and potentially can be scaled to meet the pressing need for continual word learning in this group. Specifically, a program that trains caregivers (e.g., parents) to teach new words through book reading and provides a monthly set of books and teaching materials has the potential to be cost effective and have far-reaching benefits: The caregiver can regularly teach their child new words. The proposed preliminary clinical trial takes a first step towards this long-term goal by developing a caregiver- administered book reading treatment aimed at pre-kindergarten children at-risk for DLD. Forty children with DLD and their caregivers will participate in a summer book reading program across three phases: (1) a 4-week period where they are provided with books with highlighted vocabulary words and a reading log (baseline phase to document typical reading and teaching behaviors); (2) a 4-week period where they receive training, support, books, and teaching materials (implementation phase); (3) a 4-week period where they receive books and teaching materials to examine their ability to continue the program (sustainability phase). Aims 1 and 2 determine whether caregivers increase the treatment dose (the number of times words are taught during book reading) and dose frequency (the number of times a book is read) in implementation and sustainment relative to baseline. Aim 3 will use surveys, interviews, and field notes to determine what caregivers find to be easy or difficulty about the treatment, especially in terms of dose and dose frequency. Aim 4 will determine whether child word learning varies by caregiver dose and/or dose frequency. This research advances our understanding of what aspects of treatment (dose or dose frequency) are the most difficult for caregivers to implement. This will improve our ability to effectively train and support caregivers in administering treatments, moving us closer to creating a scalable, effective word learning treatment for children with DLD.