Determining Optimal Treatment Intensity for Children with Language Impairment (LI)

确定语言障碍儿童 (LI) 的最佳治疗强度

• 批准号: 10327332
• 负责人: Mary Beth Schmitt
• 金额: $ 59.46万
• 依托单位: UNIVERSITY OF TEXAS AT AUSTIN
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-02-10 至 2024-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10327332
• 关键词: 6 year old; Address; Adult; Affect; Aftercare; Area; Books; Businesses; Characteristics; Child; Communication; Complex; Developmental Disabilities; Diagnosis; Dose; Education; Effectiveness of Interventions; Frequencies; Goals; Internships; Intervention; Intervention Studies; Intuition; Investigation; Investments; Justice; Knowledge; Language; Language Therapy; Learning; Literature; Long-Term Effects; Measures; Nature; Occupations; Outcome; Participant; Privatization; Randomized; Reading; Regimen; Research; Research Design; Schedule; School-Age Population; Schools; Services; Special Education; Students; Symptoms; Teaching Method; Testing; Therapeutic; Time; Treatment Protocols; Treatment outcome; Variant; Vocabulary; Work; clinical practice; college; design; dosage; effective intervention; effective therapy; evidence base; follow-up; improved; improved outcome; kindergarten; language impairment; low socioeconomic status; novel; optimal treatments; peer; post intervention; reading ability; recruit; skills; statistics; theories; therapy duration; treatment optimization; word learning

Project Summary The proposed study aims to determine the optimal levels of treatment intensity of a word learning intervention for young school-age children with language impairment (LI; 5- 6-years-old) by systematically manipulating the treatment dose and frequency children receive. Cumulative intensity is the product of treatment dose (the number of treatment exposures) and treatment frequency (the number of treatment sessions) and both contribute to intervention effectiveness. To date, there are few studies that have examined the interplay of dose and frequency to determine optimal levels to affect change, and the extent to which there may be a threshold, or a level after which significant gains diminish. Within the framework of distributed learning theory (Cepeda et al., 2006), the proposed study will determine the optimal level of treatment intensity of an efficacious work learning intervention (Justice et al., 2005; Storkel et al., 2017; Voelmle and Storkel, 2017) designed to improve the vocabulary knowledge of children with LI. The first aim, determining the optimal number of treatment sessions, is proposed to determine differences between treatment provided within a distributed, or spaced, schedule (high-frequency, 4 times a week) and a consolidated, or massed, treatment session (low-frequency, 1 time a week). The second aim of this study, identifying optimal dosage, will determine the number of times a word should be targeted, using rich instructive strategies, within each frequency condition. Preliminary studies of children with LI in the public schools suggest that children with LI who received high frequency/low dose treatment (or low frequency/high dose) made better gains over time than children receiving the extremes (Schmitt et al., 2017). These findings are correlational in nature; the current study aims to manipulate both parameters of intensity (dose and frequency) to determine the optimal levels of treatment intensity. This study’s third aim will examine the point at which increases in dose with respect to frequency (i.e., more word exposures) are no longer advantageous to children’s outcomes. To address these aims, the proposed study will recruit 180 children with LI over three consecutive years. Participants will be randomized into one of two frequency conditions (high vs. low) which will determine how frequently they receive treatment (once/week or four times/week). Within those treatment sessions, children will learn 60 words; each word will be randomly assigned to one of six possible dose conditions (0 – 20 word exposures). Student interns will deliver the manualized word learning intervention in one-on-one sessions for 10 weeks in the summer. Although frequency conditions differ, all children will receive 120 minutes of therapy per week. Children’s learning of the novel words, as well as their overall vocabulary skills will be measured at three time points: pre-treatment, immediate post-treatment, and 6-months post treatment to assess the impact of the treatment and intensity regimens on short and long-term outcomes. Findings will immediately inform clinical practice regarding quantity of therapy needed for improving the vocabulary skills of children with LI.

项目摘要 这项研究旨在确定词汇学习的最佳处理强度水平 对5~6岁学龄儿童语言障碍的系统干预 操纵儿童接受的治疗剂量和频率。累积强度是以下各项的乘积 治疗剂量(治疗暴露次数)和治疗频率(治疗次数 会议)，并且两者都有助于干预的有效性。到目前为止，很少有研究检查过 剂量和频率的相互作用，以确定影响变化的最佳水平，以及影响的程度 可能是一个门槛，也可能是一个水平，在这个水平之后，显著的收益就会减少。在分布式的框架内 学习理论(Cepeda等人，2006年)，拟议的研究将确定治疗强度的最佳水平 有效的工作学习干预(Justice等人，2005；Storkel等人，2017；Voelmle和Storkel，2017) 旨在提高黎族儿童的词汇知识。第一个目标，确定最优 治疗疗程的次数，建议用来确定在 分散的或间隔的时间表(高频，每周4次)和综合或集中治疗 会议(低频率，每周1次)。这项研究的第二个目标，确定最佳剂量，将 使用丰富的指导性策略，在每个单词中确定一个单词应该被瞄准的次数 频率条件。对公立学校李氏病儿童的初步研究表明，李氏病儿童 接受高频/低剂量治疗(或低频/高剂量)的人随着时间的推移取得了更好的进展 而不是孩子们接受极端(Schmitt等人，2017年)。这些发现在本质上是相互关联的； 目前的研究目的是操纵强度的两个参数(剂量和频率)来确定最佳的 治疗强度的水平。这项研究的第三个目标将检查剂量增加的时间点 在频率方面(即，更多的单词暴露)不再对儿童的结果有利。 为了实现这些目标，这项拟议的研究将在连续三年内招募180名患有李氏综合症的儿童。 参与者将被随机分成两种频率条件(高频率和低频率)之一，这将决定如何 他们经常接受治疗(每周一次或每周四次)。在这些治疗过程中，儿童 将学习60个单词；每个单词将被随机分配到六个可能的剂量条件(0-20个单词)之一 曝光)。学生实习生将在一对一的课程中提供手工单词学习干预 夏天有10个星期。尽管频率条件不同，所有儿童都将接受120分钟的治疗 每周。孩子们对新词的学习以及他们的整体词汇技能将在 三个时间点：治疗前、治疗后即刻和治疗后6个月以评估影响 治疗和强度方案对短期和长期结果的影响。调查结果将立即通知 提高黎族儿童词汇技能所需治疗量的临床实践。