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

项目摘要 辅助和替代交流（AAC）干预可以提高语言，识字，社交和沟通能力。 为有严重沟通障碍的儿童提供适应技能。然而，AAC在语音中没有得到充分利用- 为智力和发育障碍（IDD）幼儿提供语言治疗。混合远程保健模式 可以通过扩大对言语语言病理学家的访问来改变早期AAC干预措施的实施 （SLP），并减少服务不足社区的地理和交通障碍。 这项建议的目的是开发和试点测试的混合远程保健AAC干预幼儿 IDD及其家人。我们采用实施科学的方法，使用系统的定性 方法，以确定照顾者和SLP的喜好和单例实验设计方法，以评估 审计咨询委员会干预的可行性。中心假设是，干预将改善照顾者的 使用AAC策略，这将导致儿童的表达沟通技巧的增加。三 提出了具体目标。目标1：确定利益攸关方对审计咨询委员会两个关键领域的偏好和需求 干预组成部分：（a）提供服务和（B）加强坚持治疗的战略。我们 将与照顾者和SLP进行访谈，以评估他们对 干预访谈结果将告知对服务提供模式和治疗的初步修改 目标2和3中研究的坚持策略。目标2：通过迭代开发审计咨询委员会干预措施 测试周期。我们将进行六个跨行为的多重基线设计，以完善AAC干预 并使用面对面的服务交付展示初步功效。这项研究的结果将告知 适应AAC干预的混合远程保健提供，包括面对面和远程保健 目标3中评估的会话。目标3：进行混合远程保健AAC干预的试点测试。我们将 在参与者中使用组合多探头设计对混合远程医疗AAC干预进行试点测试 和行为。九个亲子配对将接受24次干预会议，8次会议提供给 16个家庭通过远程保健提供。主要结果是照顾者对AAC干预的使用 策略，次要结果是儿童沟通行为。这是一项创新，因为它 使用实施科学的方法来开发一种新的混合远程医疗AAC干预， 可行的，可接受的，并适合其最终用户，增加的可能性， 常规临床实践。该项目意义重大，因为它解决了早期审计咨询委员会的关键需求 为家庭使用而设计的语言干预。我们的预期成果是开发出AAC 干预和实施战略，为R 01应用程序进行大规模 临床试验

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.