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

通过混合远程医疗提供早期增强和替代沟通 (AAC) 干预

• 批准号: 10437264
• 负责人: Emily Dayle Quinn
• 金额: $ 20.6万
• 依托单位: OREGON HEALTH & SCIENCE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-04-04 至 2025-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10437264
• 关键词: Address; Adherence; Adoption; Augmentative and Alternative Communication; Behavior; Caregiver support; Caregivers; Child; Child Language; Clinical Trials; Communication; Communication impairment; Comprehension; Data; Development; Educational Activities; Educational process of instructing; Experimental Designs; Exposure to; Family; Foundations; Future; Geography; Goals; Home; Hybrids; Instruction; Intellectual functioning disability; Intervention; Interview; Language; Language Development; Language Therapy; Learning; Methods; Modeling; Modification; National Institute on Deafness and Other Communication Disorders; Nursery Schools; Outcome; Parents; Participant; Pathologist; Persons; Population; Preparation; Procedures; Qualitative Methods; Questionnaires; Research; Research Priority; Service delivery model; Speech; Testing; Text Messaging; Time; Toddler; Transportation; Visual; Vocabulary; Work; base; clinical practice; community based treatment; critical period; design; effective intervention; effectiveness implementation study; effectiveness implementation trial; elementary school; experience; experimental study; implementation science; implementation strategy; improved; innovation; intervention effect; language impairment; language outcome; literacy; novel; pilot test; post intervention; preference; primary outcome; secondary outcome; service delivery; skills; social; telehealth; therapy design; therapy development; treatment adherence; underserved community

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.

项目总结