Maximizing outcomes for preschoolers with developmental language disorder: testing the effects of a sequentially targeted naturalistic intervention

项目总结 7%-10%的儿童患有发育性语言障碍(DLD)，但没有其他发育障碍 对幼儿园入学的担忧，1，2使他们面临学业和社会成绩不佳的重大风险 3短暂的自然主义干预可以显著增加表现力 接受和表达语言延迟的学步儿童的词汇，4但这不足以减少 词汇或句法方面的发展差距。5到目前为止，还没有研究考察持续的 早期干预以最大限度地提高语言效果。拟议的研究将：(A)评价一项 序贯语言干预对发育高危幼儿词汇和语法的影响 语言障碍(DLD)和(B)检查干预效果的调节因子和中介因子。建议数 混合式干预(EMT-SF)提供了一种经验性的干预，增强了教学环境 (EMT)，与理论上有动机的、以句子为重点(SF)的治疗目标序列6、7和 新的输入修改策略。8，9中心假设是干预将导致更多的词汇量 以及治疗组中DLD高危儿童的语法结果。拟议的研究是一项 父母实施EMT-SF干预效果的分层随机临床试验 和治疗师，将108名30个月大的儿童和他们的父母纳入控制条件。四个具体的 指导研究的目标是： 1.比较治疗组和对照组儿童在词汇和语法结果上的差异 48个月大。 2.确定父母语言输入和父母对干预策略的使用程度 调节儿童语言结果。 3.确定干预期间儿童水平因素和儿童进步预测的程度 语言效果 4.确定干预对口语和口语的更广泛方面的影响程度 与识字和入学准备有关的行为(去语境化的语言、叙事能力、 行为问题)(探索性)。 影响：这项研究将确定持续的早期干预是否可以降低DLD的长期风险，将 告知发展理论，并提供可能改变学龄前服务交付的关键信息 模特们。

PROJECT SUMMARY Between 7-10% of children have developmental language disorders (DLD) without other developmental concerns at kindergarten entry,1,2 which place them at significant risk for poor academic and social outcomes across the school years and into adulthood.3 Brief naturalistic intervention can significantly increase expressive vocabulary in toddlers with receptive and expressive language delays,4 but it is not sufficient to reduce the developmental gaps in vocabulary or syntax.5 No studies to date have examined the potential of sustained early intervention for maximizing language outcomes. The proposed study will: (a) evaluate the effects of a sequential language intervention on the vocabulary and grammar of young children at risk for developmental language disorder (DLD) and (b) examine moderators and mediators of intervention effects. The proposed hybrid intervention (EMT-SF) provides an empirically-supported intervention, Enhanced Milieu Teaching (EMT), blended with a theoretically-motivated, sentence-focused (SF) sequence of treatment targets6,7 and new input modification strategies.8,9 The central hypothesis is that intervention will result in greater vocabulary and grammar outcomes for children at high risk for DLD in the treatment group. The proposed research is a stratified randomized clinical trial comparing the effects of the EMT-SF intervention, implemented by parents and therapists, to a control condition and enrolling 108, 30-month-old children and their parents. Four specific aims guide the study: 1. Compare differences in vocabulary and grammar outcomes in treatment vs control children at 48 months of age. 2. Determine the extent to which parent language input and parental use of intervention strategies mediate child language outcomes. 3. Determine the extent to which child-level factors and child progress during intervention predict language outcomes 4. Determine the extent to which the intervention impacts broader aspects of spoken language and behavior related to literacy and school readiness (decontextualized language, narrative abilities, behavior problems) (exploratory). IMPACT: This study will determine if sustained early intervention can reduce the long-term risks of DLD, will inform developmental theory, and provide critical information that may transform preschool service delivery models.