Exercise as Treatment in Children with Communication Impairments

项目摘要/摘要 在美国，大约10%的3-10岁儿童会受到沟通障碍的影响，罚款/总罚款 令人震惊的是，30%-85%的人同时存在运动障碍。一个明显高的亚群 患有发育性语言障碍(DLD；a)的儿童的语言和运动障碍并存的比率 影响1/13儿童表达和/或接受性语言的高度常见的障碍)。因此， 数以百万计的儿童患有这些衰弱的损伤，需要耗时和昂贵的治疗， 这通常发生在特定学科的竖井中。孤立的方法有局限性，因为它不能充分利用 当我们治疗整个儿童而不是干预时，可能达到的潜在协同效应 一条又一条的纪律。不幸的是，这种现状孤立的方法导致了有限的增量收益。 需要利用神经可塑性和产生多系统收益的替代的、根本性的干预措施。 以填补语言和运动障碍儿童治疗选择上的这一空白。 这项拟议研究的目标有两个。目标1研究将确定运动能力和体能。 儿童运动障碍的水平，并仔细描述这一人群中儿童运动障碍的特征。其目的是 2研究是一项0期/早期1期随机对照试验，旨在测试体育锻炼作为促进 患有DLD的儿童的认知-语言、运动和健康方面的进步。参与者将被随机分配到 进行6周(3次/周)的运动训练(即训练心血管健康、敏捷性、平衡性、 体力、耐力)或安静的休息状态(例如，乐高和上色)。两者都有 干预措施将在4名或4名以下儿童的小组中提供。认知-语言、运动技能和健康 将在治疗前以及治疗后1周、1个月和3个月再次进行评估，以确定 这些措施带来的治疗和维持收益。这项研究将为第二阶段收集重要信息 初步疗效试验，并提供高质量的证据，将帮助言语语言病理学家和 其他从业者则以证据为基础做出临床决策。这项研究计划的长期目标是 确定患有沟通障碍的儿童的共病障碍的广度，并以最佳方式发展 有效治疗，最大限度地提高数百万有沟通能力的儿童的结局和生活质量 残障人士及其家人。

Project Summary/Abstract Communication impairments affect ~10% of children in the US between 3-10 years of age, and fine/gross motor deficits co-occur in an astounding 30-85% of this population. One subpopulation that evidences high rates of co-occurring language and motor deficits is children with developmental language disorder (DLD; a highly common disorder that affects expressive and/or receptive language in 1/13 children). Consequently, millions of children present with these debilitating impairments that require time-consuming and costly therapy, which typically occurs in discipline-specific silos. The siloed approach has limitations as it fails to leverage potentially synergistic effects that may be achieved when we treat the whole child, rather than intervene discipline by discipline. Unfortunately, this status quo siloed approach results in limited, incremental gains. Alternative, ground-shifting interventions that harness neuroplasticity and yield multisystem gains are needed to fill this gap in treatment options for children with co-occurring language and motor deficits. The goal of the proposed research is two-fold. The Aim 1 study will establish motor performance and fitness levels for children with DLD and carefully characterize the motor deficits of children in this population. The Aim 2 study is a Phase 0/Early Phase 1 RCT that tests the efficacy of physical exercise as treatment to promote cognitive-linguistic, motor, and fitness gains in children with DLD. Participants will be randomly assigned to undergo 6 weeks (3x/week) of exercise training (i.e., activities to train cardiovascular fitness, agility, balance, strength, endurance) or to a quiet rest condition (e.g., legos and coloring) on the same schedule. Both interventions will be provided in small groups of 4 children or less. Cognitive-linguistic, motor skills, and fitness will be assessed pre-treatment and again at 1-week, 1-month, and 3-months post treatment to determine treatment and maintenance gains on these measures. This research will gather vital information for a Phase 2 trial of preliminary efficacy and contribute high-quality evidence that will help speech language pathologists and other practitioners make evidence-based clinical decisions. The long-term goal of this research program is to identify the breadth of comorbid impairments in children with communication disorders and develop optimally effective treatments to maximize outcomes and quality of life for the millions of children with communication impairments and their families.