Effects of Intensity of Early Communication Intervention

描述(由申请人提供)：我们率先开发了一种语言前和语言环境干预(PLMT)，旨在建立有意的沟通，并促进有语言障碍和语言障碍的幼儿和幼儿的早期沟通和语言发展。PLMT包括对幼儿的直接干预，以及旨在建立和支持高度反应的亲子互动风格的家长培训。我们的初步研究采用随机实验设计，S对儿童进行了非常小的直接干预，为期六个月，平均每周约一小时。我们观察到的效果是令人鼓舞的，但也是温和的，特别是在6个月干预期之后直接衡量的结果。这项研究是对这样一种假设的检验，即更密集地应用PLMT将产生更积极的结果。我们建议对80名具有一般通信延迟的幼儿在两种不同强度下进行PLMT的效果进行实验研究，这些儿童被随机分配到高强度组或低强度组。低强度组的儿童将接受为期9个月的每周1小时的直接干预，而分配给高强度组的儿童将接受为期9个月的每周5小时的直接干预。两组的所有受试者都将再接受6个月的随访。这项研究的具体目的是比较高剂量和低剂量的PLMT对儿童非语言和言语交流技能的影响。我们还将测试干预措施和几种儿童预适应特征之间的假设交互作用，并测试预测治疗效果的预测中介因素。分析将包括t检验、2x2方差分析和多水平分析(HLM)。如果需要对治疗前的差异进行统计控制，将使用多元回归或ANCOVA。要求提供五年的资金。

DESCRIPTION (provided by applicant): We have pioneered the development of a prelinguistic and linguistic milieu intervention (PLMT) designed to establish intentional communication and enhance the development of early communication and language development in toddlers and young children with language delays and disorders. PLMT involves direct intervention with toddlers as well as parent training designed to establish and support a highly responsive style of parent-child interaction. Our preliminary research using randomized experimental design s has involved a very small "dose" of direct intervention with the child, averaging approximately one hour per week for six months. The effects we have observed have been encouraging, but moderate, especially when measured directly after the 6-month intervention period. The proposed research is a test of the hypothesis that more intensive application of PLMT will have dramatically more positive outcomes, We propose an experimental investigation of the effects of PLMT delivered at two different levels of intensity to 80 young children with general communication delays randomly assigned to either a "high" or "low" intensity group. Children in the low- intensity group will receive one hour of direct intervention per week for 9 months while children assigned to the high-intensity group will receive 5 hours a week of direct intervention for 9 months. All subjects in both groups will be followed for an additional 6 months. Specific aims of the study are to compare the effects of high and low doses of PLMT on children's nonverbal and verbal communication skills. We will also test hypothesized interactions between the interventions and several child pretreatment characteristics and test predicted mediators for the predicted treatment effects. Analyses will include t-tests, 2x2 ANOVA, and multi-level analysis (HLM). Multiple regression or ANCOVA will be used if statistical control of pre-treatment differences are necessary. Five years of funding is requested.