Infant Assessment of Early Communication Risk Factors: The ECBS

描述（由申请人提供）：有效的早期干预取决于尽快可靠地识别沟通障碍的风险。已确定的婴儿沟通障碍的风险因素包括不良的话轮转换、手势、接受性语言、评论、象征性游戏和言语。尽管这些危险因素可以在12- 18个月内检测到。并可靠地预测以后的语言和社会发展，试图在2-12个月的儿童中检测类似的风险因素。由于可用评估的极端局限性（通常仅包括4-6项用于这些婴儿的预先有意交流的项目）而不成功（即，反应性或主动的婴儿沟通行为，不针对听众）。没有可用的规范化评估提供关于婴儿故意交流的全面和动态数据，并反映基于证据的预测因素，以区分12个月前有交流障碍风险的婴儿。当从业者不能发现婴儿的行为已知与沟通风险，他们不能有针对性的早期干预，以儿童最大的需求和改善的潜力。如果我们能够及早识别沟通风险，我们就可以干预预测后期沟通障碍的技能，并可能减轻儿童原发性障碍的影响，降低影响沟通和其他生活技能的继发性障碍的可能性。该项目的计划是开发一种预测性的、全面的、独立于模态的评估方法，以检测2-12个月大的有意图婴儿的沟通风险（早期沟通行为量表，或ECBS）。首席研究员的初步研究表明，一个简短的行为探针可以可靠地从2-12个月大的婴儿中引出有预谋的沟通行为，这些行为代表了11个基于证据的沟通风险预测因子。这11个预测因子对应于幼儿主要动态沟通评估的行为集群，沟通和象征行为量表（Wetherby和Prizant，1993; CSBS）。一个明确的预测的沟通风险可以证明早期参与的语音语言病理学家的婴儿以及年龄较大的儿童谁有复杂的沟通需求。我们将使用来自对2-12个月的典型发育婴儿施用ECBS的试验数据，并从专家小组建议中收集新数据，对已知残疾的意向前婴儿的回顾性视频数据进行评分，并测试100名2-12个月的典型发育意向前婴儿的新样本，以实现这些特定目标：使用视频数据库，确定ECBS域，区分有沟通障碍风险的先天婴儿和典型发育中的婴儿。开发ECBS项目，集群，并占现有婴儿样本的年龄和高危残疾状态的歧视域的复合材料。使用相关分析（包括探索性因素分析和聚类分析），在典型发育婴儿的新样本中建立ECBS量表、聚类和综合评分的信度和效度。 公共卫生相关性：我们已经认识到有必要尽早发现沟通问题，以便我们可以开始必要的早期沟通干预，但我们目前没有评估，为我们提供足够的信息，说明12个月以下有沟通障碍风险的婴儿的沟通看起来有何不同。早期沟通行为量表（ECBS）将是第一个全面和规范的评估沟通的婴儿2-12个月。有了这个工具，我们可以提高我们提供临床评估和干预的能力，在此期间磨练关键的沟通技能，为有可疑沟通风险因素的婴儿带来最大的公共卫生影响。我们还可以使用ECBS为那些继续需要这些早期沟通技能支持超过12个月的年龄较大的儿童和成年人制定更好的干预策略，并预测这些早期沟通技能的有效变化，这些早期沟通技能将大大提高生活质量，并为有重大沟通挑战的人提供互动。

DESCRIPTION (provided by applicant): Effective early intervention depends on reliable identification of risk for communication impairments as soon as possible. Established infant risk factors for communication impairments include poor turntaking, gestures, receptive language, commenting, symbolic play, and speech. Although these risk factors can be detected by 12- 18 mos. and reliably predict later language and social development, attempts to detect similar risk factors in children 2-12 mos. have been unsuccessful because of extreme limitations in available assessments that typically include only 4-6 items for these infants' preintentional communication (i.e., reactive or active infant communication behaviors that are not directed toward listeners). There are no available normed assessments that provide comprehensive and dynamic data on infant preintentional communication and reflect evidence- based predictors that discriminate infants at risk for communication impairments before 12 months. When practitioners cannot detect infant behaviors known to be associated with communication risk, they cannot target early intervention to children with the greatest needs and potential for improvement. If we can identify communication risk early enough, we can intervene in the skills that predict later communication impairments and potentially mitigate effects of primary impairments in children and reduce the likelihood of secondary impairments that affect communication and other life skills. The plan for this project is to develop a predictive, comprehensive, modality-independent assessment to detect communication risk in preintentional infants 2-12 months (the Early Communication Behavior Scales, or ECBS). Pilot research by the Principal Investigator showed that a short behavior probe could reliably elicit preintentional communication behaviors from infants age 2-12 months that represent 11 evidence-based predictors of communication risk. These 11 predictors correspond to behavior clusters for the leading dynamic communication assessment for toddlers, the Communication and Symbolic Behavior Scales (Wetherby and Prizant, 1993; CSBS). A clear prediction of communication risk could justify the early involvement of speech-language pathologists for infants as well as for older children who have complex communication needs. We will use pilot data from administering the ECBS to typically developing infants 2-12 months, and collect new data from expert panel advice, score retrospective video data from preintentional infants with known disabilities, and test new samples of 100 typically developing preintentional infants 2-12 months of age, to achieve these specific aims: Identify ECBS domains that discriminate preintentional infants at risk for communication disabilities from typically developing infants, using video databases. Develop ECBS items, clusters, and a composite that account for domains that discriminate by age and at-risk disability status in existing infant samples. Establish the reliability and validity of the scale, cluster, and composite scores for the ECBS in a new sample of typically developing infants using correlational analyses, including exploratory factor analysis and cluster analysis. PUBLIC HEALTH RELEVANCE: We have recognized the need for detecting communication problems as early as possible so that we can start essential early communication intervention, but we do not presently have assessments that provide us enough information about how communication looks different in infants under 12 months at risk for communication disabilities. The Early Communication Behavior Scales (ECBS) would be the first comprehensive and normed assessment of communication for infants 2-12 months. With this tool, we could enhance our ability to provide clinical assessment and intervention to hone in on key communication skills during this period that make the greatest public health impact for infants with suspected communication risk factors. We can also use the ECBS to develop better intervention strategies for older children and adults who continue to need support with these early communication skills for longer than 12 months, and to predict effective changes in these early communication skills that vitally enhance quality of life and interaction for persons with significant communication challenges.