Communication in Infants and Social Screener : The CISS

描述（由申请人提供）：有效的早期干预取决于尽快可靠地筛查沟通障碍风险。已确定的婴儿沟通风险因素包括注意力不集中、手势、社交联系、探索性游戏和言语。尽管这些危险因素可以在 12-18 个月后被发现。并可靠地预测以后的语言和社交障碍，尝试在 2-1 个月的婴儿中检测类似的危险因素。由于现有筛选器的局限性，该筛选器仅包含 2-3 个用于前意向沟通的项目（即不针对听众的反应性或主动婴儿沟通行为），因此未能成功。目前还没有可用的筛查工具可以提供有关前意向沟通的规范且敏感的数据，并反映基于证据的预测因素，以区分 12 个月前有沟通障碍风险的婴儿。当从业者无法检测到已知与沟通风险相关的婴儿行为时，他们就无法针对最需要和有改善潜力的儿童进行早期干预。如果我们能够尽早识别沟通风险，我们就可以干预预测沟通障碍的技能，减轻儿童原发性障碍的影响，并减少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、灵敏、独立于模态的筛查仪，以检测 2-12 个月的意向前婴儿的沟通风险。 （婴儿沟通和社会筛查，或 CISS）。首席研究员的试点研究表明，一套简短的定性判断可以可靠地区分 2-12 个月的婴儿。那些后来表现出沟通障碍的人具有典型的发展（TD）。 CISS的简单定性判断源自PI对前意向性婴儿沟通的综合评估——婴儿社交和沟通行为量表，并对应于领先的幼儿沟通评估的行为集群——沟通和符号行为量表发展概况-婴幼儿检查表（CSBS DP-ITC）；韦瑟比和普里赞特，2002）。针对沟通风险的敏感而具体的筛查可以证明言语病理学家早期参与婴儿以及具有复杂沟通需求的较大儿童的合理性。我们将修订试点 CISS，以检测 2-12 个月婴儿的沟通风险因素。对有或没有已知残疾的婴儿进行回顾性视频数据评分，并在 2-12 个月时测试 130 名 TD 或有风险的前意向婴儿的新样本，以实现以下具体目标：使用视频数据库识别区分有沟通障碍风险的前意向婴儿和 TD 婴儿的 CISS 域。开发 CISS 集群和复合材料，以敏感性和特异性区分现有婴儿样本中的高危残疾状态。 使用相关分析（包括探索性因素分析和聚类分析），在 TD 和高危婴儿的新样品和录像样品中建立 CISS 聚类和综合评分的信度和效度。

DESCRIPTION (provided by applicant): Effective early intervention depends on reliable screening of risk for communication impairments as soon as possible. Established infant communication risk factors include poor attention, gestures, social connectedness, exploratory play, and speech. Although these risk factors can be detected by 12-18 mos. and reliably predict later language and social disorders, attempts to detect similar risk factors in infants 2-1 mos. have been unsuccessful because of limitations in available screeners that include only 2-3 items for preintentional communication (i.e., reactive or active infant communication behaviors not directed toward listeners). There are no available screeners that provide normed and sensitive data on preintentional communication and reflect evidence-based predictors that discriminate infants at risk for communication impairments before 12 mos. 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 skills that predict communication impairments, mitigate effects of primary impairments in children, and reduce potential for secondary impairments that affect communication and other life skills. The plan for this project is to develop a predictive, sensitive, modality- independent screener to detect communication risk in preintentional infants 2-12 mos. (Communication in Infants and Social Screener, or CISS). Pilot research by the Principal Investigator showed that a short set of qualitative judgments could reliably discriminate infants age 2-12 mos. with typical development (TD) from those who later showed communication impairment. The easy qualitative judgments on the CISS have been derived from the PI's comprehensive assessment of preintentional infant communication, the Infant Social and Communication Behavior Scales, and correspond to behavior clusters for the leading toddler communication assessment, the Communication and Symbolic Behavior Scales Development Profile - Infant Toddler Checklist (CSBS DP-ITC); Wetherby & Prizant, 2002). A sensitive and specific screener for communication risk could justify the early involvement of speech-language pathologists for infants as well as for older children with complex communication needs. We will revise the pilot CISS to detect communication risk factors in infants 2- 12 mos. with and without known disabilities, score retrospective video data from preintentional infants with and without known disabilities, and test new samples of 130 TD or at-risk preintentional infants at 2-12 mos., to achieve these specific aims: Identify CISS domains that discriminate preintentional infants at risk for communication disabilities from TD infants using video databases. Develop CISS clusters and a composite that discriminate at-risk disability status in existing infant samples with sensitivity and specificity. Establish reliability and validity of CISS cluster and composite scores in new as well as videotaped samples of TD and at-risk infants using correlational analyses, including exploratory factor analysis and cluster analysis.