Infant Screening of Early Communication Risk: The CISS, Phase II

婴儿早期沟通风险筛查：CISS，第二阶段

• 批准号: 8902769
• 负责人: CYNTHIA J CRESS
• 金额: $ 28.1万
• 依托单位: PAUL H. BROOKES PUBLISHING COMPANY, INC.
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-04-15 至 2019-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8902769
• 关键词: 3 year old; Affect; Age; Attention; Autistic Disorder; Behavior; Child; Communication; Communication Disability; Communication impairment; Complex; Data; Development; Diagnosis; Disease; Early Intervention; Factor Analysis; Family; Gestures; Goals; Health; Impairment; Infant; Infant Behavior; Intervention; Judgment; Language; Language Development; Language Disorders; Language Therapy; Life; Measures; Modality; Modeling; Nebraska; Neurologic; Outcome; Parents; Pathologist; Phase; Play; Principal Investigator; Process; Provider; Reporting; Research; Risk; Risk Factors; Sampling; Services; Severities; Site; Social Behavior; Social Development; Speech; Speech Sound; Staging; System; Testing; Toddler; Training; Validity and Reliability; Visit; base; communication behavior; cost effective; developmental disease; disability; evidence base; flexibility; follow-up; high risk infant; improved; joint attention; meetings; pediatrician; public health relevance; satisfaction; screening; skills; social; sound; tool

 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 refine and norm a predictive, sensitive, modality-independent screener to detect communication risk in preintentional infants 2-12 mos. (Communication in Infants and Social Screener, or CISS). Phase I research by the Principal Investigator showed that the CISS is an internally consistent measure to reliably identify preintentional risk factors in infants 2-12 months who later show communication impairments. 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 (ISCBS), 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 and norm the Phase I CISS to detect communication risk factors in infants 2-12 mos. with and without known disabilities, test new samples of over 350 TD and over 150 at-risk preintentional infants at 2-12 mos., and administer the CISS through pediatrician well-baby visits to achieve these specific aims: Establish the reliability, validity, and age-based norms of the scales, domains, and composite scores for the CISS in nationally representative samples of typically developing infants using correlational analyses, including confirmatory factor analysis; demonstrate the efficacy of the CISS at discriminating communication risk factors associated with disability in high-risk infants as well as infants without known risk; and establish the feasibility and efficacy of CISS administration through pediatrician well-baby visits.

 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的风险。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。虽然这些危险因素可以在12-18个月内被检测到。并可靠地预测以后的语言和社交障碍，试图在2-1个月的婴儿中检测类似的危险因素。由于可用筛查器仅包括2-3项事前沟通(即反应性或主动性的婴儿沟通行为，而不是针对听者)的限制，这些项目都不成功。目前还没有可用的筛查器来提供有关故意沟通的正常和敏感数据，并反映出基于证据的预测指标，这些预测指标可以在12个月之前区分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有关的婴儿行为时，他们就不能针对最有需求和改进潜力的儿童进行早期干预。如果我们能够足够早地识别沟通风险，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。这个项目的计划是完善和规范一种预测性的、灵敏的、不依赖于医疗机构的筛查器，以检测 预想婴儿2-12个月的沟通风险。(婴儿和社交筛选器中的交流，或称CI)。首席调查员进行的第一阶段研究表明，CI是一种内部一致的测量方法，可以可靠地识别2-12个月后出现沟通障碍的婴儿的预想风险因素。对婴儿沟通障碍的简单定性判断来自于PI对有意前婴儿沟通的综合评估，婴儿社交和沟通行为量表(ISCBS)，并对应于主要幼儿沟通评估的行为分类，沟通和符号行为量表发展概况-婴幼儿-幼儿检查表(CSBS DP-ITC；Wetherby&Prizant，2002)。对沟通风险进行敏感和具体的筛查，可以证明言语语言病理学家对婴儿和有复杂沟通需求的年龄较大的儿童的早期参与是合理的。我们将修订和规范第一阶段CI，以检测2-12个月婴儿的沟通危险因素。在2-12个月测试350多个TD和150多个高危预想婴儿的新样本，并通过儿科医生的婴幼儿访视来管理CISS，以实现这些特定目标：利用包括验证性因素分析在内的相关分析，建立具有全国代表性的发育中婴幼儿样本的CISS量表、领域和综合分数的信度、效度和基于年龄的常模；展示CISS在区分高危婴儿以及非已知风险婴儿中与残疾相关的沟通危险因素的有效性；以及通过儿科医生的婴幼儿访视来建立CISS管理的可行性和有效性。