Enhancing Communication between Children in EI and their Depressed Mothers

 描述(由申请人提供)：这个分两个阶段的项目将测试在早期干预(EI)服务中纳入干预措施的可行性，以加强诊断为或怀疑患有发育障碍的婴儿和幼儿与其抑郁的母亲之间的沟通。联邦政府资助的EI服务在所有50个州为发育迟缓的婴儿和幼儿提供，以改善儿童的长期认知和行为结果。当儿童接受一致的发展支持活动时，EI服务得到优化，这是家庭全天、每一天的正常程序的一部分。EI服务经常包括家长实施的语言丰富干预措施，以增加以儿童为中心的演讲和互惠(话轮转换)交流，这与积极的儿童结果有关。这样的干预依赖于父母始终如一的注意、互惠互动和对孩子暗示的敏感性。抑郁症状在EI注册儿童的母亲中普遍存在，可能会剥夺母亲的这些能力。幸运的是，为抑郁的母亲提供具体的、可获得的技能来改善与孩子的互动可以减少 抑郁症对母子的影响。EI是一个理想的环境，可以将筛查、支持和有针对性的沟通技能整合到抑郁症母亲身上，以改善EI儿童的结局。首先，我们将使用焦点小组和访谈数据，为企业员工量身定做工具包和培训计划，并确定员工识别、筛选和支持是否可行 有抑郁症状的母亲。关于该工具包的数据将从4名EI工作人员那里收集关于可行性(易用性、所需时间)和母亲可接受程度的数据。然后，我们将确定母亲是否可以利用嵌入在EI服务中的技术支持的语言增强评估/干预系统(LENA)进行干预，以增加以儿童为中心的言语和相互交流。Lena使用婴儿或蹒跚学步的衣服，带有一个集成的录音带设备，可以记录以孩子为中心的成人语音、孩子的发声以及父母和孩子之间的互换对话。Lena软件产生视觉反馈，母亲可以用来集中与孩子基于语言的互动。Lena支持的沟通反馈干预将在10名母亲和10名EI工作人员中实施，每周使用Lena一天，连续使用16个小时，连续三周。将对可行性数据、Lena交流数据(成人字数、儿童发声和话轮转换)、交流和符号行为量表、母亲抑郁症状(PHQ-9)和儿童残疾情况(马伦早期学习量表)进行分析，以确定该方法的潜在用处。这套量身定制的干预方案将为最大限度地提高可扩展性而设计，最终目标是让全国的EI专业人员使用它来加强母子沟通，最大限度地提高EI对儿童的效果。

 DESCRIPTION (provided by applicant): This two-phase project will test the feasibility of integrating into Early Intervention (EI) services an intervention to enhance communication between infants and toddlers with diagnosed or suspected developmental disabilities and their depressed mothers. Federally-funded EI services are provided in all 50 states to infants and toddlers with developmental delays to improve long-term child cognitive and behavioral outcomes. EI services are optimized when the child receives consistent developmentally supportive activities as part of the family's normal routines throughout the day, every day. EI services frequently include parent-implemented language enrichment interventions to increase child-centered speech and reciprocal (turn-taking) communication, which have been linked to positive child outcomes. Such interventions are dependent on consistent parent attentiveness, reciprocal interactions, and sensitivity to child cues. Depressive symptoms, prevalent in mothers of EI-enrolled children, can rob mothers of these capabilities. Fortunately, providing depressed mothers with concrete, attainable skills for improving interactions with their child can reduce the impact of depression on mother and child. EI is an ideal setting in which to integrate screening, support, and targeted communication skills for depressed mothers in order to improve EI child outcomes. First, we will use focus group and interview data to tailor a toolkit and training program for EI staff and determine whether it is feasible for staff to identify, screen and support mothers with depressive symptoms. Data on the toolkit will be collected from 4 EI staff on feasibility (ease of use, time required) and acceptability to mothers. Then, we will determine whether it is feasible for mothers to engage in an intervention to increase their child-centered speech and reciprocal communication using a technology-supported Language ENhancement Assessment/intervention system (LENA) embedded in EI services. The LENA uses an infant or toddler garment with an integrated audiotape device that records adult speech centered on the child, child vocalizations, and reciprocal turn-taking conversations between parent and child. The LENA software produces visual feedback that a mother can use to focus her language-based interactions with her child. The LENA-supported communication feedback intervention will be implemented with 10 mothers and 10 EI staff by using LENA one day a week for 16 consecutive hours for three consecutive weeks. Feasibility data, LENA communication data (adult word count, child vocalizations and conversational turn-taking), the Communication and Symbolic Behavior Scale, maternal depressive symptoms (PHQ-9) and child disability profiles (Mullen Scales of Early Learning) will be analyzed to determine the potential usefulness of the approach. The tailored intervention package will be designed for maximum scalability, with the ultimate goal of use by EI professionals across the country to enhance mother-child communication and maximize EI outcomes for children.