Determining Optimal Treatment Intensity for Children with Language Impairment (LI)

确定语言障碍儿童 (LI) 的最佳治疗强度

• 批准号: 9887768
• 负责人: Mary Beth Schmitt
• 金额: $ 66.89万
• 依托单位: UNIVERSITY OF TEXAS AT AUSTIN
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-02-10 至 2024-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9887768
• 关键词: 6 year old; Address; Adult; Affect; Aftercare; Area; Books; Businesses; Characteristics; Child; Communication; Complex; Developmental Disabilities; Diagnosis; Dose; Education; Effectiveness of Interventions; Frequencies; Goals; Internships; Intervention; Intervention Studies; Intuition; Investigation; Investments; Justice; Knowledge; Language; Language Therapy; Learning; Literature; Long-Term Effects; Measures; Nature; Occupations; Outcome; Participant; Privatization; Randomized; Reading; Regimen; Research; Research Design; Schedule; School-Age Population; Schools; Services; Special Education; Students; Symptoms; Teaching Method; Testing; Therapeutic; Time; Treatment Protocols; Treatment outcome; Variant; Vocabulary; Work; clinical practice; college; design; dosage; effective intervention; effective therapy; evidence base; follow-up; improved; improved outcome; kindergarten; language impairment; low socioeconomic status; novel; optimal treatments; peer; post intervention; reading ability; recruit; skills; statistics; theories; therapy duration; treatment optimization; word learning

Project Summary The proposed study aims to determine the optimal levels of treatment intensity of a word learning intervention for young school-age children with language impairment (LI; 5- 6-years-old) by systematically manipulating the treatment dose and frequency children receive. Cumulative intensity is the product of treatment dose (the number of treatment exposures) and treatment frequency (the number of treatment sessions) and both contribute to intervention effectiveness. To date, there are few studies that have examined the interplay of dose and frequency to determine optimal levels to affect change, and the extent to which there may be a threshold, or a level after which significant gains diminish. Within the framework of distributed learning theory (Cepeda et al., 2006), the proposed study will determine the optimal level of treatment intensity of an efficacious work learning intervention (Justice et al., 2005; Storkel et al., 2017; Voelmle and Storkel, 2017) designed to improve the vocabulary knowledge of children with LI. The first aim, determining the optimal number of treatment sessions, is proposed to determine differences between treatment provided within a distributed, or spaced, schedule (high-frequency, 4 times a week) and a consolidated, or massed, treatment session (low-frequency, 1 time a week). The second aim of this study, identifying optimal dosage, will determine the number of times a word should be targeted, using rich instructive strategies, within each frequency condition. Preliminary studies of children with LI in the public schools suggest that children with LI who received high frequency/low dose treatment (or low frequency/high dose) made better gains over time than children receiving the extremes (Schmitt et al., 2017). These findings are correlational in nature; the current study aims to manipulate both parameters of intensity (dose and frequency) to determine the optimal levels of treatment intensity. This study’s third aim will examine the point at which increases in dose with respect to frequency (i.e., more word exposures) are no longer advantageous to children’s outcomes. To address these aims, the proposed study will recruit 180 children with LI over three consecutive years. Participants will be randomized into one of two frequency conditions (high vs. low) which will determine how frequently they receive treatment (once/week or four times/week). Within those treatment sessions, children will learn 60 words; each word will be randomly assigned to one of six possible dose conditions (0 – 20 word exposures). Student interns will deliver the manualized word learning intervention in one-on-one sessions for 10 weeks in the summer. Although frequency conditions differ, all children will receive 120 minutes of therapy per week. Children’s learning of the novel words, as well as their overall vocabulary skills will be measured at three time points: pre-treatment, immediate post-treatment, and 6-months post treatment to assess the impact of the treatment and intensity regimens on short and long-term outcomes. Findings will immediately inform clinical practice regarding quantity of therapy needed for improving the vocabulary skills of children with LI.

项目摘要 本研究的目的是确定单词学习的最佳处理强度水平 对5- 6岁学龄期语言障碍儿童进行系统干预， 控制儿童接受的治疗剂量和频率。累积强度是以下各项的乘积： 治疗剂量（治疗暴露次数）和治疗频率（治疗暴露次数） 两者都有助于干预的有效性。到目前为止，很少有研究 剂量和频率的相互作用，以确定影响变化的最佳水平，以及 可以是一个阈值或一个水平，在该水平之后，显著的增益减小。在分布式框架内， 学习理论（Cepeda等人，2006年），拟议的研究将确定治疗强度的最佳水平 有效的工作学习干预（Justice等人，2005; Storkel等人，2017; Voelmle和Storkel，2017） 旨在提高语言障碍儿童的词汇知识。第一个目标，确定最佳的 治疗疗程数，建议确定治疗内提供的差异 分布式或间隔时间表（高频率，每周4次）和合并或集中治疗 （低频，每周1次）。本研究的第二个目的是确定最佳剂量， 确定一个词应该被定位的次数，使用丰富的指导性策略，在每个 频率条件对公立学校中的LI儿童的初步研究表明，LI儿童 接受高频率/低剂量治疗（或低频率/高剂量）的患者随着时间的推移获得了更好的收益 比接受极端情况的儿童（施密特等人，2017年）。这些发现在本质上是相互关联的; 目前的研究旨在操纵强度（剂量和频率）的两个参数，以确定最佳的 治疗强度的水平。本研究的第三个目的将检查在剂量增加时， 相对于频率（即，更多的单词接触）不再对孩子的结果有利。 为了实现这些目标，拟议的研究将连续三年招募180名LI儿童。 参与者将被随机分配到两个频率条件（高与低）之一中，这将决定如何 他们经常接受治疗（每周一次或每周四次）。在这些治疗过程中，儿童 将学习60个单词;每个单词将被随机分配到六种可能的剂量条件之一（0 - 20个单词 曝光）。实习生将在一对一的会议上提供手动单词学习干预， 夏天的10周虽然频率条件不同，所有儿童将接受120分钟的治疗 的一年孩子们对新单词的学习，以及他们的整体词汇技能将在 三个时间点：治疗前、治疗后即刻和治疗后6个月，以评估影响 治疗和强度方案对短期和长期结果的影响。调查结果将立即通知 关于提高LI儿童词汇技能所需治疗量的临床实践。