ASSIST: Child Apraxia Speech Treatment

协助：儿童失用症言语治疗

• 批准号: 9914245
• 负责人: Edwin Maas
• 金额: $ 45.73万
• 依托单位: TEMPLE UNIV OF THE COMMONWEALTH
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-04-15 至 2024-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9914245
• 关键词: Address; Affect; Apraxias; Area; Child; Childhood; Client; Clinical; Complex; Control Groups; Developmental apraxia; Experimental Designs; Family; Genetic Transcription; Goals; Healthcare Systems; Hour; Impairment; Individual; Intervention; Language; Learning; Measures; Methodology; Methods; Motivation; Motor; Motor Skills; Movement; National Institute on Deafness and Other Communication Disorders; Neuronal Plasticity; Outcome; Outcome Measure; Parents; Pathologist; Phase; Population; Prevalence; Quality of life; Randomized; Recommendation; Reporting; Research; Research Design; Resources; Sample Size; Schools; Selection for Treatments; Series; Social Development; Social Functioning; Societies; Speech; Speech Disorders; Speech Intelligibility; Speech Therapy; Strategic Planning; Testing; Translating; base; clinical decision-making; comparative; design; economic outcome; effective therapy; efficacy trial; evidence base; functional outcomes; lexical; literacy; motor learning; optimal treatments; phase 1 study; phase II trial; phase III trial; primary outcome; programs; speech accuracy; success; treatment effect; treatment group; treatment program; treatment response; virtual

Project Summary Childhood apraxia of speech (CAS) is a pediatric motor speech disorder that impairs the planning of movements needed for intelligible speech. CAS may limit literacy, academic and economic outcomes and participation in society. Approximately 40,000 to 160,000 children under 10 have CAS in the US, and over 60% of school-based speech-language pathologists have children with CAS on their caseload, with on average 3 children per caseload. Children with CAS often show little or slow progress in standard speech therapy, which has led to recommendations for intensive intervention and calls for systematic research to optimize outcomes. Given the limited resources in clinical settings, it is imperative to maximize impact of these limited resources for children with CAS. This proposal fits with NIDCD’s Strategic Plan in that it aims to develop and test an effective treatment for an explicitly noted understudied population (CAS). Various treatment approaches for CAS exist, with integral stimulation treatment (“watch me, listen to me, say what I say”) being the only treatment method to date with independently replicated support. Nevertheless, the current evidence base is limited both in study quality and scope. In terms of study quality, all studies to date have involved single-case experimental designs with small sample sizes and varying methodological rigor. In terms of scope, the extant studies vary considerably with respect to important treatment parameters that may critically impact outcomes. Two such important yet poorly understood parameters relate to optimal target selection and optimal treatment intensity. Another limitation of scope is that virtually all studies have relied exclusively on impairment-level outcome measures, and have not included more functional outcome measures related to activity and participation. For these reasons, speech-language pathologists lack adequate information to make clinical decisions for their clients. The proposed research is a Phase I study that tests initial efficacy and optimal parameters of a theoretically based integral stimulation treatment called ASSIST (Apraxia of Speech Systematic Integral Stimulation Treatment). In three small randomized group design studies, children (N=20 per study) receive 16 hours of individual ASSIST. The three studies systematically investigate treatment intensity (2 vs. 4 weeks) and two critical aspects of target selection: complexity (simple vs. complex target) and lexicality (words vs. nonwords). Each study also systematically examines the effect of treatment on functional outcome measures, including parent ratings of intelligibility and communicative participation, and objective intelligibility measures obtained from unfamiliar listeners. Thus, this research will gather vital information for a Phase II trial of preliminary efficacy and contribute high-quality evidence that will help speech-language pathologists make evidence-based clinical decisions. The long term goal of this research program is to develop optimally effective treatments to maximize outcomes and communicative quality of life for the many children with CAS and their families.

项目摘要 儿童言语失用（CAS）是一种儿科运动言语障碍，损害了计划 可理解的语音所需的动作。 CAS可能会限制识字率，学术和经济成果，以及 参与社会。在美国，大约有40,000至160,000名儿童有CAS，超过60％ 基于学校的言语病理学家有孩子的案件载有CAS，平均为3 每个案件的孩子。患有CAS的儿童通常在标准语音疗法中表现出很少或缓慢的进展，这 已经提出了有关密集干预的建议，并呼吁进行系统研究以优化结果。 考虑到临床环境中资源有限，必须最大程度地提高这些有限资源的影响 患有CAS的孩子。该建议符合NIDCD的战略计划，旨在开发和测试有效的 明确注意到的人群（CAS）的治疗。 存在各种CAS的治疗方法，并具有整体刺激治疗（“看着我，听我说，说 我所说的”）是唯一可以在独立复制支持下迄今为止的治疗方法。但是， 当前的证据基础在研究质量和范围上都受到限制。在学习质量方面，迄今为止的所有研究都有 涉及单盘实验设计，样本量较小，方法严格不同。按照 范围，与重要治疗参数有关的范围研究的范围有所不同。 影响结果。两个如此重要但理解的参数与最佳目标选择有关，并且 最佳治疗强度。范围的另一个限制是，实际上所有研究都完全依赖 损伤级的结果指标，并且不包括与 活动和参与。由于这些原因，语音语言病理学家缺乏足够的信息来制作 为客户的临床决定。 拟议的研究是I阶段研究，该研究测试了理论的初始有效性和最佳参数 基于辅助的基于积分刺激治疗（语音系统积分刺激的失用） 治疗）。在三个小型随机小组设计研究中，儿童（每次研究20）接受16小时的 个人协助。这三项研究系统地研究了治疗强度（2 vs. 4周）和两个 目标选择的关键方面：复杂性（简单与复杂的目标）和词汇性（单词与非单词）。 每项研究还系统地检查了治疗对功能结果指标的影响，包括 父母对可理解性和沟通参与的评分以及获得的客观可理解性措施 来自陌生的听众。这是这项研究将收集重要信息，以进行初步效率的II期试验 并贡献高质量的证据，以帮助语音语言病理学家进行基于证据的临床 决定。该研究计划的长期目标是开发最佳有效治疗以最大化 成果和传达许多CAS及其家人的儿童的生活质量。