Effects of Technology-Supported Social Communication Baby Navigator Intervention to Improve Outcomes of Toddlers with Communication Delays: Preliminary Study

技术支持的社交沟通婴儿导航仪干预对改善沟通延迟幼儿的结果的影响：初步研究

• 批准号: 9979140
• 负责人: AMY M WETHERBY
• 金额: $ 16.52万
• 依托单位: FLORIDA STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-04-01 至 2022-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9979140
• 关键词: 3 year old; Address; African American; Age-Months; Brain; Child; Child Development; Child Health; Child Rearing; Clinical Trials; Clip; Communication; Companions; Cues; Development; Diagnosis; Early Diagnosis; Early Intervention; Empirical Research; Environmental Risk Factor; Evaluation; Evidence based intervention; Family; Family Characteristics; Feasibility Studies; Feedback; Growth; Health Services Accessibility; Individual; Internet; Intervention; Language; Language Delays; Language Development; Lead; Learning; Life; Low income; Measures; Mediating; Methodology; Methods; Modeling; Movement; Narration; Nursery Schools; Outcome; Outcome Measure; Outcome Study; Parents; Personal Satisfaction; Poverty; Randomized; Research; Resources; School-Age Population; Sequential Multiple Assignment Randomized Trial; Services; Signal Transduction; Social Interaction; Social support; Special Education; Technology; Testing; Time; Toddler; Vocabulary; World Health Organization; autism spectrum disorder; base; care coordination; design; early experience; efficacy trial; evidence base; externalizing behavior; family support; health care delivery; implementation science; improved; improved outcome; infancy; innovative technologies; kindergarten; meetings; mobile computing; multiphase optimization strategy; navigator intervention; new technology; recruit; response; rural families; service intervention; skills; social communication; socioeconomics; sound; telehealth; tool; trial design; user-friendly; web platform

PROJECT ABSTRACT About one in three children in the U.S. enter kindergarten unprepared to learn and lacking sufficient communication skills. Despite the federal mandate for early intervention (EI), less than 25% of children who will require special education at school age are receiving EI services. A confluence of empirical research on poverty, environmental risk factors, and brain development shows that early experiences are uniquely powerful in the first years of life, providing further impetus for early detection and intervention. Measures of early- developing social communication skills offer a viable solution for earlier detection of children with language delays and subsequent educational challenges. We propose testing a new technology-supported platform with three parent-mediated intervention components for babies with early communication delays using mobile technology: 1) the Social Communication Growth Charts, a self-guided app to explore video clips illustrating early milestones and to chart their child’s development; 2) Baby Navigator Class, group weekly online meetings designed as a companion to the Growth Charts; and 3) Mobile Coaching, individual weekly telehealth sessions to coach parents in their everyday activities. In response to PA-18-145, we propose using a multiphase optimization strategy (MOST) as a framework for development, optimization, and evaluation of our dynamic web intervention platform and prepare for a full-scale 2-stage sequential multiple assignment randomized trial (SMART) design. We will recruit 80 children with communication delays at 12 months of age. Families will be invited to the Social Communication Growth Charts bundled with the Baby Navigator Class. At 18 months, slow responders will be randomized to continue the bundle with or without Mobile Coaching, and responders will continue the bundle. Child outcome measures include social communication, internalizing and externalizing behaviors, and vocabulary at 18 and 24 months and expressive and receptive language at 24 months. Parent outcome measures include responsive parenting, family functioning, and parent engagement in the technology- supported platform. We will address the following research aims: Aim 1. document the feasibility and effects of the Social Communication Growth Charts and the Baby Navigator Class bundled on child and parent outcomes at 18 and 24 months; Aim 2. compare the effects of optimization with or without Mobile Coaching for slow responders on child and parent outcomes at 24 months; Aim 3. explore individual child and family characteristics that may moderate response to the technology-supported intervention components; and Aim 4. examine responsive parenting and parent engagement with each technology-supported intervention component and prepare for a full-scale SMART that will control for maturation. This study will enhance the sustainability, scalability, and lead to transformative changes to efficiently and effectively improve healthcare delivery via the use of innovative technology, an implementation science methodology, and user-friendly tools and web platform.

项目摘要 在美国，大约三分之一的儿童在进入幼儿园时没有做好学习准备，并且缺乏足够的资源 沟通技巧。尽管联邦强制要求进行早期干预 (EI)，但只有不到 25% 的儿童接受了早期干预 (EI)。 需要在学龄接受特殊教育 正在接受 EI 服务。实证研究的汇合 贫困、环境风险因素和大脑发育表明，早期经历具有独特的力量 在生命的最初几年，为早期发现和干预提供进一步的动力。早期措施—— 发展社交沟通技能为及早发现儿童语言障碍提供了可行的解决方案 延误和随后的教育挑战。我们建议测试一个新技术支持的平台 针对使用手机进行早期沟通延迟的婴儿的三个家长介导的干预措施 技术：1) 社交传播增长图表，一个用于探索说明视频剪辑的自助应用程序 早期里程碑并绘制孩子的发展图表； 2) 宝宝导航班、每周小组在线会议 设计为生长图表的伴侣； 3) 移动辅导、每周个人远程医疗课程 指导父母的日常活动。为了响应 PA-18-145，我们建议使用多相 优化策略（MOST）作为动态网络开发、优化和评估的框架 干预平台并为全面的两阶段序贯多重分配随机试验做准备 （智能）设计。我们将招募 80 名 12 个月大时存在沟通障碍的儿童。家人会 受邀参加与婴儿导航课程捆绑在一起的社交沟通成长图表。 18个月时， 反应慢的人将被随机分配继续使用或不使用移动辅导的捆绑包，并且响应者将 继续捆绑。儿童成果衡量标准包括社交沟通、内化和外化 18 个月和 24 个月时的行为和词汇，以及 24 个月时的表达性和接受性语言。家长 结果衡量标准包括响应式养育、家庭功能以及家长对技术的参与。 支持的平台。我们将实现以下研究目标： 目标 1. 记录可行性和效果 社交沟通成长图表和婴儿导航课程与儿童和家长的成果捆绑在一起 18 个月和 24 个月时；目标 2. 比较有或没有移动辅导的优化效果 24 个月时儿童和家长结果的回应者；目标 3. 探索个别儿童和家庭的特征 这可能会缓和对技术支持的干预措施的反应；目标 4. 检查 响应式育儿和家长参与每个技术支持的干预组成部分， 为控制成熟的全面 SMART 做好准备。这项研究将增强可持续性， 可扩展性，并导致变革，通过以下方式高效、有效地改善医疗保健服务： 使用创新技术、实施科学方法以及用户友好的工具和网络平台。