RR&D Research Career Scientist Award Application

RR

• 批准号: 9795374
• 负责人: Julie L. Wambaugh
• 金额: --
• 依托单位: VA SALT LAKE CITY HEALTHCARE SYSTEM
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-10-01 至 2019-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9795374
• 关键词: Academy; Acquired Communication Disorders; Acute; Address; Age; Aphasia; Apraxias; Area; Articulation; Award; Behavior Therapy; Benchmarking; Biofeedback; Biological Markers; Brain; Brain Injuries; California; Characteristics; Chronic; Clinical; Clinical Research; Clinical Treatment; Combined Modality Therapy; Communication impairment; Development; Disease; Dose; Evidence based practice; Feedback; Focal Brain Injuries; Frequencies; Goals; Guidelines; Head; Health care facility; Healthcare; Healthcare Systems; Hour; Impairment; Investigation; Investigational Therapies; Language; Language Therapy; Lead; Lesion; Literature; Maintenance; Measurement; Mentors; Meta-Analysis; Methods; Neoplasms; Neurologic; Neuronal Plasticity; Outcome; Outcome Measure; Palate; Participant; Patients; Performance; Persons; Phase; Prediction of Response to Therapy; Prevalence; Production; Publications; Publishing; Randomized Controlled Clinical Trials; Rehabilitation therapy; Reporting; Research; Research Activity; Research Personnel; Resources; Retrieval; Role; Sampling; Science; Scientist; Severities; Site; Speech; Speech Therapy; Stroke; Symptoms; Testing; Time; Tongue; Training; Treatment Protocols; Treatment outcome; Veterans; Visual; Work; base; career; clinical application; design; doctoral student; improved; interest; motor learning; novel; phrases; predicting response; programs; research clinical testing; response; skills; sound; therapy design; treatment duration; treatment effect; treatment guidelines; treatment response; wound

The over-arching goal of Dr. Wambaugh's research program is to advance understanding and management of acquired apraxia of speech (AOS) and aphasia. Her current research activities are focused on the development and testing of clinically-applicable therapies for AOS and aphasia using sound theoretical bases for treatment and rigorous experimental methods. Her on-going VA RR&D merit project, “Effects of intensity of treatment on rehabilitation of acquired apraxia of speech” continues her work with Sound Production Treatment (SPT). SPT is a behavioral treatment for AOS which was developed by Dr. Wambaugh; it has been shown to consistently result in improved speech production with persons with AOS representing broad ranges of AOS severity, aphasia severity, chronicity, and age. In order to move SPT toward randomized controlled clinical trials, Dr. Wambaugh has been studying ways to maximize its outcomes. Treatment intensity is a potentially critical factor to consider in the administration of treatment. Dr. Wambaugh and her colleagues are currently evaluating the relative effects of intense administration of SPT (3 hours per day/ 3 days per week / 3 weeks) versus non-intense (“traditional”) SPT (1 hour per day/ 3 days per week/ 9 weeks). Dose frequency and treatment duration are being compared in terms of short and longer term maintenance of production of treated and untreated items (word/phrases). Dr. Wambaugh and her colleague, Dr. Mauszycki, are also comparing the effects of SPT to the effects of electropalatographic (EPG) treatment for AOS. EPG is a method for providing visual biofeedback concerning tongue to palate contact. Some speakers with AOS may have disrupted feedback associated with speech production and may benefit more from visual biofeedback in comparison to clinician-provided feedback. Dr. Wambaugh is also collaborating with researchers from the VA Northern California Health Care System to examine the role of site of lesion in predicting response to SPT and to identify neural plasticity changes associated with treatment. This line of research is the first to address brain biomarkers of treatment response in AOS. Because AOS typically co-occurs with aphasia and it is currently difficult for clinicians to determine how to allocate valuable therapy time among the two disorders, Dr. Wambaugh recently developed a treatment that simultaneously targets speech (AOS) and language (aphasia) symptoms – Combined Aphasia and Apraxia of Speech Treatment (CAAST). Dr. Wambaugh is continuing to refine the CAAST protocol and is conducting additional in-depth analyses of outcomes associated with this treatment with the aim of bringing this new treatment to randomized controlled clinical trials. In another area of aphasia treatment, Dr. Wambaugh has been extending her work with word-retrieval treatments to identify participant characteristics associated with response to treatment. She and her colleagues have recently begun to study practice effects as a predictor of ability to change (and ultimately benefit from treatment). Her pending RR&D merit submission is designed to address practice effects as a predictor of treatment response as well as a factor influencing generalized responding. Dr. Wambaugh's lab is also engaged in the development of reliable outcome measures for use in evaluating treatment outcomes. As part of Dr. Wambaugh's recent SPiRE award, “A novel treatment for aphasia and apraxia of speech: Measurement of Outcomes” her lab has collected repeated speech/language samples (over time) from a group of 30 speakers with AOS-aphasia and will be completing stability analyses for numerous outcome measures.

Wambaugh博士研究计划的整理目标是提高理解和 言语中获得的失用（AOS）和失语症的管理。她目前的研究活动 专注于针对AOS的临床适用疗法的开发和测试 使用合理的理论基础进行治疗和严格的实验方法的失语症。她 正在进行的VA RR＆D优异项目，“治疗强度对获得的康复的影响 语音的失用”继续她的声音生产处理（SPT）。SPT是一个 由Wambaugh博士开发的AO的行为治疗；已经证明 始终导致与AO代表广泛的人的语音生产改善 AOS严重性，失语症的严重程度，慢性和年龄的范围。为了将SPT移至 随机对照临床试验，Wambaugh博士一直在研究最大化其的方法 结果。治疗强度是在管理中要考虑的一个可能关键因素 治疗。 Wambaugh博士及其同事目前正在评估 与非密集型相比 （“传统”）SPT（每天1小时/每周3天/ 9周）。剂量频率和治疗 根据短期和长期维护的生产的生产比较持续时间 经过处理和未经处理的项目（单词/短语）。 Wambaugh博士和她的同事Mauszycki博士， 还比较了SPT对电体摄影（EPG）处理的影响 AOS。 EPG是一种提供有关舌头接触舌的视觉生物反馈的方法。 一些具有AOS的演讲者可能会破坏与语音生产相关的反馈和 与临床提供的反馈相比，视觉生物反馈可能会受益更多。博士 Wambaugh还与弗吉尼亚州北加州卫生保健的研究人员合作 系统以检查病变位点在预测对SPT反应并识别中性的系统中的作用 与治疗相关的可塑性变化。这一研究是第一个解决大脑的问题 AOS中治疗反应的生物标志物。因为AOS通常与失语症共同出现 目前，临床医生很难确定如何在 两种疾病，Wambaugh博士最近开发了一种仅针对的治疗方法 语音（AOS）和语言（失语症）符号 - 综合性失语和语言 治疗（caast）。 Wambaugh博士正在继续完善CAST协议，并且是 对此目的进行与这种治疗相关的结果进行的其他深入分析 将这种新方法带到随机对照临床试验中。在另一个失语症 治疗，Wambaugh博士一直将她的文字疗程治疗的工作扩展到 确定与治疗反应相关的参与者特征。她和她 同事最近开始研究实践效应，以预测变化能力（和 最终受益于治疗）。她未决的RR＆D值得提交旨在解决 实践效应作为治疗反应的预测指标以及因素影响广义 回应。 Wambaugh博士的实验室也参与了可靠结果的发展 用于评估治疗结果的措施。作为Wambaugh博士最近的尖顶的一部分 她的奖项，“一种新颖的言语失语和言语失用：测量结果的方法” 实验室已从30个发言人组中收集了反复的语音/语言样本（随着时间的推移） 借助AOS-APHASIA，将完成稳定分析，以实现众多结果指标。

项目成果

Language Changes Following Combined Aphasia and Apraxia of Speech Treatment.

失语症和言语失用症联合治疗后的语言变化。

• DOI: 10.1044/2018_ajslp-16-0193
• 发表时间: 2018
• 期刊: American journal of speech-language pathology
• 影响因子: 2.6
• 作者: Bunker,LisaD;Wright,Sandra;Wambaugh,JulieL
• 通讯作者: Wambaugh,JulieL

Effect Size Benchmarks for Response Elaboration Training: A Meta-Analysis.

反应细化培训的效果大小基准：荟萃分析。

• DOI: 10.1044/2018_ajslp-17-0152
• 发表时间: 2019
• 期刊: American journal of speech-language pathology
• 影响因子: 2.6
• 作者: Bunker,LisaD;Nessler,Christina;Wambaugh,JulieL
• 通讯作者: Wambaugh,JulieL

Combined aphasia and apraxia of speech treatment (CAAST): Systematic replications in the development of a novel treatment.

失语症和言语失用症联合治疗（CAAST）：在开发新型治疗方法中进行系统复制。

• DOI: 10.1080/17549507.2016.1267262
• 发表时间: 2018
• 期刊: International journal of speech-language pathology
• 影响因子: 1.8
• 作者: Wambaugh,JulieL;Wright,Sandra;Mauszycki,ShannonC;Nessler,Christina;Bailey,Dallin
• 通讯作者: Bailey,Dallin