Cognitive and Biological Mechanisms in Pediatric Voice Therapy

儿科声音治疗中的认知和生物机制

• 批准号: 10470901
• 负责人: Katherine Verdolini
• 金额: $ 60.89万
• 依托单位: UNIVERSITY OF DELAWARE
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-01 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10470901
• 关键词: Acoustics; Address; Adult; Affect; Age; Ambulatory Care; Applied Research; Basic Science; Behavior Therapy; Behavioral; Benign; Biological; Biological Factors; Biomechanics; Characteristics; Child; Child Care; Childhood; Clinic; Clinical Trials; Cognitive; Communication; Communication impairment; Data; Development; Diet; Disease; Elasticity; Evaluation; Foundations; Goals; Hand; Health; Hygiene; Image; Impairment; Intervention; Lamina Propria; Language; Larynx; Lasers; Learning; Lesion; Longitudinal observational study; Measures; Medical; Modeling; Mucous Membrane; Neuropsychology; Nodule; Otolaryngologist; Outcome; Pathologist; Pattern; Phonation; Play; Positioning Attribute; Property; Public Health; Quality of life; Randomized; Recommendation; Reporting; Research; Research Design; School-Age Population; Schools; Science; Series; Speech; Speed; Technology; Testing; Therapeutic; Time; Tissues; Voice; Voice Disorders; Voice Quality; Voice Training; Work; base; behavior influence; causal model; child physical development; cognitive development; cognitive function; cohort; common treatment; comorbidity; emotional functioning; follow-up; new technology; novel; novel strategies; parental involvement; programs; response; social; standard of care; success; therapy outcome; treatment response; vibration; vocal cord; voice therapy

Project Summary/Abstract. The objective of this research is to investigate the influence of developmental factors that may influence the outcome of a vetted, standard of care voice therapy for children with common, benign phonotraumatic lesions, vocal fold nodules. Specific Aim 1 will investigate the influence of children's cognitive developmental abilities on their learning response in voice therapy, in terms of their acquisition of a therapeutic phonation pattern, “resonant voice,” in the vetted therapy program, Adventures in Voice (AIV). Specific Aim 2 will investigate the influence of children's physical development stage on their biological response to Adventures in Voice, in terms of reduction in nodule size, as a function of baseline estimates of vocal fold tissue elasticity, which is known to vary with age. Specific Aim 3 is exploratory, and assesses a fuller, integrated causal model of vocal and laryngeal improvements with voice therapy for nodules, as a function of cognitive and physical maturation. Specific Aim 3 will also address at an exploratory level other factors that may contribute to therapy outcome such as medical co-morbidities, reported child compliance with therapy, and reported parental involvement with therapy. We will use a longitudinal observational study design in a single cohort across aims, incorporating technologies that are novel for such studies but well vetted in bench science, including high- speed video imaging and videostroboscopy with laser projection, this latter to obtain precise measures of nodule size pre and post therapy. These technologies will be integrated with more traditional ones including acoustic and perceptual evaluation of voice and larynx. The long-term goal is to refine and advance intervention models for millions of children whose quality of life is affected by these benign vocal fold lesions. Results will inform emerging behavioral strategies in voice therapy for the millions of children who are affected by these conditions, and who currently suffer substantial health- related consequences as a result.

项目摘要/摘要。 本研究的目的是调查可能影响发育的因素的影响 针对患有常见良性语音创伤性病变的儿童进行经过审查的标准护理语音治疗的结果， 声带小结。具体目标1将调查儿童认知发展能力的影响 他们在声音治疗中的学习反应，就他们获得治疗性发声模式而言， 经过审查的治疗计划“声音冒险”（AIV）中的“共鸣声音”。具体目标 2 将调查 儿童身体发育阶段对其对《声音历险记》的生物反应的影响 就结节尺寸的减小而言，作为声带组织弹性基线估计的函数，即 已知随年龄变化。具体目标 3 是探索性的，评估了更全面、综合的声音因果模型 作为认知和身体成熟的函数，结节发声疗法可改善喉部。 具体目标 3 还将在探索性水平上解决可能影响治疗结果的其他因素 例如医疗合并症、报告的儿童对治疗的依从性以及报告的父母参与 与治疗。我们将在单个队列中跨目标使用纵向观察研究设计， 结合了此类研究中新颖但在实验室科学中经过充分审查的技术，包括高 速度视频成像和视频频闪检查与激光投影，后者可以获得精确的测量 治疗前和治疗后的结节大小。这些技术将与更传统的技术相结合，包括 声音和喉部的声学和知觉评估。 长期目标是为数百万生活质量较差的儿童完善和推进干预模式 受这些良性声带病变的影响。结果将为声音治疗中新兴的行为策略提供信息 对于受这些疾病影响且目前健康状况严重恶化的数百万儿童来说， 由此产生的相关后果。