Maximizing outcomes for preschoolers with developmental language disorder: testing the effects of a sequentially targeted naturalistic intervention

项目摘要 7-10%的儿童患有发育性语言障碍（DLD）， 对幼儿园入学的担忧，1，2使他们面临学业和社会成绩不佳的重大风险 3.简短的自然主义干预可以显著提高表达能力， 接受性和表达性语言延迟的幼儿的词汇量，4但这不足以减少 词汇或句法的发展差距。5迄今为止，还没有研究探讨持续的 早期干预，以最大限度地提高语言效果。拟议的研究将：（a）评估 序贯语言干预对发育性语言障碍高危儿童词汇和语法的影响 语言障碍（DLD）和（B）检查干预效果的调节剂和介导剂。拟议 混合干预（EMT-SF）提供了一种辅助性干预，即增强环境教学 (EMT)，与理论上激发的，治疗靶点聚焦（SF）序列6，7和 新的输入修改策略。8，9中心假设是，干预将导致更大的词汇量 治疗组中DLD高危儿童的语法结果。拟议的研究是一个 分层随机临床试验，比较父母实施EMT-SF干预的效果 和治疗师，以控制条件和登记108，30个月大的儿童和他们的父母。四个具体 指导研究的目标： 1.比较治疗组与对照组儿童在词汇和语法方面的差异， 48个月大。 2.确定父母语言输入和父母使用干预策略的程度 孩子的语言成绩。 3.确定儿童水平因素和儿童在干预期间的进展预测的程度 语言成果 4.确定干预对口语更广泛方面的影响程度， 与识字和入学准备有关的行为（脱离语境的语言，叙述能力， 行为问题（探索性）。 影响：这项研究将确定持续的早期干预是否可以降低DLD的长期风险， 告知发展理论，并提供可能改变学前服务提供的关键信息 模型

PROJECT SUMMARY Between 7-10% of children have developmental language disorders (DLD) without other developmental concerns at kindergarten entry,1,2 which place them at significant risk for poor academic and social outcomes across the school years and into adulthood.3 Brief naturalistic intervention can significantly increase expressive vocabulary in toddlers with receptive and expressive language delays,4 but it is not sufficient to reduce the developmental gaps in vocabulary or syntax.5 No studies to date have examined the potential of sustained early intervention for maximizing language outcomes. The proposed study will: (a) evaluate the effects of a sequential language intervention on the vocabulary and grammar of young children at risk for developmental language disorder (DLD) and (b) examine moderators and mediators of intervention effects. The proposed hybrid intervention (EMT-SF) provides an empirically-supported intervention, Enhanced Milieu Teaching (EMT), blended with a theoretically-motivated, sentence-focused (SF) sequence of treatment targets6,7 and new input modification strategies.8,9 The central hypothesis is that intervention will result in greater vocabulary and grammar outcomes for children at high risk for DLD in the treatment group. The proposed research is a stratified randomized clinical trial comparing the effects of the EMT-SF intervention, implemented by parents and therapists, to a control condition and enrolling 108, 30-month-old children and their parents. Four specific aims guide the study: 1. Compare differences in vocabulary and grammar outcomes in treatment vs control children at 48 months of age. 2. Determine the extent to which parent language input and parental use of intervention strategies mediate child language outcomes. 3. Determine the extent to which child-level factors and child progress during intervention predict language outcomes 4. Determine the extent to which the intervention impacts broader aspects of spoken language and behavior related to literacy and school readiness (decontextualized language, narrative abilities, behavior problems) (exploratory). IMPACT: This study will determine if sustained early intervention can reduce the long-term risks of DLD, will inform developmental theory, and provide critical information that may transform preschool service delivery models.