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

最大限度地提高患有发展性语言障碍的学龄前儿童的成果：测试顺序有针对性的自然干预的效果

• 批准号: 10656032
• 负责人: Pamela A Hadley
• 金额: $ 15.6万
• 依托单位: VANDERBILT UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-08-16 至 2024-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10656032
• 关键词: Adult; Age-Months; Behavior; Child; Child Language; Clinical Trials; Development; Early Intervention; Educational process of instructing; Enrollment; Growth; Hybrids; Intervention; Language; Language Delays; Language Development Disorders; Mediating; Mediator of activation protein; Modification; Nursery Schools; Outcome; Parents; Phase; Problem behavior; Randomized Clinical Trials; Readiness; Research; Risk; Schools; Service delivery model; Social outcome; Testing; Toddler; Vocabulary; efficacy evaluation; high risk; intervention effect; kindergarten; language outcome; literacy; syntax; theories; treatment group; trial comparing

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.

项目概要 7-10% 的儿童患有发育性语言障碍 (DLD)，但没有其他发育性障碍 入园时的担忧，1,2 这使他们面临学业和社会成绩不佳的重大风险 整个学年直至成年。3 简短的自然干预可以显着提高表达能力 语言接受和表达延迟的幼儿的词汇量有所增加，4但这还不足以减少 词汇或句法方面的发展差距。5 迄今为止，还没有研究探讨持续性学习的潜力。 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 对有发育风险的幼儿的词汇和语法进行顺序语言干预 语言障碍（DLD）和（b）检查干预效果的调节因素和中介因素。拟议的 混合干预（EMT-SF）提供了一种经验支持的干预措施，增强的环境教学 （EMT），与理论驱动的、以句子为中心的（SF）治疗目标序列6、7和 新的输入修改策略。8,9 中心假设是干预将导致更多的词汇量 以及治疗组中 DLD 高危儿童的语法结果。拟议的研究是 分层随机临床试验，比较由父母实施的 EMT-SF 干预的效果 和治疗师，以控制条件并招募了 108 名 30 个月大的儿童及其父母。四具体 指导研究的目标： 1. 比较治疗组儿童与对照组儿童在词汇和语法方面的差异 48个月大。 2. 确定家长语言输入和家长使用干预策略的程度 调解儿童语言结果。 3. 确定干预期间儿童层面因素和儿童进步的预测程度 语言成果 4. 确定干预措施对口语和口语更广泛方面的影响程度 与识字和入学准备相关的行为（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， 为发展理论提供信息，并提供可能改变学前服务提供的关键信息 模型。