Identifying and Treating Childhood Apraxia of Speech in Minimally Verbal Children with Autism

识别和治疗很少言语的自闭症儿童的儿童期言语失用症

• 批准号: 10123334
• 负责人: KAREN V CHENAUSKY
• 金额: $ 6.7万
• 依托单位: MGH INSTITUTE OF HEALTH PROFESSIONS
• 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 2021-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10123334
• 关键词: Identifying; Treating; Childhood; Apraxia; Speech

Although one in four children with autism remain minimally verbal past age five, we do not know all the factors that limit spoken language in these minimally verbal children with autism. One powerful contributor may be a concomitant motor speech disorder, Childhood Apraxia of Speech (CAS). CAS is an impairment in the ability to plan and sequence for speech, which renders speech inconsistent and imprecise. But because producing intelligible speech is a prerequisite to acquiring spoken language, there is an urgent need to understand how CAS may affect speech movements and intelligibility in minimally verbal children with autism, and to develop interventions that incorporate strategies to address CAS, when present. This project proposes three studies to investigate the relationship between CAS and speech in minimally verbal children with autism and CAS. First, we compare a group of 11 minimally verbal children with autism who meet criteria for CAS to a group of 11 who do not meet criteria for CAS. We hypothesize that facial movement tracking, a non-invasive method to investigate speech motor function, will reveal that the +CAS group show lower movement consistency and precision than the –CAS group. Next, we investigate the relationship of clinical signs of CAS to speech movement parameters and to intelligibility. We hypothesize that more severe CAS predicts lower movement consistency and precision, and lower intelligibility, in an additional group of 22 minimally verbal children with autism+CAS. Finally, we use the previous investigations to inform treatment for a group of 20 minimally verbal children with autism+CAS. First we identify the speech movements for each child that are both disordered and degrade intelligibility,. Then, we create a set of mono- and bisyllabic stimuli involving these movements and train participants on a subset of them in a series of single-subject experiments. Treatment will involve principles of motor learning (massed and distributed practice) and dynamic cueing, which have been shown to be effective for treating CAS. Both perceptual (intelligibility-based) and objective (movement-based) outcome measures will demonstrate the extent to which this targeted treatment improves speech production in these children. The findings will inform clinical practice for minimally verbal children with autism and lead to the development of novel interventions for this severely affected population.

尽管四分之一的自闭症儿童在五岁之后仍保持最低限度的语言能力，但我们并不知道所有的情况 限制这些语言能力极低的自闭症儿童口语的因素。一强 促成因素可能是伴随的运动性言语障碍，即儿童言语失用症（CAS）。中科院 言语计划和排序能力受损，导致言语不一致 且不精确。但因为产生可理解的言语是获得口语的先决条件 语言中，迫切需要了解 CAS 如何影响言语运动和 语言能力最低的自闭症儿童的可理解性，并制定干预措施，其中包括 解决 CAS 的策略（如果存在）。该项目提出了三项研究来调查 患有自闭症和 CAS 的最低语言能力儿童的 CAS 与言语之间的关系。首先，我们 将一组 11 名符合 CAS 标准的语言能力最低的自闭症儿童与一组 11 名不符合 CAS 标准的人。我们假设面部运动跟踪是一种非侵入性的 调查言语运动功能的方法，将揭示+CAS组表现出较低的运动能力 一致性和精确度均高于 –CAS 组。接下来，我们探讨临床症状之间的关系 CAS 对语音运动参数和清晰度的影响。我们假设更严重的 CAS 预测在另一组中较低的运动一致性和精确度以及较低的可理解性 22 位语言能力极差的自闭症儿童+CAS。最后，我们利用之前的调查来告知 对 20 名患有自闭症 + CAS 的语言能力最低的儿童进行的治疗。首先我们识别演讲内容 每个孩子的动作既混乱又降低可理解性。然后，我们创建一个集合 涉及这些动作的单音节和双音节刺激，并训练参与者其中的一部分 在一系列单受试者实验中。治疗将涉及运动学习的原则（集中 和分布式练习）和动态提示，已被证明可以有效治疗 CAS。感知（基于可理解性）和客观（基于运动）结果测量都将 证明这种有针对性的治疗在多大程度上改善了这些人的言语产生 孩子们。研究结果将为语言能力极低的自闭症儿童的临床实践提供信息，并导致 针对这一受到严重影响的人群制定新的干预措施。