Technology-assisted language intervention for children who are deaf/hard-of-hearing (TALI)

针对聋哑/听力障碍儿童的技术辅助语言干预 (TALI)

• 批准号: 10599981
• 负责人: Jareen Meinzen-Derr
• 金额: $ 59.67万
• 依托单位: CINCINNATI CHILDRENS HOSP MED CTR
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-04-20 至 2025-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10599981
• 关键词: Academic achievement; Address; Adherence; Adult; Age; Area; Auditory; Augmentative and Alternative Communication; Caregivers; Child; Child Development; Clinical Trials Design; Cognitive; Colorado; Communication; Complex; Computer software; Coupled; Data; Decision Making; Development; Diagnosis; Disadvantaged; Early identification; Educational process of instructing; Effectiveness; Effectiveness of Interventions; Emerging Technologies; Evidence based intervention; Family; Feedback; Future; Goals; Home; Human; Infant; Intervention; Language; Language Delays; Language Development; Language Disorders; Language Therapy; Measures; Medical center; Modeling; Monitor; National Institute on Deafness and Other Communication Disorders; Outcome; Outcome Measure; Outcome Study; Outcomes Research; Parents; Pediatric Hospitals; Population; Problem behavior; Psychology; Public Health; Randomized; Randomized, Controlled Trials; Reproducibility; Research Design; Research Support; Risk; Sampling; Semantics; Severities; Site; Social Behavior; Social Functioning; Speech; Standardization; Strategic Planning; Techniques; Technology; Testing; Visual; Work; behavioral outcome; care delivery; childhood hearing loss; cognitive ability; deaf; design; effective therapy; effectiveness testing; evidence base; falls; hard of hearing; hearing impairment; improved; improved outcome; innovation; intervention program; language outcome; multidisciplinary; post intervention; primary outcome; programs; randomized trial; recruit; skills; social; standard care; syntax; tool; treatment as usual

PROJECT SUMMARY Upon diagnosis of hearing loss, parents/caregivers of children who are deaf/hard-of-hearing (DHH) make decisions around numerous approaches to language and communication development. Despite strong efforts to improve long-term outcomes, DHH children continue to fall short of age-appropriate language levels, placing them at risk for reduced academic achievement, behavioral problems, and poor social abilities that persist into adulthood. The lack of research supporting innovative intervention strategies leaves a gaping hole in our ability to fully support DHH children. Thus, we are unable to provide families with the quality information regarding intervention options. Evidence supports augmentative and alternative communication (AAC) for enhancing language development, yet technology-based AAC has not been applied or effectively studied in DHH children. To address the substantial and pervasive language deficits among DHH children that have persisted despite advances in amplification technology and early identification, we designed a technology-assisted language intervention (TALI) that incorporates high-tech AAC into speech-language therapy as a language teaching tool specifically adapted for DHH children. Our central hypothesis is that DHH children who participate in the TALI will have greater gains in spoken language outcomes compared to DHH children who receive treatment-as-usual (TAU) speech-language therapy. In a small randomized trial to test the effectiveness of the TALI, our preliminary data show that the TALI significantly improves spoken language outcomes for DHH children and is more effective than TAU. However, there remains a need to (a) provide evidence for reproducibility and generalizability in a larger population and (b) understand the TALI effectiveness on additional language outcome measures. We propose a randomized controlled trial of 114 DHH children at 2 recruitment sites (Cincinnati Children’s Hospital Medical Center and Children’s Hospital of Colorado). Children will be randomized to either receive 24 weeks of the TALI or 24 weeks TAU therapy. We will expand our current work to include additional language outcomes, creating a more complete picture of the effectiveness of the proposed intervention. We will test our central hypothesis through the following specific aims: (1) Compare spoken (expressive) language outcomes in DHH children and participating in the TALI with those participating in TAU therapy; (2) Compare language outcomes measured on standardized assessments between children who are DHH participating in the TALI with those participating in TAU; (3) Evaluate whether the benefits of the TALI on language outcomes is maintained 6 months post-intervention. Primary outcomes include syntax, semantics and discourse collected from language samples measured every 6 weeks and receptive/expressive standardized language scores measured pre and post intervention. AAC use will be monitored to measure adherence to the TALI while at home. This project directly aligns with NIDCD’s strategic plan’s overarching goal of improving outcomes in human communication.

项目摘要 在诊断出听力损失后，耳聋/听力障碍儿童（DHH）的父母/照顾者 决定围绕语言和沟通发展的许多方法。尽管做出了巨大努力 为了改善长期结果，DHH儿童仍然达不到与年龄相适应的语言水平， 他们面临着学业成绩下降、行为问题和社交能力差的风险， 成年缺乏支持创新干预策略的研究，在我们的研究中留下了一个巨大的漏洞。 有能力全面支持DHH儿童。因此，我们无法为家庭提供高质量的信息， 关于干预的选择。证据支持增强和替代沟通（AAC）， 增强语言发展，但基于技术的AAC尚未得到应用或有效研究， DHH儿童。为了解决DHH儿童中存在的大量和普遍的语言缺陷， 尽管在放大技术和早期识别方面取得了进展，但这种情况仍然存在，我们设计了一种技术辅助语言干预（TALI），将高科技AAC纳入语音语言治疗， 专门为卫生部儿童设计的语言教学工具。我们的中心假设是， 参加TALI的儿童在口语方面的成绩比参加DHH的儿童更好， 接受常规治疗（TAU）的语言治疗。在一项小型随机试验中， TALI的有效性，我们的初步数据显示，TALI显着提高口语 结果DHH儿童，比TAU更有效。然而，仍然需要（a）提供 在更大人群中的再现性和普遍性的证据，以及（B）理解TALI 其他语言成果措施的有效性。我们提出了一项随机对照试验， 2个招募地点（辛辛那提儿童医院医疗中心和辛辛那提儿童医院）的DHH儿童 科罗拉多）。儿童将随机接受24周的TALI或24周的TAU治疗。我们 将扩大我们目前的工作，包括其他语言的成果，创造一个更完整的图片， 建议干预的有效性。我们将通过以下具体步骤来检验我们的中心假设： 目的：（1）比较DHH儿童和参加TALI的口语（表达）语言结果， 参与TAU治疗的患者;（2）比较标准化评估中测量的语言结果 参加TALI的DHH儿童与参加TAU的儿童之间的差异;（3）评估是否 TALI对语言结果的益处在干预后6个月保持不变。主要结局 包括从每6周测量一次语言样本中收集的句法、语义和语篇， 接受/表达标准化语言得分测量干预前后。AAC的使用将是 监测以测量在家时对TALI的依从性。该项目直接符合NIDCD的战略 该计划的首要目标是改善人类交流的成果。