PETAL: Promoting Early Intervention Timing and Attention to Language

PETAL：促进早期干预时机和对语言的关注

• 批准号: 10568487
• 负责人: CONNIE L. KASARI
• 金额: $ 80.94万
• 依托单位: UNIVERSITY OF CALIFORNIA LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-06-01 至 2028-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10568487
• 关键词: Address; Adult; Age; Age Months; Area; Attention; Behavior; Behavior Therapy; Behavioral; Boston; Brain; Child; Communication; Development; Diagnosis; Early Intervention; Early identification; Electroencephalography; Enrollment; Environment; Family; Family history of; Frequencies; Future; Gestures; Goals; Home; Individual; Infant; Infrastructure; Intervention; Joints; Language; Language Delays; Language Development; Language Disorders; Learning; Life; Los Angeles; Measures; Mediating; Mediation; Minority; Monitor; Neurobiology; Nursery Schools; Outcome; Parents; Phase; Play; Population; Productivity; Quality of life; Questionnaires; Randomized; Resources; Rest; Risk; Sampling; Science; Sequential Multiple Assignment Randomized Trial; Siblings; Site; Speech; Structure; Testing; Time; Toddler; Vocation; autism spectrum disorder; autistic children; behavior measurement; behavior prediction; brain based; clinical practice; communication behavior; experience; language outcome; marginalization; neural; primary outcome; recruit; screening; secondary outcome; social communication; social engagement; socioeconomics; trial design; vocalization

PROJECT ABSTRACT The proposed study (PETAL: Promoting Early intervention Timing and Attention to Language) aims to determine the timing of a parent mediated intervention among infants with Increased Likelihood for Autism (ILA) (at risk for autism by virtue of having an older sibling with autism) on communication and language outcomes at 24 months. ILA infants are likely to experience delays in language with ~ 40% at risk for language delay and/or later diagnosis of ASD. However, interventions for ILA infants remain rare and none of the current interventions explicitly focus on language or include many infants from lower socioeconomic circumstances who may be at even greater risk for language delays. Although enthusiasm is high for very early interventions due to known brain plasticity in the first years of life, we do not know WHEN or with WHAT MEASURES to determine if an intervention is appropriate for ILA infants who are not yet showing signs of autism or delay. The overarching goal of the proposed study is to determine the optimal timing of very early intervention for ILA infants (starting at 9, 12 or 15 months) that explicitly targets communication and language. We will use a battery of brain- and behavioral-based markers to identify the combination of change in language, behaviors and brain measures that predict expressive language outcomes at 24 months. 140 infants beginning at 6 months of age will participate at two sites, Los Angeles and Boston areas with many from traditionally marginalized and minoritized families. All parents will receive infant developmental monitoring beginning at 6 months, and then using a four-phase, sequential multiple assignment randomized trial design, parents will receive augmentation with a specialized language coaching intervention at 9, 12 or 15 months; all infant parent dyads receive coaching by 15 months. A diverse sample of dyads will be recruited; assessments will occur at home at 6-,9-,12-,15-, 18- and 24-months using brain-based EEG measures, social- communication, and language measures. Intervention support will be provided by clinicians remotely. The study addresses key questions of whether earlier intervention is better on primary language and secondary outcomes of social communication behaviors that support language development (e.g., joint engagement, vocalizations, words, object play) and which measures will inform the ideal transition to intervention on language outcomes at 24 months. Moreover, using LENA to capture the home language environment, adult word count and conversational turns will be examined for mediation on language outcome. Results of this study have potential for determining when (9 vs 12 vs 15), and based on which measures (brain, language, or their combination), to augment parental support with a specialized parent-mediated coaching intervention.

项目摘要 拟议的研究（PETAL：促进早期干预时机和对语言的注意力）旨在 确定对自闭症可能性增加的婴儿进行父母介导干预的时机 (ILA)（由于有患有自闭症的哥哥姐姐而面临自闭症的风险）沟通和语言 24 个月时的结果。 ILA 婴儿可能会出现语言发育迟缓，约 40% 的婴儿面临语言发育迟缓的风险 延迟和/或延迟诊断自闭症谱系障碍 (ASD)。然而，针对 ILA 婴儿的干预措施仍然很少，目前还没有任何干预措施 干预措施明确侧重于语言或包括许多来自较低社会经济环境的婴儿 谁可能面临更大的语言发育迟缓风险。尽管人们对早期干预的热情很高 由于已知生命最初几年的大脑可塑性，我们不知道何时或采取什么措施 确定干预措施是否适合尚未表现出自闭症或发育迟缓迹象的 ILA 婴儿。 拟议研究的总体目标是确定早期的最佳时机 针对 ILA 婴儿（从 9、12 或 15 个月开始）的干预，明确针对沟通和交流 语言。我们将使用一系列基于大脑和行为的标记来识别变化的组合 预测 24 个月时表达性语言结果的语言、行为和大脑测量。 140名婴儿 从 6 个月大开始，将在洛杉矶和波士顿地区两个地点参加，其中许多来自 传统上被边缘化和少数民族的家庭。所有父母都将接受婴儿发育监测 从 6 个月开始，然后使用四阶段、序贯多重分配随机试验设计， 父母将在 9 个月、12 个月或 15 个月时接受专门的语言辅导干预；全部 婴儿父母二人在 15 个月大时接受辅导。将招募多样化的二人组样本；评估 将在 6、9、12、15、18 和 24 个月时在家中使用基于大脑的脑电图测量、社会- 沟通和语言措施。临床医生将远程提供干预支持。这 研究解决了早期干预对于第一语言和第二语言是否更好的关键问题 支持语言发展的社会沟通行为的结果（例如共同参与、 发声、言语、物体游戏）以及哪些措施将指导向干预的理想过渡 24 个月时的语言成果。此外，使用 LENA 捕捉家庭语言环境、成人 将检查字数和会话轮换对语言结果的调节作用。结果 研究有可能确定何时（9 vs 12 vs 15），以及基于哪些措施（大脑、语言或 他们的组合），通过专门的家长介导的辅导干预来增强家长的支持。