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注意语言）旨在 确定对自闭症可能性增加的婴儿进行家长介导干预的时机 (ILA)（由于有一个患有自闭症的哥哥或姐姐而有患自闭症的风险）对沟通和语言的影响 24个月的结果。ILA婴儿可能会出现语言延迟，约40%的婴儿存在语言风险 ASD的延迟和/或晚期诊断。然而，对ILA婴儿的干预仍然很少见，目前没有任何干预措施。 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 他们可能面临更大的语言延迟风险。尽管人们对早期干预的热情很高， 由于已知的大脑可塑性在生命的第一年，我们不知道什么时候或用什么措施， 确定干预是否适合尚未显示自闭症或发育迟缓迹象的ILA婴儿。 拟议研究的首要目标是确定最佳时间， 对ILA婴儿（从9个月、12个月或15个月开始）进行干预，明确以沟通为目标， 语言我们将使用一组基于大脑和行为的标记来识别变化的组合 在语言，行为和大脑的措施，预测表达语言的结果在24个月。140名婴儿 从6个月大开始，将在两个地点参加，洛杉矶和波士顿地区， 传统上被边缘化和少数群体化的家庭。所有父母将接受婴儿发育监测 从6个月开始，然后采用四期、序贯多重分配随机试验设计， 父母将在9、12或15个月时接受专门的语言辅导干预;所有 婴儿父母二人组在15个月时接受辅导。将招募不同的二元样本;评估 将发生在家里6-，9-，12-，15-，18-和24个月，使用基于大脑的脑电图测量，社会- 沟通和语言措施。干预支持将由临床医生远程提供。的 研究解决了早期干预是否对小学和中学更好的关键问题 支持语言发展的社会交流行为的结果（例如，共同参与， 发声，文字，物体游戏），以及哪些措施将告知理想的过渡到干预， 24个月时的语言结果。此外，使用LENA捕捉家庭语言环境，成人 词汇量和会话轮数将被检查，以调节语言结果。成果 研究有可能确定何时（9对12对15），以及基于哪些措施（大脑，语言，或 他们的组合），以增加父母的支持与专门的父母调解辅导干预。