Treatment of Speech Disorders in Children with Down Syndrome

唐氏综合症儿童言语障碍的治疗

• 批准号: 7849882
• 负责人: Stephen Mark Camarata
• 金额: $ 18.92万
• 依托单位: VANDERBILT UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-07-17 至 2011-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7849882
• 关键词: Address; Adolescence; Adolescent; Adult; Affect; Aftercare; Area; Auditory; Birds; Characteristics; Child; Clinical Trials; Cognitive; Competence; Data; Development; Down Syndrome; Elements; Funding; Growth; Heterogeneity; Impairment; Incidence; Individual; Individual Differences; Intervention; Investigation; Joints; Knowledge; Language; Learning; Life; Literature; Measures; Mediating; Methods; Modeling; Motor; Motor Skills; Neurologic; Outcome; Outcome Measure; Phase; Population; Procedures; Production; Public Health; Rain; Randomized; Recruitment Activity; Relative (related person); Reporting; Research; Research Personnel; Role; Sampling; Social Development; Speech; Speech Development; Speech Disorders; Speech Sound; Speech Therapy; Staging; Suggestion; System; Testing; Training; base; design; effective therapy; experience; follow-up; improved; knowledge base; phonology; post intervention; programs; response; skills; sound; speech accuracy; speech processing; standardize measure; syntax; therapy design; treatment effect

DESCRIPTION (provided by applicant): A major developmental challenge for children with Down Syndrome (DS) is generating comprehensible and accurate speech within the context of a dynamic, maturing system, which is mediated by input from immature, dynamic speech processing ability. It is perhaps not surprising that the development of speech often goes awry in DS, with speech disorder being a relatively high incidence condition that typically persists through adolescence into adulthood and is often a life-long disabling characteristic of DS. Because of this, it is important to develop more effective treatments that improve two key elements of speech disorders: Speech-comprehensibility and speech accuracy. In addition, because children with DS display considerable heterogeneity in abilities that affect differential response to speech treatment methods, it is important to examine the relationship between particular pretreatment skills as potential predictors or moderators of growth and differential response to treatment for speech-comprehensibility and speech accuracy. The purpose of this project is to examine the relationship between pretreatment levels of: Cognitive ability, speech-motor ability, degree of speech accuracy in elicited and spontaneous contexts, degree of speech- comprehensibility in spontaneous contexts, EEG/ERP measures of auditory differentiation of phonemes and (a) growth in levels of speech-comprehensibility and speech accuracy within children with DS who experienced speech therapy and (b) differential response to two types of speech treatment designed to increase levels of speech accuracy and speech comprehensibility in these children. Sixty children with DS who all have severe speech disorders at pretreatment will be recruited in this project. At entry into the study, auditory differentiation of phonemes will be measured using PCA and ICA methods, as will levels of speech accuracy and speech comprehensibility. The children with DS will then be randomly assigned to one of two treatments designed to improve speech skills: Phonological Knowledge Recast (PKR) treatment or Articulatory Training (AT) treatment. These children will receive treatment in a 1:1 format for 60 minutes/session, 2/week for 6 months. Speech-comprehensibility and speech accuracy will be subsequently tested again using the spontaneous sampling methods: a) twice during the treatment phase, b) immediately after treatment, and c) at two follow-up periods. All EEG/ERP measures, standardized test measures, speech-motor measures, and measures of speech accuracy, and speech-comprehensibility will also be repeated at the last period. Multiple regression, multivariate permutation tests, and growth curve analyses will be used to test the research questions. Five years of funding are requested. Relevance of this research to public health: People with DS often have difficulty developing accurate and comprehensible speech, which in turn has detrimental impacts on language, educational and social development. This project is designed to develop more effective treatments for speech disorders in DS.

描述(申请人提供)：唐氏综合症(DS)儿童的一个主要发展挑战是在动态、成熟的系统中生成可理解和准确的语音，这是由不成熟的、动态的语音处理能力提供的输入。也许并不令人惊讶的是，DS患者的言语发育经常出错，言语障碍是一种相对较高的发病率，通常会持续到青春期到成年，通常是DS的终生残疾特征。正因为如此，开发更有效的治疗方法来改善言语障碍的两个关键因素：言语可理解性和言语准确性是很重要的。此外，由于DS儿童在影响对语音治疗方法的差异反应的能力上表现出相当大的异质性，因此重要的是检查特定的预处理技能作为潜在的生长预测或调节因素与语音可理解性和语音准确性治疗的差异反应之间的关系。本项目的目的是研究以下两种言语治疗前水平之间的关系：认知能力、言语运动能力、在诱发和自发语境中的言语准确度、自发语境中的言语可理解性程度、音素听觉分化的脑电/事件相关电位测量，以及(A)接受言语治疗的DS儿童的言语可理解性和言语准确性水平的增长，以及(B)旨在提高这些儿童的言语准确度和言语可理解性水平的两种言语治疗的差异反应。本项目将招募60名DS儿童，他们在治疗前都有严重的言语障碍。在进入这项研究时，将使用主成分分析和独立成分分析方法测量音素的听觉差异，以及语音准确性和语音可理解性的水平。然后，患有DS的儿童将被随机分配到两种旨在提高言语技能的治疗中：语音知识重铸(PKR)治疗或关节训练(AT)治疗。这些儿童将以1：1的形式接受治疗，每次60分钟，每周2次，为期6个月。随后将使用自发抽样方法再次测试语音可理解性和语音准确性：a)在治疗阶段进行两次，b)在治疗后立即进行，以及c)在两个随访期进行。所有脑电/事件相关电位测量、标准化测试测量、言语运动测量以及语音准确度和语音可理解性测量也将在最后一节课中复习。将使用多元回归、多元排列检验和增长曲线分析来检验研究问题。要求提供五年的资金。这项研究与公共卫生的相关性：DS患者往往难以形成准确和可理解的语言，这反过来又对语言、教育和社会发展产生不利影响。该项目旨在开发更有效的治疗DS的言语障碍的方法。