Building Complex Language: Effect of Treatment and Dosage

描述(由申请人提供)：这项建议的目的是检查治疗干预的结果，旨在增加影响识字和学业成绩的小学语言障碍学龄儿童对复杂(多从句)句子的功能性使用。治疗方案包括：(1)三种类型的复句(状语、关系、宾语补语)，(2)与真实语篇中的复句以及各种形式(说、听、读、写)的复句相遇，以及(3)对复句进行元语言理解的活动。具体目标是：(1)在去语境和自然语言环境中记录治疗效果的大小和范围；(2)记录治疗强度(剂量)的影响；(3)探索句子复杂亚型对治疗结果的影响；(4)探索治疗结果与参与者变量(治疗前的复句知识、言语工作记忆和非语言认知)之间的关系。设计：这项早期临床疗效研究将采用两个设计。在三年内，每年有10名参与者将完成治疗，随机分配到两个剂量水平中的一个。随着每个参与者的完成，疗效和效果大小将使用多基线单一受试者设计进行测量。一旦所有30名参与者都完成了治疗，效果大小和剂量(治疗强度)的影响将使用前测-后测小组设计进行评估，并将仔细描述和分析参与者特征与个人表现模式之间的相关性。参与者：这项研究的目标是10至14岁之间有言语语言障碍和/或特殊学习障碍的学龄儿童，他们正在接受言语语言病理学家(SLP)的服务，以治疗一种或多种高级语言行为。预计参与者将表现出比治疗前基线水平更高的复杂句子流利性，治疗效果将在几种方式和自然语言环境中得到反映。 与公共卫生相关：有语言障碍和学习障碍的学生占IDEA B部分学校所有学生的60%以上。在患有初级语言障碍的年龄较大的儿童和青少年群体中，有充分的证据表明，复杂句子的理解和产生水平降低，以及口语缺陷对后来的识字结果的影响。这项对高龄学龄儿童特定高级语言技能治疗的调查解决了这一领域缺乏对照研究的问题。

DESCRIPTION (provided by applicant): The objective of this proposal is to examine outcomes of a treatment intervention designed to increase functional use of complex (multi-clausal) sentences in school-age students with primary language impairments that impact literacy and academic achievement. The treatment protocol includes: (1) three types of complex sentences (adverbial, relative, object complement), (2) encounters with complex sentences in real texts and across all modalities (speaking, listening, reading, writing), and (3) activities that engage metalinguistic understanding of complex sentences. Specific objectives are to (1) document treatment effect in terms of size and scope in decontextualized as well as naturalistic language contexts, (2) document the effect of treatment intensity (dosage), (3) explore effects of sentence complexity subtype on treatment outcomes, and (4) explore relationships between treatment outcomes and participant variables (pre-treatment knowledge of complex sentences, verbal working memory, and non-verbal cognition). DESIGN: This early clinical efficacy study will utilize two designs. Ten participants per year over three years will complete the treatment, randomly assigned to one of two dosage levels. As each participant finishes, efficacy and effect size will be measured using a multiple-baseline single-subject design. Once all 30 participants have completed the treatment, effect size and the impact of dosage (treatment intensity) will be evaluated using a pretest-posttest group design, and correlations between participant characteristics and individual patterns of performance will be carefully described and analyzed. PARTICIPANTS: This study targets school-age students with a Speech-Language Impairment and/or a Specific Learning Disability between the ages of 10 and 14 who are receiving services from a Speech- Language Pathologist (SLP) for one or more higher-level language behaviors. It is expected that participants will demonstrate higher levels of fluency with complex sentences compared with pretreatment baseline levels and that treatment effects will be reflected in several modalities and in naturalistic language contexts. PUBLIC HEALTH RELEVANCE: Students with language impairments and learning disabilities account for more than 60% of all students served under IDEA Part B in schools. Reduced levels of comprehension and production of complex sentences is well documented in the population of older children and adolescents with primary language impairment, as is the impact of oral language deficits on later literacy outcomes. This investigation of treatment for specific higher-level language skills in older school-age students addresses a scarcity of controlled research in this area.