Building Complex Language: Effect of Treatment and Dosage

描述（由申请人提供）：本提案的目的是研究一项治疗干预的结果，该干预旨在提高影响读写能力和学业成绩的有主要语言障碍的学龄学生复杂（多句）句子的功能性使用。治疗方案包括：(1)三种类型的复杂句子（状语、关系、宾语补语），(2)在真实文本中遇到复杂句子，并在所有形式（说、听、读、写）中遇到复杂句子，以及(3)对复杂句子进行元语言理解的活动。具体目标是：(1)记录治疗效果在去语境化和自然语言语境中的大小和范围，(2)记录治疗强度（剂量）的影响，(3)探索句子复杂性亚型对治疗结果的影响，(4)探索治疗结果与参与者变量（治疗前复杂句子知识、言语工作记忆和非言语认知）之间的关系。设计：这项早期临床疗效研究将采用两种设计。每年有10名参与者将在三年内完成治疗，随机分配到两种剂量水平中的一种。当每个参与者完成后，将使用多基线单受试者设计测量疗效和效应量。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组设计进行评估，参与者特征和个人表现模式之间的相关性将被仔细描述和分析。参与者：本研究的对象是年龄在10到14岁之间，患有语言障碍和/或特殊学习障碍的学龄学生，他们接受语言病理学家（SLP）的一种或多种高级语言行为的服务。与预处理基线水平相比，预期参与者将表现出更高水平的复杂句子流畅性，并且治疗效果将反映在几种模式和自然语言环境中。

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.