Technology-assisted language intervention for children who are deaf/hard-of-hearing (TALI)

项目总结 在被诊断为听力损失时，聋人/重听人(DHH)儿童的父母/照顾者应 围绕语言和交流发展的多种方法做出决定。尽管付出了巨大的努力 为了改善长期结果，DHH儿童继续达不到适合年龄的语言水平， 他们面临着学习成绩下降、行为问题和社交能力低下的风险，这些问题会持续到 成人期。缺乏支持创新干预策略的研究在我们的 有能力完全支持DHH儿童。因此，我们无法向家庭提供质量信息 关于干预措施的选择。证据支持增强型和替代性沟通(AAC) 促进语言发展，但基于技术的AAC在 DHH的孩子。解决患有严重和普遍语言缺陷的DHH儿童 尽管在放大技术和早期识别方面取得了进展，但我们仍然坚持下去，我们设计了一种技术辅助语言干预(TALI)，它将高科技AAC结合到语言治疗中作为一种 专门为DHH儿童改编的语言教学工具。我们的中心假设是DHH儿童 与DHH儿童相比，参加TALI的儿童在口语成绩上会有更大的收获 接受照常治疗(TAU)言语语言治疗。在一项小型随机试验中，以测试 TALI的有效性，我们的初步数据表明，TALI显著提高了口语水平 对DHH儿童的结果，并且比TAU更有效。然而，仍然需要(A)提供 在更大的人群中证明可重复性和可推广性的证据，以及(B)了解Tali 其他语言成果衡量标准的有效性。我们提出了一项随机对照试验，共114项 2个招募地点(辛辛那提儿童医院医学中心和#年儿童医院)的DHH儿童 科罗拉多州)。儿童将随机接受24周的TALI或24周的TAU治疗。我们 将扩展我们目前的工作，包括更多的语言成果，创造一个更完整的图景 拟议干预措施的有效性。我们将通过以下具体实例来测试我们的中心假设 目的：(1)比较DHH儿童和参与TALI的DHH儿童的口语(表达)语言结果 那些参与TAU治疗的人；(2)比较标准化评估中测量的语言结果 参加TALI的DHH儿童和参加TAU的儿童之间的差异；(3)评估 TALI对语言结果的益处在干预后6个月保持不变。主要结果 包括从每6周测量语言样本收集的句法、语义和语篇，且 接受/表达标准化语言分数在干预前后测量。AAC的使用将是 监测以衡量在家时对TALI的遵守情况。该项目直接与NIDCD的战略一致 该计划的首要目标是改善人类交流的成果。

PROJECT SUMMARY Upon diagnosis of hearing loss, parents/caregivers of children who are deaf/hard-of-hearing (DHH) make decisions around numerous approaches to language and communication development. Despite strong efforts to improve long-term outcomes, DHH children continue to fall short of age-appropriate language levels, placing them at risk for reduced academic achievement, behavioral problems, and poor social abilities that persist into adulthood. The lack of research supporting innovative intervention strategies leaves a gaping hole in our ability to fully support DHH children. Thus, we are unable to provide families with the quality information regarding intervention options. Evidence supports augmentative and alternative communication (AAC) for enhancing language development, yet technology-based AAC has not been applied or effectively studied in DHH children. To address the substantial and pervasive language deficits among DHH children that have persisted despite advances in amplification technology and early identification, we designed a technology-assisted language intervention (TALI) that incorporates high-tech AAC into speech-language therapy as a language teaching tool specifically adapted for DHH children. Our central hypothesis is that DHH children who participate in the TALI will have greater gains in spoken language outcomes compared to DHH children who receive treatment-as-usual (TAU) speech-language therapy. In a small randomized trial to test the effectiveness of the TALI, our preliminary data show that the TALI significantly improves spoken language outcomes for DHH children and is more effective than TAU. However, there remains a need to (a) provide evidence for reproducibility and generalizability in a larger population and (b) understand the TALI effectiveness on additional language outcome measures. We propose a randomized controlled trial of 114 DHH children at 2 recruitment sites (Cincinnati Children’s Hospital Medical Center and Children’s Hospital of Colorado). Children will be randomized to either receive 24 weeks of the TALI or 24 weeks TAU therapy. We will expand our current work to include additional language outcomes, creating a more complete picture of the effectiveness of the proposed intervention. We will test our central hypothesis through the following specific aims: (1) Compare spoken (expressive) language outcomes in DHH children and participating in the TALI with those participating in TAU therapy; (2) Compare language outcomes measured on standardized assessments between children who are DHH participating in the TALI with those participating in TAU; (3) Evaluate whether the benefits of the TALI on language outcomes is maintained 6 months post-intervention. Primary outcomes include syntax, semantics and discourse collected from language samples measured every 6 weeks and receptive/expressive standardized language scores measured pre and post intervention. AAC use will be monitored to measure adherence to the TALI while at home. This project directly aligns with NIDCD’s strategic plan’s overarching goal of improving outcomes in human communication.