Exercise as Treatment in Children with Communication Impairments

项目总结/摘要 沟通障碍影响美国约10%的3-10岁儿童， 运动缺陷同时发生在令人震惊的30-85%的人群中。有一个亚群 患有发育性语言障碍（DLD; a）的儿童同时出现语言和运动缺陷的比率 在1/13的儿童中影响表达和/或接受性语言的高度常见的障碍）。因此，委员会认为， 数以百万计的儿童存在这些需要耗时和昂贵的治疗的使人衰弱的损伤， 这通常发生在特定学科的筒仓中。孤立的方法有其局限性，因为它无法利用 潜在的协同效应，当我们治疗整个孩子，而不是干预， 纪律的纪律。不幸的是，这种孤立的现状方法导致有限的增量收益。 我们需要替代性的、基础性的干预措施来利用神经可塑性并产生多系统收益 以填补这一空白的治疗方案，为儿童共同发生的语言和运动缺陷。 拟议研究的目标是双重的。目标1研究将建立运动性能和健身 水平的DLD儿童和仔细描述运动缺陷的儿童在这一人群。目的 2研究是一项0期/早期1期随机对照试验，旨在测试体育锻炼作为治疗的有效性， DLD儿童的认知语言、运动和健康改善。参与者将被随机分配到 进行6周（3x/周）的运动训练（即，训练心血管健康，敏捷性，平衡， 强度，耐力）或安静的休息状态（例如，乐高和着色）在同一时间表。两 干预措施将在4名儿童或更少的小组中提供。认知语言，运动技能和健身 将在治疗前和治疗后1周、1个月和3个月再次进行评估，以确定 治疗和维护的收益。这项研究将为第二阶段收集重要信息。 初步疗效的试验，并提供高质量的证据，这将有助于言语语言病理学家和 其他从业者则根据证据做出临床决策。这项研究计划的长期目标是 识别沟通障碍儿童共病障碍的广度，并优化发展 有效的治疗，以最大限度地提高数百万儿童的生活质量和结果与沟通 残疾人及其家庭。

Project Summary/Abstract Communication impairments affect ~10% of children in the US between 3-10 years of age, and fine/gross motor deficits co-occur in an astounding 30-85% of this population. One subpopulation that evidences high rates of co-occurring language and motor deficits is children with developmental language disorder (DLD; a highly common disorder that affects expressive and/or receptive language in 1/13 children). Consequently, millions of children present with these debilitating impairments that require time-consuming and costly therapy, which typically occurs in discipline-specific silos. The siloed approach has limitations as it fails to leverage potentially synergistic effects that may be achieved when we treat the whole child, rather than intervene discipline by discipline. Unfortunately, this status quo siloed approach results in limited, incremental gains. Alternative, ground-shifting interventions that harness neuroplasticity and yield multisystem gains are needed to fill this gap in treatment options for children with co-occurring language and motor deficits. The goal of the proposed research is two-fold. The Aim 1 study will establish motor performance and fitness levels for children with DLD and carefully characterize the motor deficits of children in this population. The Aim 2 study is a Phase 0/Early Phase 1 RCT that tests the efficacy of physical exercise as treatment to promote cognitive-linguistic, motor, and fitness gains in children with DLD. Participants will be randomly assigned to undergo 6 weeks (3x/week) of exercise training (i.e., activities to train cardiovascular fitness, agility, balance, strength, endurance) or to a quiet rest condition (e.g., legos and coloring) on the same schedule. Both interventions will be provided in small groups of 4 children or less. Cognitive-linguistic, motor skills, and fitness will be assessed pre-treatment and again at 1-week, 1-month, and 3-months post treatment to determine treatment and maintenance gains on these measures. This research will gather vital information for a Phase 2 trial of preliminary efficacy and contribute high-quality evidence that will help speech language pathologists and other practitioners make evidence-based clinical decisions. The long-term goal of this research program is to identify the breadth of comorbid impairments in children with communication disorders and develop optimally effective treatments to maximize outcomes and quality of life for the millions of children with communication impairments and their families.