Effects of Intensity of Early Communication Intervention

描述（由申请人提供）：我们率先开发了一种语言前和语言环境干预（PLMT），旨在建立有意沟通，并加强幼儿和有语言迟缓和障碍的幼儿的早期沟通和语言发展。PLMT包括对幼儿的直接干预，以及旨在建立和支持高度响应式亲子互动的家长培训。我们的初步研究采用随机实验设计，对儿童进行了非常小的“剂量”直接干预，平均每周约一小时，持续六个月。我们观察到的效果令人鼓舞，但并不明显，尤其是在6个月的干预期后直接测量时。我们提出了一项实验研究，对80名患有一般沟通延迟的幼儿进行两种不同强度的PLMT治疗的效果进行了实验研究，这些儿童被随机分配到“高”或“低”强度组。低强度组的儿童将在9个月内每周接受1小时的直接干预，而高强度组的儿童将在9个月内每周接受5小时的直接干预。两组的所有受试者将被额外随访6个月。该研究的具体目的是比较高剂量和低剂量PLMT对儿童非语言和语言沟通技能的影响。我们还将测试干预措施与几个儿童预处理特征之间的假设相互作用，并测试预测治疗效果的预测介质。分析将包括t检验、2x2方差分析和多层次分析（HLM）。如果需要对预处理差异进行统计控制，将使用多元回归或ANCOVA。要求提供五年的经费。

DESCRIPTION (provided by applicant): We have pioneered the development of a prelinguistic and linguistic milieu intervention (PLMT) designed to establish intentional communication and enhance the development of early communication and language development in toddlers and young children with language delays and disorders. PLMT involves direct intervention with toddlers as well as parent training designed to establish and support a highly responsive style of parent-child interaction. Our preliminary research using randomized experimental design s has involved a very small "dose" of direct intervention with the child, averaging approximately one hour per week for six months. The effects we have observed have been encouraging, but moderate, especially when measured directly after the 6-month intervention period. The proposed research is a test of the hypothesis that more intensive application of PLMT will have dramatically more positive outcomes, We propose an experimental investigation of the effects of PLMT delivered at two different levels of intensity to 80 young children with general communication delays randomly assigned to either a "high" or "low" intensity group. Children in the low- intensity group will receive one hour of direct intervention per week for 9 months while children assigned to the high-intensity group will receive 5 hours a week of direct intervention for 9 months. All subjects in both groups will be followed for an additional 6 months. Specific aims of the study are to compare the effects of high and low doses of PLMT on children's nonverbal and verbal communication skills. We will also test hypothesized interactions between the interventions and several child pretreatment characteristics and test predicted mediators for the predicted treatment effects. Analyses will include t-tests, 2x2 ANOVA, and multi-level analysis (HLM). Multiple regression or ANCOVA will be used if statistical control of pre-treatment differences are necessary. Five years of funding is requested.