Effects of Intensity of Early Communication Intervention

描述（由申请人提供）：我们开创了语言前和语言环境干预（PLMT）的发展，旨在建立有意的沟通，并加强语言发育迟缓和障碍的幼儿和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反应式亲子互动的父母培训。我们采用随机实验设计的初步研究涉及对儿童进行非常小的“剂量”的直接干预，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，但中等，特别是在6个月的干预期后直接测量时。拟议的研究是一个假设，即更密集的应用PLMT将有显着更积极的结果，我们提出了一个实验调查的影响PLMT提供了两个不同的强度水平，以80名幼儿与一般通信延迟随机分配到一个“高”或“低”强度组。低强度组的儿童将每周接受一小时的直接干预，持续9个月，而高强度组的儿童将每周接受5小时的直接干预，持续9个月。两组中的所有受试者将额外随访6个月。该研究的具体目的是比较高剂量和低剂量的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和几个儿童治疗前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 ANOVA和多水平分析（HLM）。如果需要对治疗前差异进行统计学控制，则将使用多元回归或ANCOVA。已申请五年资助。

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.