Infant Assessment of Early Communication Risk Factors: The ECBS

描述(由申请人提供)：有效的早期干预取决于尽快可靠地识别沟通障碍的风险。已确定的婴儿沟通障碍的危险因素包括糟糕的话轮转换、手势、接受性语言、评论、象征性游戏和言语。虽然这些危险因素可以在12-18个月内被检测到。并可靠地预测未来的语言和社会发展，试图在2-12个月的儿童中检测类似的危险因素。由于现有评估非常有限，通常只包括4-6个项目来描述这些婴儿的故意交流(即反应性或主动性的婴儿交流行为，而不是针对听者)，这些评估都是不成功的。目前还没有现成的规范评估来提供关于婴儿故意沟通的全面和动态数据，并反映出基于证据的预测因素，这些预测因素可以区分12个月前有沟通障碍风险的婴儿。当从业者无法检测到已知与沟通风险有关的婴儿行为时，他们就不能针对最有需求和改进潜力的儿童进行早期干预。如果我们能够足够早地识别沟通风险，我们就可以对预测未来沟通障碍的技能进行干预，潜在地减轻儿童原发障碍的影响，降低影响沟通和其他生活技能的继发性障碍的可能性。该项目的计划是开发一种预测性的、全面的、不依赖于模式的评估，以检测2-12个月有预见性的婴儿的沟通风险(早期沟通行为量表，简称ECBS)。首席调查员的初步研究表明，一个简短的行为探测可以可靠地引发2-12个月大的婴儿的预想沟通行为，这些行为代表了11个基于证据的沟通风险预测因素。这11个预测因子对应于领先的幼儿动态沟通评估的行为分类，即沟通和符号行为量表(Wetherby和Prizant，1993；CSBS)。对沟通风险的明确预测可以证明言语语言病理学家对婴儿以及有复杂沟通需求的年龄较大的儿童的早期参与是合理的。我们将使用对2-12个月的典型发育婴儿实施ECBS的试点数据，并从专家小组建议中收集新数据，对已知残疾的预想婴儿的回顾视频数据进行评分，并测试100个2-12个月大的典型发育预想婴儿的新样本，以实现这些特定目标：使用视频数据库识别区分有沟通障碍风险的预想婴儿和典型发育中的婴儿的ECBS领域。开发ECBS项目、集群和复合体，以说明现有婴儿样本中按年龄和高危残疾状况进行歧视的领域。使用相关分析，包括探索性因素分析和聚类分析，建立典型发育婴儿新样本的ECBS量表、聚类和综合得分的信度和效度。 与公共卫生相关：我们已经认识到需要尽早发现沟通问题，以便我们能够开始必要的早期沟通干预，但我们目前没有评估为我们提供足够的信息，说明12个月以下有沟通障碍风险的婴儿的沟通方式有何不同。早期沟通行为量表(ECBS)将是对2-12个月婴儿的第一次全面和常态化的沟通评估。有了这个工具，我们可以增强我们提供临床评估和干预的能力，以便在这段时间内磨练关键的沟通技能，从而对有可疑沟通风险因素的婴儿产生最大的公共健康影响。我们还可以利用ECB为继续需要这些早期沟通技能支持超过12个月的年龄较大的儿童和成年人制定更好的干预策略，并预测这些早期沟通技能的有效变化，这些变化极大地提高了有重大沟通困难的人的生活质量和互动。

DESCRIPTION (provided by applicant): Effective early intervention depends on reliable identification of risk for communication impairments as soon as possible. Established infant risk factors for communication impairments include poor turntaking, gestures, receptive language, commenting, symbolic play, and speech. Although these risk factors can be detected by 12- 18 mos. and reliably predict later language and social development, attempts to detect similar risk factors in children 2-12 mos. have been unsuccessful because of extreme limitations in available assessments that typically include only 4-6 items for these infants' preintentional communication (i.e., reactive or active infant communication behaviors that are not directed toward listeners). There are no available normed assessments that provide comprehensive and dynamic data on infant preintentional communication and reflect evidence- based predictors that discriminate infants at risk for communication impairments before 12 months. When practitioners cannot detect infant behaviors known to be associated with communication risk, they cannot target early intervention to children with the greatest needs and potential for improvement. If we can identify communication risk early enough, we can intervene in the skills that predict later communication impairments and potentially mitigate effects of primary impairments in children and reduce the likelihood of secondary impairments that affect communication and other life skills. The plan for this project is to develop a predictive, comprehensive, modality-independent assessment to detect communication risk in preintentional infants 2-12 months (the Early Communication Behavior Scales, or ECBS). Pilot research by the Principal Investigator showed that a short behavior probe could reliably elicit preintentional communication behaviors from infants age 2-12 months that represent 11 evidence-based predictors of communication risk. These 11 predictors correspond to behavior clusters for the leading dynamic communication assessment for toddlers, the Communication and Symbolic Behavior Scales (Wetherby and Prizant, 1993; CSBS). A clear prediction of communication risk could justify the early involvement of speech-language pathologists for infants as well as for older children who have complex communication needs. We will use pilot data from administering the ECBS to typically developing infants 2-12 months, and collect new data from expert panel advice, score retrospective video data from preintentional infants with known disabilities, and test new samples of 100 typically developing preintentional infants 2-12 months of age, to achieve these specific aims: Identify ECBS domains that discriminate preintentional infants at risk for communication disabilities from typically developing infants, using video databases. Develop ECBS items, clusters, and a composite that account for domains that discriminate by age and at-risk disability status in existing infant samples. Establish the reliability and validity of the scale, cluster, and composite scores for the ECBS in a new sample of typically developing infants using correlational analyses, including exploratory factor analysis and cluster analysis. PUBLIC HEALTH RELEVANCE: We have recognized the need for detecting communication problems as early as possible so that we can start essential early communication intervention, but we do not presently have assessments that provide us enough information about how communication looks different in infants under 12 months at risk for communication disabilities. The Early Communication Behavior Scales (ECBS) would be the first comprehensive and normed assessment of communication for infants 2-12 months. With this tool, we could enhance our ability to provide clinical assessment and intervention to hone in on key communication skills during this period that make the greatest public health impact for infants with suspected communication risk factors. We can also use the ECBS to develop better intervention strategies for older children and adults who continue to need support with these early communication skills for longer than 12 months, and to predict effective changes in these early communication skills that vitally enhance quality of life and interaction for persons with significant communication challenges.