Communication in Infants and Social Screener : The CISS

描述（由申请人提供）：有效的早期干预取决于尽早可靠地筛查沟通障碍风险。已确定的婴儿沟通风险因素包括注意力不集中、手势、社会联系、探索性游戏和言语。虽然这些危险因素可以在12-18岁之间被发现。并可靠地预测以后的语言和社交障碍，试图在2-1岁的婴儿中发现类似的风险因素。由于可用的筛选器的局限性，这些筛选器仅包括2-3个意向前沟通项目（即不针对听众的反应性或主动性婴儿沟通行为）。目前还没有一种筛查方法可以提供关于有意前沟通的规范和敏感数据，并反映出基于证据的预测指标，这些指标可以区分12个月前有沟通障碍风险的婴儿。当从业者不能发现已知的与沟通风险相关的婴儿行为时，他们就不能针对有最大需求和改善潜力的儿童进行早期干预。如果我们能够尽早识别沟通风险，我们就可以干预预测沟通障碍的技能，减轻原发性障碍对儿童的影响，并减少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可预测的、敏感的、与模式无关的筛查方法，以检测2-12岁学龄前婴儿的沟通风险。（婴儿沟通和社会筛选，或CISS）。首席研究员的初步研究表明，一组简短的定性判断可以可靠地区分2-12岁的婴儿。与那些后来表现出沟通障碍的人的典型发展（TD）相比。对CISS的简单定性判断来源于PI对婴儿有意前交流的综合评估，即婴儿社会和交流行为量表，并对应于主要的幼儿交流评估的行为集群，即交流和符号行为量表发展概要-婴幼儿检查表（CSBS DP-ITC）；Wetherby & Prizant, 2002)。对沟通风险进行敏感而具体的筛查，可以证明语言病理学家对婴儿以及有复杂沟通需求的大一点的儿童的早期介入是合理的。我们将修订试点CISS，以检测2- 12个月婴儿的沟通风险因素。有和没有已知残疾，对有和没有已知残疾的前故意婴儿的回顾性视频数据进行评分，并对130名2-12个月大的TD或有风险的前故意婴儿的新样本进行测试。使用视频数据库识别区分有沟通障碍风险的前故意婴儿和TD婴儿的CISS域。开发CISS集群和组合，以敏感性和特异性区分现有婴儿样本中的高危残疾状况。

DESCRIPTION (provided by applicant): Effective early intervention depends on reliable screening of risk for communication impairments as soon as possible. Established infant communication risk factors include poor attention, gestures, social connectedness, exploratory play, and speech. Although these risk factors can be detected by 12-18 mos. and reliably predict later language and social disorders, attempts to detect similar risk factors in infants 2-1 mos. have been unsuccessful because of limitations in available screeners that include only 2-3 items for preintentional communication (i.e., reactive or active infant communication behaviors not directed toward listeners). There are no available screeners that provide normed and sensitive data on preintentional communication and reflect evidence-based predictors that discriminate infants at risk for communication impairments before 12 mos. 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 skills that predict communication impairments, mitigate effects of primary impairments in children, and reduce potential for secondary impairments that affect communication and other life skills. The plan for this project is to develop a predictive, sensitive, modality- independent screener to detect communication risk in preintentional infants 2-12 mos. (Communication in Infants and Social Screener, or CISS). Pilot research by the Principal Investigator showed that a short set of qualitative judgments could reliably discriminate infants age 2-12 mos. with typical development (TD) from those who later showed communication impairment. The easy qualitative judgments on the CISS have been derived from the PI's comprehensive assessment of preintentional infant communication, the Infant Social and Communication Behavior Scales, and correspond to behavior clusters for the leading toddler communication assessment, the Communication and Symbolic Behavior Scales Development Profile - Infant Toddler Checklist (CSBS DP-ITC); Wetherby & Prizant, 2002). A sensitive and specific screener for communication risk could justify the early involvement of speech-language pathologists for infants as well as for older children with complex communication needs. We will revise the pilot CISS to detect communication risk factors in infants 2- 12 mos. with and without known disabilities, score retrospective video data from preintentional infants with and without known disabilities, and test new samples of 130 TD or at-risk preintentional infants at 2-12 mos., to achieve these specific aims: Identify CISS domains that discriminate preintentional infants at risk for communication disabilities from TD infants using video databases. Develop CISS clusters and a composite that discriminate at-risk disability status in existing infant samples with sensitivity and specificity. Establish reliability and validity of CISS cluster and composite scores in new as well as videotaped samples of TD and at-risk infants using correlational analyses, including exploratory factor analysis and cluster analysis.