Infant Screening of Early Communication Risk: The CISS, Phase II

 描述（由申请人提供）：有效的早期干预取决于尽快对沟通障碍风险进行可靠的筛查。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。尽管这些危险因素可以在12-18个月内检测到。并可靠地预测以后的语言和社会障碍，试图在婴儿2-1个月内检测类似的危险因素。由于可用筛选器中仅包括2-3个用于预先意图通信的项目的限制（即，反应或主动的婴儿沟通行为不针对听众）。没有可用的筛选器，提供规范的和敏感的数据，前故意的沟通，并反映基于证据的预测因素，区分婴儿在12个月前的沟通障碍的风险。当从业者不能发现婴儿的行为已知与沟通风险，他们不能有针对性的早期干预，以儿童最大的需求和改善的潜力。如果我们能够及早识别沟通风险，我们就可以干预预测沟通障碍的技能，减轻儿童原发性障碍的影响，并减少影响沟通和其他生活技能的继发性障碍的可能性。该项目的计划是完善和规范一个预测性的，敏感的，独立于模态的筛选器，以检测 2-12个月前婴儿的沟通风险。（婴儿沟通和社会筛选，或CISS）。主要研究者的I期研究表明，CISS是一种内部一致的测量方法，可以可靠地识别2-12个月婴儿的预先危险因素，这些婴儿后来表现出沟通障碍。对CISS的简单定性判断来自PI对婴儿意向前沟通的综合评估，即婴儿社会和沟通行为量表（ISCBS），并对应于主要幼儿沟通评估的行为簇，即沟通和象征行为量表发展概况-婴儿-幼儿检查表（CSBS DP-ITC）; Wetherby & Prizant，2002）。一个敏感和具体的沟通风险筛选可以证明早期参与的语言病理学家的婴儿以及复杂的沟通需求的年龄较大的儿童。我们将修订并规范第一阶段CISS，以检测婴儿2-12个月的沟通危险因素。在2-12个月时，对超过350名TD和超过150名有风险的意向前婴儿的新样本进行测试，并通过儿科医生对健康婴儿的访问来管理CISS，以实现这些特定目标：使用相关分析（包括验证性因素分析），在典型发育婴儿的全国代表性样本中建立CISS量表、领域和综合评分的可靠性、有效性和基于年龄的规范;证明CISS在区分高危婴儿和无已知风险婴儿中与残疾相关的沟通风险因素方面的有效性;并通过儿科医生对健康婴儿的访视，确定CISS给药的可行性和有效性。

 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 refine and norm a predictive, sensitive, modality-independent screener to detect communication risk in preintentional infants 2-12 mos. (Communication in Infants and Social Screener, or CISS). Phase I research by the Principal Investigator showed that the CISS is an internally consistent measure to reliably identify preintentional risk factors in infants 2-12 months who later show communication impairments. 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 (ISCBS), 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 and norm the Phase I CISS to detect communication risk factors in infants 2-12 mos. with and without known disabilities, test new samples of over 350 TD and over 150 at-risk preintentional infants at 2-12 mos., and administer the CISS through pediatrician well-baby visits to achieve these specific aims: Establish the reliability, validity, and age-based norms of the scales, domains, and composite scores for the CISS in nationally representative samples of typically developing infants using correlational analyses, including confirmatory factor analysis; demonstrate the efficacy of the CISS at discriminating communication risk factors associated with disability in high-risk infants as well as infants without known risk; and establish the feasibility and efficacy of CISS administration through pediatrician well-baby visits.