Enhancing Communication between Children in EI and their Depressed Mothers

 描述（由申请人提供）：这两个阶段的项目将测试纳入早期干预（EI）服务的干预，以加强诊断或疑似发育障碍的婴幼儿和他们的抑郁母亲之间的沟通的可行性。联邦政府资助的EI服务在所有50个州提供给发育迟缓的婴儿和幼儿，以改善长期的儿童认知和行为结果。当孩子每天接受持续的发展支持活动作为家庭日常生活的一部分时，EI服务得到了优化。EI服务通常包括父母实施的语言丰富干预措施，以增加以儿童为中心的演讲和互惠（话轮转换）沟通，这与积极的儿童成果有关。这种干预依赖于父母的持续关注、互动和对儿童线索的敏感性。抑郁症状，在EI登记儿童的母亲中普遍存在，可以剥夺母亲的这些能力。幸运的是，为抑郁的母亲提供具体的，可实现的技能，以改善与孩子的互动，可以减少 抑郁症对母亲和孩子的影响EI是一个理想的环境，在其中整合筛查，支持和有针对性的沟通技巧，抑郁的母亲，以改善EI儿童的结果。首先，我们将使用焦点小组和访谈数据为EI员工量身定制工具包和培训计划，并确定员工识别，筛选和支持是否可行 有抑郁症状的母亲将从4名教育研究所工作人员那里收集关于工具包的可行性（易用性、所需时间）和母亲可接受性的数据。然后，我们将确定是否可行的母亲参与干预，以增加他们的儿童为中心的讲话和互惠交流使用技术支持的语言增强评估/干预系统（LENA）嵌入在EI服务。LENA使用带有集成录音带装置的婴儿或幼儿服装，该录音带装置记录以儿童为中心的成人讲话、儿童发声以及父母和儿童之间的相互话轮转换对话。LENA软件产生视觉反馈，母亲可以用它来集中她与孩子基于语言的互动。LENA支持的沟通反馈干预将与10名母亲和10名EI工作人员一起实施，每周使用LENA一天，连续16小时，连续三周。将分析可行性数据、LENA沟通数据（成人字数、儿童发声和会话话轮转换）、沟通和象征行为量表、母亲抑郁症状（PHQ-9）和儿童残疾概况（马伦早期学习量表），以确定该方法的潜在有用性。量身定制的干预方案将被设计为最大的可扩展性，最终目标是由全国各地的EI专业人员使用，以加强母婴沟通，并最大限度地提高EI对儿童的影响。

 DESCRIPTION (provided by applicant): This two-phase project will test the feasibility of integrating into Early Intervention (EI) services an intervention to enhance communication between infants and toddlers with diagnosed or suspected developmental disabilities and their depressed mothers. Federally-funded EI services are provided in all 50 states to infants and toddlers with developmental delays to improve long-term child cognitive and behavioral outcomes. EI services are optimized when the child receives consistent developmentally supportive activities as part of the family's normal routines throughout the day, every day. EI services frequently include parent-implemented language enrichment interventions to increase child-centered speech and reciprocal (turn-taking) communication, which have been linked to positive child outcomes. Such interventions are dependent on consistent parent attentiveness, reciprocal interactions, and sensitivity to child cues. Depressive symptoms, prevalent in mothers of EI-enrolled children, can rob mothers of these capabilities. Fortunately, providing depressed mothers with concrete, attainable skills for improving interactions with their child can reduce the impact of depression on mother and child. EI is an ideal setting in which to integrate screening, support, and targeted communication skills for depressed mothers in order to improve EI child outcomes. First, we will use focus group and interview data to tailor a toolkit and training program for EI staff and determine whether it is feasible for staff to identify, screen and support mothers with depressive symptoms. Data on the toolkit will be collected from 4 EI staff on feasibility (ease of use, time required) and acceptability to mothers. Then, we will determine whether it is feasible for mothers to engage in an intervention to increase their child-centered speech and reciprocal communication using a technology-supported Language ENhancement Assessment/intervention system (LENA) embedded in EI services. The LENA uses an infant or toddler garment with an integrated audiotape device that records adult speech centered on the child, child vocalizations, and reciprocal turn-taking conversations between parent and child. The LENA software produces visual feedback that a mother can use to focus her language-based interactions with her child. The LENA-supported communication feedback intervention will be implemented with 10 mothers and 10 EI staff by using LENA one day a week for 16 consecutive hours for three consecutive weeks. Feasibility data, LENA communication data (adult word count, child vocalizations and conversational turn-taking), the Communication and Symbolic Behavior Scale, maternal depressive symptoms (PHQ-9) and child disability profiles (Mullen Scales of Early Learning) will be analyzed to determine the potential usefulness of the approach. The tailored intervention package will be designed for maximum scalability, with the ultimate goal of use by EI professionals across the country to enhance mother-child communication and maximize EI outcomes for children.