Effects of Technology-Supported Social Communication Baby Navigator Intervention to Improve Outcomes of Toddlers with Communication Delays: Preliminary Study

项目摘要 在美国，大约三分之一的儿童进入幼儿园时没有准备好学习，也缺乏足够的 沟通技巧。尽管联邦政府要求早期干预(EI)，但只有不到25%的儿童 将需要特殊教育的学龄儿童都接受EI服务。关于以下方面的实证研究的汇合 贫困、环境风险因素和大脑发育表明，早期经历具有独特的威力 在生命的第一年，为早期发现和干预提供进一步的动力。早期的衡量标准- 发展社交技能为早期发现语言障碍儿童提供了一个可行的解决方案 延误和随后的教育挑战。我们建议测试一个新的技术支持的平台， 使用移动设备对早期沟通障碍婴儿的三种家长干预成分 技术：1)社交成长图表，这是一款自我引导的应用程序，可以探索以下视频片段 早期的里程碑，并为孩子的发展绘制图表；2)婴儿导航员课程，每周小组在线会议 设计为与增长图表配套使用；以及3)移动指导、个人每周远程保健会议 指导父母的日常活动。针对PA-18-145，我们建议使用多相 优化策略(MOST)作为开发、优化和评估我们的动态网络的框架 干预平台和准备全规模两阶段序贯多分配随机试验 (智能)设计。我们将招募80名12个月大的沟通障碍儿童。家庭将会 受邀参加与Baby Navigator课程捆绑在一起的社交发展图表。在18个月的时候， 响应速度较慢的人员将被随机选择使用或不使用移动指导来继续捆绑，响应人员将 继续捆绑。儿童成果衡量标准包括社会沟通、内化和外化 18个月和24个月时的行为和词汇，以及24个月时的表达和接受性语言。父级 结果衡量标准包括响应性育儿、家庭功能和父母对技术的参与度- 支持的平台。我们将致力于以下研究目标：目标1.记录可行性和效果 社交成长图表和婴儿导航员课程捆绑在孩子和父母的结果上 在18个月和24个月时；目标2：比较使用和不使用移动教练对慢速进行优化的效果 24个月时关于儿童和父母结果的响应者；目标3.探索儿童和家庭的个体特征 这可能会缓和对技术支持的干预组件的反应；以及目标4.检查 通过每个技术支持的干预组件进行响应式育儿和家长参与，以及 准备好一个全面的智能，将控制成熟。这项研究将增强可持续性， 可伸缩性，并带来变革性变化，通过 使用创新技术、实施科学方法以及用户友好的工具和网络平台。

PROJECT ABSTRACT About one in three children in the U.S. enter kindergarten unprepared to learn and lacking sufficient communication skills. Despite the federal mandate for early intervention (EI), less than 25% of children who will require special education at school age are receiving EI services. A confluence of empirical research on poverty, environmental risk factors, and brain development shows that early experiences are uniquely powerful in the first years of life, providing further impetus for early detection and intervention. Measures of early- developing social communication skills offer a viable solution for earlier detection of children with language delays and subsequent educational challenges. We propose testing a new technology-supported platform with three parent-mediated intervention components for babies with early communication delays using mobile technology: 1) the Social Communication Growth Charts, a self-guided app to explore video clips illustrating early milestones and to chart their child’s development; 2) Baby Navigator Class, group weekly online meetings designed as a companion to the Growth Charts; and 3) Mobile Coaching, individual weekly telehealth sessions to coach parents in their everyday activities. In response to PA-18-145, we propose using a multiphase optimization strategy (MOST) as a framework for development, optimization, and evaluation of our dynamic web intervention platform and prepare for a full-scale 2-stage sequential multiple assignment randomized trial (SMART) design. We will recruit 80 children with communication delays at 12 months of age. Families will be invited to the Social Communication Growth Charts bundled with the Baby Navigator Class. At 18 months, slow responders will be randomized to continue the bundle with or without Mobile Coaching, and responders will continue the bundle. Child outcome measures include social communication, internalizing and externalizing behaviors, and vocabulary at 18 and 24 months and expressive and receptive language at 24 months. Parent outcome measures include responsive parenting, family functioning, and parent engagement in the technology- supported platform. We will address the following research aims: Aim 1. document the feasibility and effects of the Social Communication Growth Charts and the Baby Navigator Class bundled on child and parent outcomes at 18 and 24 months; Aim 2. compare the effects of optimization with or without Mobile Coaching for slow responders on child and parent outcomes at 24 months; Aim 3. explore individual child and family characteristics that may moderate response to the technology-supported intervention components; and Aim 4. examine responsive parenting and parent engagement with each technology-supported intervention component and prepare for a full-scale SMART that will control for maturation. This study will enhance the sustainability, scalability, and lead to transformative changes to efficiently and effectively improve healthcare delivery via the use of innovative technology, an implementation science methodology, and user-friendly tools and web platform.