Word by Word: Building Sentences with Preschoolers who use AAC

项目摘要/摘要 人们倾向于错误地认为孩子的语言越难懂，认知障碍就越严重 那孩子才是。然而，可理解性与智力并没有很强的相关性。事实上，很多孩子都有深刻的 言语障碍的认知能力远远超过他们的言语能力。不幸的是，这是错误的 假设导致了一系列负面的社会、教育、健康、生活质量和最终的就业 结果--对于美国每100到125人中就有一人发表如此严肃的演讲的情况来说，这种结果太常见了 残疾人需要补充和替代沟通(AAC)。如果孩子们可以使用AAC 用句子“说话”，这将改变人们的预期和结果。知识中的两个鸿沟防止 读写前儿童通过AAC产生句子：(1)基于数据的干预几乎集中在 仅限于基本的社交和词汇技能，而不是造句技能；以及(2)iPad上的AAC应用程序 而其他移动技术过于复杂。识字前儿童花费宝贵的认知资源 寻找图片符号，而不是造句子。结果就是他们用一个词来“说话” 在大多数情况下，尽管有产生完整句子的潜在能力。因此，迫切需要 开发数据驱动的干预措施，支持AAC造句，同时将学习需求降至最低 当前的技术。不进行这项研究将导致学龄前儿童严重言语障碍 继续经历成绩不佳和生活质量低下的终生残疾。长期的 这一研究的目标是确定能够使儿童成为完全能力的AAC干预措施 传播者在生活中越早越好，从而获得丰富的机会。的关注点 目前的建议是比较AAC生成性语言干预方法的有效性 AAC关于学龄前句子产生的照护条件标准。所有儿童都将使用现有的瑞声iPad 申请。中心假设是，接受AAC生成性语言干预的学龄前儿童将 创造更长的、语法上更完整的句子，与关爱标准条件相比。特定的 目的1比较这些干预措施对严重言语障碍和典型接受能力的学龄前儿童的影响 语言，而特定目标2对唐氏综合症儿童也是如此。特定目标3测试 年龄、动态评估分数、句子类型、接受性对干预效果的可能调节 语言能力、以前使用过AAC、性别、精神年龄和残疾。目标1和目标2将通过以下方式实现 随机对照试验。将使用分层线性建模来检查AIM 3的交互作用。 这些目标的实现将对早期句子发展和长期生活质量产生广泛影响 适用于使用AAC的儿童。这项工作将绘制AAC研究的新地平线，以创建基于数据的 利用当前技术的可用性、简化现有AAC应用程序并促进 早期句子制作，目的是反映同龄人的语言技能和生活质量。

PROJECT SUMMARY/ABSTRACT People tend to falsely assume that the more unintelligible a child’s speech is, the more cognitively impaired that child is. However, intelligibility is not strongly correlated with intellect. In fact, many children with profound speech impairments have cognitive abilities that far exceed their speech abilities. Unfortunately, this false assumption leads to a series of negative social, educational, health, quality of life, and eventual employment outcomes – outcomes that are all too common for the 1 in 100-125 people in the U.S. with such severe speech disabilities that they require augmentative and alternative communication (AAC). If children could use AAC to ‘speak’ in sentences, this would transform expectations and outcomes. Two gaps in knowledge prevent preliterate children from producing sentences via AAC: (1) data-based interventions have focused almost exclusively on basic social and vocabulary skills - not sentence-building skills; and (2) the AAC apps on iPads and other mobile technologies are too complex. Preliterate children spend precious cognitive resources searching for picture symbols instead of building sentences. The result is that they ‘speak’ using single words in most cases, despite an underlying ability to produce full sentences. Therefore, a critical need exists to develop data-driven interventions that support AAC sentence-building while minimizing the learning demands of current technologies. Failure to conduct this research will result in preschoolers with severe speech impairments continuing to experience a lifetime of underachievement and poor quality of life. The long-term goal for this line of research is to identify AAC interventions that enable children to become fully competent communicators as early in life as possible, thereby gaining access to a wealth of opportunities. The focus of the current proposal is to compare the effectiveness of the AAC Generative Language Intervention approach to an AAC Standard of Care condition on preschool sentence productions. All children will use existing AAC iPad applications. The central hypothesis is that preschoolers receiving AAC Generative Language Intervention will create longer, more grammatically complete sentences compared with the Standard of Care condition. Specific Aim 1 compares these interventions for preschoolers with severe speech impairments and typical receptive language, and Specific Aim 2 does the same for children with Down syndrome. Specific Aim 3 tests for possible moderation of the intervention effect by age, dynamic assessment scores, sentence type, receptive language abilities, prior AAC use, sex, mental age, and disability. Aims 1 and 2 will be accomplished using randomized controlled trials. Hierarchical linear modeling will be used to examine interactions for Aim 3. The achievement of the aims will have a broad impact on early sentence development and long-term quality of life for children who use AAC. This work will chart a new horizon of AAC research to create data-based interventions that capitalize on the availability of current technologies, simplify existing AAC apps, and promote early sentence productions, with the goal of mirroring the language skills and quality of life outcomes of peers.