儿童言语失用症运动语言干预中治疗保真度的测量框架。

IF 2.5 3区 医学 Q1 AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY
Maria I Grigos, Panagiota Tampakis, Emily W Wang, Nicole Kolenda, Edythe A Strand, Julie L Wambaugh, Ying Lu, Zhuojun Lyu, Julie Case
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引用次数: 0

摘要

目的:检查治疗方案的依从性是干预研究的关键组成部分。这在涉及儿童言语失用症(CAS)的治疗中尤其具有挑战性,因为治疗是以动态方式提供的。这项工作的目的是首先提出一个测量动态时间和触觉线索(DTTC)保真度的框架,DTTC是一种为CAS儿童设计的基于运动的治疗方法。该框架包括DTTC保真度检查表和研究人员与治疗言语语言病理学家(slp)之间的合作审查过程。然后,我们量化了经过培训的slp对患有CAS的幼儿进行DTTC管理的保真度。方法:3个slp对19例CAS患儿(2岁、9-6岁、7岁)进行8周的干预。两名调查员和slp在干预期间的多个时间点独立评定保真度。回归分析用于估计保真度随时间和跨DTTC保真度检查表的特定类别的变化。研究者与slp之间的信度采用调整后的Spearman相关检验。结果:slp表现出对DTTC协议的高度依从性。在DTTC保真度检查表中,有一个类别的评分较低,该类别涉及为儿童提供基于运动的线索和给予明确的指示来感受语言运动。研究者和SLP评分彼此高度一致,并且在所有类别中相关性非常强。结论:本研究提出了一个测量DTTC治疗保真度的框架。研究者和SLP评分之间的高互信度支持DTTC保真度检查表作为一种基于证据的工具,为提高临床和研究环境中DTTC实施的准确性提供了基础。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A Framework for Measuring Treatment Fidelity in Motor-Based Speech Intervention for Children With Childhood Apraxia of Speech.

Purpose: Examining adherence to a treatment protocol is a critical component of intervention research. This is particularly challenging in treatment involving young children with childhood apraxia of speech (CAS) where treatment is provided in a dynamic manner. The purpose of this work was to first present a framework for measuring fidelity of Dynamic Temporal and Tactile Cueing (DTTC), a motor-based treatment designed for children with CAS. This framework includes the DTTC Fidelity Checklist and a collaborative review process between investigators and treating speech-language pathologists (SLPs). We then quantify the fidelity of SLPs trained to administer DTTC to young children with CAS.

Method: Three SLPs provided 8 weeks of intervention to 19 children with CAS (ages 2;9-6;7 [years;months]). Two investigators and the SLPs independently rated fidelity at multiple time points across the intervention period. Regression analyses were used to estimate the change in fidelity over time and across specific categories of the DTTC Fidelity Checklist. Reliability between the investigators and SLPs was examined using an adjusted Spearman correlation.

Results: SLPs demonstrated high levels of adherence to the DTTC protocol. Ratings were found to be lower for one category of the DTTC Fidelity Checklist related to providing the child movement-based cues and giving explicit instructions to feel speech movements. Investigator and SLP ratings were highly consistent with one another, and correlations were very strong across all categories.

Conclusions: This study presented a framework for measuring treatment fidelity during DTTC. Strong interrater reliability between investigator and SLP ratings supports the DTTC Fidelity Checklist as an evidence-based tool, providing a foundation for improving the precision of DTTC implementation in clinical and research settings.

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来源期刊
American Journal of Speech-Language Pathology
American Journal of Speech-Language Pathology AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY-REHABILITATION
CiteScore
4.30
自引率
11.50%
发文量
353
审稿时长
>12 weeks
期刊介绍: Mission: AJSLP publishes peer-reviewed research and other scholarly articles on all aspects of clinical practice in speech-language pathology. The journal is an international outlet for clinical research pertaining to screening, detection, diagnosis, management, and outcomes of communication and swallowing disorders across the lifespan as well as the etiologies and characteristics of these disorders. Because of its clinical orientation, the journal disseminates research findings applicable to diverse aspects of clinical practice in speech-language pathology. AJSLP seeks to advance evidence-based practice by disseminating the results of new studies as well as providing a forum for critical reviews and meta-analyses of previously published work. Scope: The broad field of speech-language pathology, including aphasia; apraxia of speech and childhood apraxia of speech; aural rehabilitation; augmentative and alternative communication; cognitive impairment; craniofacial disorders; dysarthria; fluency disorders; language disorders in children; speech sound disorders; swallowing, dysphagia, and feeding disorders; and voice disorders.
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