快速音节转换治疗中治疗结果的预测：一项个体参与者数据的荟萃分析。
Predicting Treatment Outcomes in Rapid Syllable Transition Treatment: An Individual Participant Data Meta-Analysis.
作者信息
Ng Wei Lin, McCabe Patricia, Heard Rob, Park Veronica, Murray Elizabeth, Thomas Donna
机构信息
The University of Sydney, New South Wales, Australia.
出版信息
J Speech Lang Hear Res. 2022 May 11;65(5):1784-1799. doi: 10.1044/2022_JSLHR-21-00617. Epub 2022 Apr 29.
PURPOSE
The purpose of this study is to identify predictors of treatment outcomes in Rapid Syllable Transition Treatment (ReST) for childhood apraxia of speech through an individual participant data meta-analysis.
METHOD
A systematic literature search identified nine ReST studies for inclusion. Individual participant data were obtained, and studies were coded for methodological design, baseline participant characteristics, service delivery factors, and treatment outcomes. Bivariate analyses were conducted to identify potential predictor variables. Multiple linear regressions were then performed to identify predictors of treatment outcomes.
RESULTS
Data for 36 participants from seven studies were included in the statistical analyses. In multivariate modeling, better performance on treated pseudowords posttreatment was predicted by higher baseline expressive language and Goldman-Fristoe Test of Articulation scores, lower speech inconsistency and percentage of vowels correct, and higher pretreatment accuracy on pseudoword targets. Better performance on untreated real words posttreatment was predicted by higher pretreatment accuracy on real words. Gains in performance and retention of gains were not significantly predicted by any individual variable or combination of variables.
CONCLUSIONS
Baseline speech and expressive language skills and accuracy on pseudowords and real words were significant predictors of absolute posttreatment performance. Regardless of baseline characteristics, all children were statistically as likely to achieve gains during ReST and retain these gains for up to 4 weeks posttreatment. Large-scale prospective research is required to further examine the effects of dose frequency and co-occurring language impairments on treatment outcomes and the complex co-effects of percentage of vowels correct with other potential predictors.
SUPPLEMENTAL MATERIAL
目的
本研究旨在通过个体参与者数据荟萃分析，确定快速音节转换治疗（ReST）对儿童言语失用症治疗效果的预测因素。
方法
通过系统的文献检索，确定了9项纳入的ReST研究。获取了个体参与者数据，并对研究的方法设计、基线参与者特征、服务提供因素和治疗效果进行了编码。进行双变量分析以确定潜在的预测变量。然后进行多元线性回归以确定治疗效果的预测因素。
结果
来自7项研究的36名参与者的数据纳入了统计分析。在多变量建模中，治疗后在治疗的假词上表现更好的预测因素包括更高的基线表达性语言和戈德曼-弗里斯托发音测试分数、更低的言语不一致性和正确元音百分比，以及在假词目标上更高的治疗前准确率。治疗后在未治疗的实词上表现更好的预测因素是在实词上更高的治疗前准确率。表现的提高和提高的保持没有被任何单个变量或变量组合显著预测。
结论
基线言语和表达性语言技能以及在假词和实词上的准确率是治疗后绝对表现的重要预测因素。无论基线特征如何，所有儿童在统计学上在ReST治疗期间获得提高并在治疗后长达4周内保持这些提高的可能性相同。需要大规模的前瞻性研究来进一步检查剂量频率和并发语言障碍对治疗效果的影响，以及正确元音百分比与其他潜在预测因素的复杂共同作用。
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