Predicting ReST outcomes: IPD meta-analysis (Ng et al., 2022)

<strong>Purpose: </strong>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. <strong>Method: </strong>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. <strong>Results: </strong>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. <strong>Conclusions: </strong>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. <br> <strong>Supplemental Material S1. </strong>Baseline variables and assessment tools. <br> <strong>Supplemental Material S2.</strong> Pearson’s correlation coefficients for potential predictor variables. <br> <strong>Supplemental Material S3. </strong>Quality ratings for included studies. <br> <strong>Supplemental Material S4. </strong>Suggested pretreatment assessment protocol. <br> Ng, W. L., McCabe, P., Heard, R., Park, V., Murray, E., &amp; Thomas, D. (2022). Predicting treatment outcomes in rapid syllable transition treatment: An individual participant data meta-analysis. <em>Journal of Speech, Language, and Hearing Research</em>. Advance online publication. https://doi.org/10.1044/2022_JSLHR-21-00617

**研究目的：** 本研究旨在通过个体参与者数据元分析（individual participant data meta-analysis），识别儿童言语失用症（childhood apraxia of speech）的快速音节转换治疗（Rapid Syllable Transition Treatment, ReST）的治疗结局预测因子。
**研究方法：** 本研究通过系统文献检索纳入9项ReST相关研究，收集个体参与者数据，并对研究的方法学设计、基线参与者特征、服务提供因素及治疗结局进行编码。随后开展双变量分析以筛选潜在预测变量，进而通过多元线性回归分析确定治疗结局的显著预测因子。
**研究结果：** 最终纳入7项研究的36名参与者的数据进行统计分析。多变量建模结果显示，基线表达性语言能力更高、Goldman-Fristoe发音测试（Goldman-Fristoe Test of Articulation）得分更高、言语不一致性更低、元音正确百分比更高，以及预处理阶段对假词目标的准确率更高，可显著预测治疗后处理过的假词表现更优。治疗后未处理的实词表现更优的显著预测因子为预处理阶段实词的准确率更高。而表现提升幅度及效果留存情况未被任何单个变量或变量组合显著预测。
**研究结论：** 基线言语与表达性语言能力、假词及实词的准确率可显著预测治疗后的绝对表现水平。无论基线特征如何，所有儿童在ReST治疗期间获得功能提升并在治疗后4周内保留该提升效果的概率无统计学差异。未来仍需开展大规模前瞻性研究，进一步探讨给药频率、共病语言障碍对治疗结局的影响，以及元音正确百分比与其他潜在预测因子的复杂协同效应。
<br>**补充材料S1：** 基线变量与评估工具
<br>**补充材料S2：** 潜在预测变量的皮尔逊相关系数（Pearson’s correlation coefficients）
<br>**补充材料S3：** 纳入研究的质量评级
<br>**补充材料S4：** 推荐的预处理评估方案
<br>Ng, W. L., McCabe, P., Heard, R., Park, V., Murray, E., & Thomas, D. (2022). 预测快速音节转换治疗的结局：一项个体参与者数据元分析。《言语、语言与听力研究期刊》(Journal of Speech, Language, and Hearing Research)，提前在线出版。https://doi.org/10.1044/2022_JSLHR-21-00617