Expressive vocabulary intervention for four 2- to 3-year-old children with cerebral palsy and speech/language difficulties: A single-case A-B study

To evaluate a parent-delivered expressive vocabulary intervention using focused stimulation for young children with cerebral palsy (CP). A single case A-B design was used. Use of expressive target words was evaluated during the baseline (A) and intervention (B) phases. Untrained expressive words were used as control behaviour. Four 2- to 3-year-old boys with CP and their parents participated. All participants had an expressive vocabulary of less than 50 words at study intake. Following training, parents delivered the intervention daily at home for 5 weeks. Generalisation of the intervention was measured with a parent-rated vocabulary checklist. Two participants showed clear gains and one participant showed a smaller gain in target words. Two of these three participants did not improve on control words, but one participant increased his use of both target and control words. One participant did not increase his use of either control or target words. All participants improved on parent-reported expressive vocabulary, and for two children, improvements were large. Parent-delivered focused stimulation may lead to gains in expressive vocabulary in children with CP and speech and language difficulties. The intervention would be suitable for larger single-case studies with more experimental control.本研究旨在评估针对脑瘫（cerebral palsy, CP）幼儿的家长实施式聚焦刺激型表达性词汇干预方案。研究采用单病例A-B实验设计（single case A-B design），在基线期（baseline，A阶段）与干预期（intervention，B阶段）分别对目标表达性词汇的使用情况进行评估，并以未经过训练的表达性词汇作为对照行为。共有4名2至3岁的脑瘫男童及其家长参与本研究，所有受试者在入组时的表达性词汇量均不足50个。经专项培训后，家长每日在家中实施该干预方案，持续5周。本研究采用家长评定版词汇检查表（vocabulary checklist）评估干预的泛化效应（generalisation）。研究结果显示，3名受试者的目标词汇使用量出现明确提升，其中1名受试者的提升幅度较小；在这3名受试者中，2名的对照词汇使用量未出现改善，而1名受试者的目标词汇与对照词汇使用量均有所提升；另有1名受试者的目标词汇与对照词汇使用量均未出现增长。所有受试者的家长报告式表达性词汇量均有所提升，其中2名儿童的提升幅度显著。本研究表明，由家长实施的聚焦刺激干预可有效改善脑瘫且伴随言语语言障碍儿童的表达性词汇能力，该干预方案适用于纳入更多实验控制变量的大型单病例研究。