NCT04755309

Brief Summary

The present project develops from a wide research line aiming at identifying very early electrophysiological risk markers for neurodevelopmental disorders. Long-term goals of the study include the characterization of language/learning developmental trajectories in children at high risk for language disorders and the implementation of ecological interventions based on enriched auditory experience to be employed to these children in an attempt to modify their atypical developmental trajectory before the emergence and crystallization of any behavioural symptoms and within the early period of known maximum cerebral plasticity. Specifically, the main aim of this study is the development and implementation of an innovative and ecological early intervention based on environmental auditory enrichment (labelled "rhythmic intervention"). This intervention is tested both on a sample of typically developing infants and on a sample of infants at high familial risk for language disorders during a time span between 7 and 9 months of age. The efficacy of the intervention is tested on the electrophysiological markers tested before and after the intervention activities and on the linguistic outcomes within a longitudinal approach. The efficacy of such an intervention is compared to the spontaneous development observed in comparable groups of infants with and without familial risk for language disorders. In addition, only in a group of typically developing infants, a control intervention providing passive exposure to the same auditory stimulation is tested, in order to verify the specific contribution of the active participation of the children to the intervention. The investigators hypothesize that the rhythmic intervention may modify the electrophysiological markers underlying auditory processing and the linguistic skills of all children, with a larger increase in infants at familial risk for language disorders who are specifically impaired in such skills.

Trial Health

75
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
125

participants targeted

Target at P50-P75 for not_applicable

Timeline
8mo left

Started Feb 2021

Longer than P75 for not_applicable

Geographic Reach
1 country

1 active site

Status
enrolling by invitation

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

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Study Timeline

Key milestones and dates

Study Progress89%
Feb 2021Dec 2026

Study Start

First participant enrolled

February 1, 2021

Completed
4 days until next milestone

First Submitted

Initial submission to the registry

February 5, 2021

Completed
11 days until next milestone

First Posted

Study publicly available on registry

February 16, 2021

Completed
5.9 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

December 31, 2026

Expected
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

December 31, 2026

Last Updated

February 5, 2025

Status Verified

February 1, 2025

Enrollment Period

5.9 years

First QC Date

February 5, 2021

Last Update Submit

February 3, 2025

Conditions

Outcome Measures

Primary Outcomes (6)

  • Electrophysiological markers in a task tapping neural entrainment administered immediately after the end on the intervention (or at comparable age).

    Early neural mechanisms supporting speech and acoustic perception are recorded in response to non-speech and speech rhythmic stimuli modulated at different rates. Neural entrainment to the incoming rhythms is measured in the form of peaks emerging from the EEG spectrum at frequencies corresponding to the rhythm envelope.

    Age 10-11 months.

  • Electrophysiological markers in a task tapping neural entrainment administered at age 18 months.

    Early neural mechanisms supporting speech and acoustic perception are recorded in response to non-speech and speech rhythmic stimuli modulated at different rates. Neural entrainment to the incoming rhythms is measured in the form of peaks emerging from the EEG spectrum at frequencies corresponding to the rhythm envelope.

    Age 18 months.

  • Electrophysiological markers (obligatory peak) in a non-speech multi-feature oddball paradigm administered at age 12 months.

    In the non-speech multi-feature paradigm, pairs of complex tones are presented at a rapid rate (70ms inter-stimulus interval) and stimuli differing in either frequency or duration serve as deviants. Latency of the obligatory peak (P1/P2) are computed.

    Age 12 months

  • Electrophysiological markers (MisMatch Response) in a non-speech multi-feature oddball paradigm administered at age 12 months.

    In the non-speech multi-feature paradigm, pairs of complex tones are presented at a rapid rate (70ms inter-stimulus interval) and stimuli differing in either frequency or duration serve as deviants. Mean amplitude of the MisMatch Response is computed.

    Age 12 months

  • Electrophysiological markers (obligatory peak) in a non-speech multi-feature oddball paradigm administered at age 24 months.

    In the non-speech multi-feature paradigm, pairs of complex tones are presented at a rapid rate (70ms inter-stimulus interval) and stimuli differing in either frequency or duration serve as deviants. Latency of the obligatory peak (P1/P2) are computed.

    Age 24 months

  • Electrophysiological markers (Mismatch Response) in a non-speech multi-feature oddball paradigm administered at age 24 months.

    In the non-speech multi-feature paradigm, pairs of complex tones are presented at a rapid rate (70ms inter-stimulus interval) and stimuli differing in either frequency or duration serve as deviants. Mean amplitude of the MisMatch Response is computed.

    Age 24 months

Secondary Outcomes (8)

  • Expressive Language at age 12 months assessed through the Bayley Scales of Infant and Toddler Development.

    Age 12 months

  • Expressive Language at age 24 months assessed through the Bayley Scales of Infant and Toddler Development.

    Age 24 months

  • Receptive Language at age 12 months assessed through the Bayley Scales of Infant and Toddler Development.

    Age 12 months

  • Receptive Language at age 24 months assessed through the Bayley Scales of Infant and Toddler Development.

    Age 24 months

  • Expressive vocabulary at age 20 months assessed through the Language Development Survey

    Age 20 months

  • +3 more secondary outcomes

Study Arms (5)

Typical development infants - experimental

EXPERIMENTAL

Children without familial risk for language disorders, who participate to the rhythmic intervention.

Behavioral: Rhythmic intervention

Typical development infants - spontaneous development

NO INTERVENTION

No intervention is provided and typical development in children without familial risk for language disorders is evaluated.

Typical development infants - control

ACTIVE COMPARATOR

Children without familial risk for language disorders, who are exposed to passive auditory stimulation.

Behavioral: Passive auditory stimulation

Infants at familial risk - experimental

EXPERIMENTAL

Children with familial risk for language disorders, who participate to the rhythmic intervention.

Behavioral: Rhythmic intervention

Infants at familial risk - spontaneous development

NO INTERVENTION

No intervention is provided and typical development in children without familial risk for language disorders is evaluated.

Interventions

The rhythmic intervention consists in an ecological and non-invasive intervention based on enriched auditory and musical active experience. It is based on the most recent scientific evidence in the field and provides exposure to and active synchronization with complex musical rhythms. It is thought to promote the infant's ability to recognize and process the complex rhythms of spoken language. Importantly, it taps into and empowers early auditory processing skills. The intervention includes several tasks described in the literature, for example tapping and bouncing at the beat of complex musical rhythms. The intervention takes place in small groups of infant-caregiver pairs (N=4/5) for 1 hour/week for 6 weeks.

Infants at familial risk - experimentalTypical development infants - experimental

The same auditory stimulation is provided to infants, but no active tasks are proposed. Children and caregiver are entertained with motor and cognitive tasks not related to the auditory stimuli presented. The intervention takes place in small groups of infant-caregiver pairs (N=4/5) for 1 hour/week for 6 weeks.

Typical development infants - control

Eligibility Criteria

Age6 Months - 9 Months
Sexall
Healthy VolunteersYes
Age GroupsChild (0-17)

You may qualify if:

  • Healthy infants aged between 6 and 9 months
  • Infants with and without familial risk for language disorders (Infants are assigned to the group with familial risk for language disorders if at least one first-degree relative had a certified (clinical) diagnosis of language and/or learning disorders.
  • Both parents are native-Italian speakers

You may not qualify if:

  • Gestational age \< 37 weeks and/or birth-weight \< 2500 grams
  • APGAR scores at birth at 1' and 5' \< 7
  • Bayley Cognitive Score \< 7
  • Presence of certified diagnosis of intellectual deficiency, attention-deficit disorder, sensorial and neurological disorders or autism within first-degree relatives.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

IRCCS Eugenio Medea

Bosisio Parini, LC, 23842, Italy

Location

MeSH Terms

Conditions

Language Development Disorders

Condition Hierarchy (Ancestors)

Language DisordersCommunication DisordersNeurobehavioral ManifestationsNeurologic ManifestationsNervous System DiseasesSigns and SymptomsPathological Conditions, Signs and Symptoms

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
NONE
Purpose
PREVENTION
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

February 5, 2021

First Posted

February 16, 2021

Study Start

February 1, 2021

Primary Completion (Estimated)

December 31, 2026

Study Completion (Estimated)

December 31, 2026

Last Updated

February 5, 2025

Record last verified: 2025-02

Data Sharing

IPD Sharing
Will not share

Locations