Development of Sensitivity to Acoustic Modulation in Infants who use Cochlear Implants

项目总结/摘要 耳蜗植入（CI）患者辨别语音的能力是最基本的 临床医生用于创建个性化临床干预措施的疗效指标。鉴于普遍的 早期识别和治疗先天性听力损失儿童的重要性， 对CI儿童的干预应在尽可能早的年龄开始。尽管例行公事 植入的前语言失聪婴儿，年轻的9个月大，目前还没有确定的临床 对小于约4岁的儿童的CI疗效的测量。的长期目标 拟议的研究是开发新的测量耳蜗植入婴儿的设备功效的方法， 用于在比目前可能的更早的年龄驱动临床决策。 感知噪声或“声学”中时间或频谱强度调制模式的能力 调制感知”可以预测成年CI用户的语音理解。在以前的工作中，PI 适用于测试婴儿和幼儿的声音调制感知测试。下一步， 在本申请中提出的，将是调查声学调制感知如何发展，并涉及 语言感知能力。这将涉及审查两个独立的 具有明显不同轨迹的因素：分辨调制的频谱位置或时间的能力，以及 对频率或时间上的强度调制的敏感性。核心假设是，正常的听力 而植入的婴儿在这些因素的发展上会表现出不对称性。频率和时间 分辨率预计在出生后6个月的听力年龄成熟，而对强度调制的敏感性 预计在7-10岁之间仍不成熟。这一假设的基础是， 时间分辨力反映了早期发展外周听觉机制，而对强度的敏感性 调制反映了后来发展的中枢听觉机制。 该提案有三个具体目标。首先是描述发展轨迹 植入后前6个月内植入和听力正常婴儿的频率和时间分辨率 纳塔尔听力体验。第二，比较了光谱和时间的发展轨迹 在婴儿期植入的儿童的调制灵敏度与正常听力儿童的调制灵敏度相比， 岁。第三是确定频率和时间分辨率是否独立地预测语音 植入儿童的感知结果。这项工作是朝着发展年龄的目标迈出的必要一步- 适当的，非语言测量的声音调制感知，反映植入的CI疗效 婴儿。如果拟议研究的长期目标得以实现，其积极影响将是使人们能够更早地， 为使用CI的年轻患者提供更有效的临床干预。

PROJECT SUMMARY/ABSTRACT The ability of patients with cochlear-implants (CI) to discriminate speech sounds is the fundamental measure of efficacy that clinicians use to create personalized clinical interventions. Given the universal importance of early identification and treatment for children born with hearing loss, the most appropriate clinical intervention for children with CIs should be initiated at the earliest possible age. Despite the routine implantation of prelingually-deaf infants as young as 9-months-old, there are currently no established clinical measures of CI efficacy for children younger than approximately 4-years-old. The long-term goal of the proposed research is to develop new measures of device efficacy in cochlear-implanted infants that can be used to drive clinical decisions at a much earlier age than is currently possible. The ability to perceive patterns of temporal or spectral intensity modulation in a noise, or “acoustic modulation perception”, is known to predict speech understanding in adult CI users. In previous work, the PI adapted tests of acoustic modulation perception for testing infants and young children. The next step, proposed in this application, will be to investigate how acoustic modulation perception develops, and relates to speech perception, in implanted infants. This will involve examining the development of two independent factors with markedly different trajectories: the ability to resolve the spectral place or timing of modulation, and sensitivity to intensity modulation across frequency or time. The central hypothesis is that both normal hearing and implanted infants will show an asymmetry in development of these factors. Frequency and temporal resolution is expected to mature by 6-months postnatal hearing-age whereas sensitivity to intensity modulation is expected to remain immature through 7-10 years old. The basis for this hypothesis is that frequency and temporal resolution reflect early-developing peripheral auditory mechanisms whereas sensitivity to intensity modulation reflects later-developing central auditory mechanisms. There are 3 specific aims to this proposal. The first is to characterize the developmental trajectory for frequency and temporal resolution in implanted and normal hearing infants during the first 6 months of post- natal hearing experience. The second is to compare the developmental trajectory of spectral and temporal modulation sensitivity in children implanted during infancy with that of normal hearing children through 10- years-of-age. The third is to determine if frequency and temporal resolution independently predict speech perception outcomes in implanted children. This work is a necessary step toward the goal of developing age- appropriate, nonlinguistic measures of acoustic modulation perception that reflect CI efficacy in implanted infants. If the long-term goal of the proposed research is realized, the positive impact will be to enable earlier, more effective, clinical interventions for young patients who use CIs.