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

项目摘要/摘要 人工耳蜗术后患者辨别语音的能力是最基本的 临床医生用来创建个性化临床干预措施的有效性度量。鉴于普遍存在的 重视对先天听力损失儿童的早期识别和治疗，最适合临床 对顺位儿童的干预应在尽可能早的年龄开始。尽管例行公事 植入年仅9个月的语前失聪婴儿，目前还没有确定的临床 测量大约4岁以下儿童的CI疗效。中国的长期目标是 拟议的研究是开发新的人工耳蜗植入婴儿的装置功效测量方法，可以 用于在比目前可能的年龄更早的时候推动临床决策。 感知噪声中的时间或光谱强度调制模式的能力 调制知觉“被认为可以预测成年CI用户的语音理解能力。在以前的工作中，PI 调整后的声音调制知觉测试，用于测试婴幼儿。下一步， 在本申请中提出的，将研究声学调制感知如何发展，并与 植入的婴儿的言语感知。这将涉及到审查两个独立的 具有明显不同轨迹的因素：解析调制的光谱位置或时间的能力，以及 对跨频率或跨时间的强度调制的敏感性。中心假设是两种正常的听力 而植入的婴儿在这些因素的发育过程中会表现出不对称性。频率和时间 分辨率预计在出生后6个月时成熟，而对强度调制的敏感性 预计将在7-10岁之间保持不成熟。这一假设的基础是频率和 时间分辨率反映了早期发展的外周听觉机制，而对强度的敏感性 调制反映了后期发展的中枢听觉机制。 这项提议有三个具体目标。第一个是刻画 植入和正常听力婴儿术后前6个月的频率和时间分辨率 纳塔尔听证经验。二是比较了光谱和时间的发展轨迹 婴儿期植入听力正常儿童的调制敏感度 年龄。第三个是确定频率和时间分辨率是否独立地预测语音 植入体内的儿童的知觉结果。这项工作是朝着发展年龄目标迈出的必要一步-- 反映植入后CI疗效的适当的、非语言的声音调制知觉测量 婴儿。如果拟议研究的长期目标得以实现，其积极影响将是能够更早地、 对使用顺铂的年轻患者进行更有效的临床干预。

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.