OTITIS MEDIA AND EARLY SPEECH DEVELOPMENT IN DAYCARE

早期和广泛的中耳感染(慢性中耳炎，COM)与幼儿的一些负面发育结果有关，包括轻到中度听力损失，以及注意力、行为、语言发育和言语发育的问题。专门关注COM的言语发展性质的研究还不够丰富，结果仍然令人困惑和矛盾。这项研究的目的是描述患有COM的儿童早期言语发展的性质及其与照顾者互动的关系。据推测，负面结果的最早警告信号之一是，随着幼儿从喋喋不休转变为有意义的言语产出，出现了非典型的言语模式。进一步的假设是，难懂的语言是与照顾者进行有问题的口头互动的先兆，并限制了儿童练习新学的语言声音和发展成人般的声音系统的机会。本文提出了两项相关的研究。在研究1中，60名在婴儿时期(大约6个月大)进入日托中心的儿童将在12、18、24、30和36个月大时纵向测量语言发育。患有COM的儿童的言语产出和可理解性的定量测量将与那些没有中耳炎的儿童进行比较，以确定早期的言语状态是否中介了后来的言语互动。在研究2中，20名儿童，10名患有COM和10名非中耳炎的儿童的语音样本将从喋喋不休的时期开始重复测量(每两周一次)，建立与成人音系的系统声音对应(约30个月)。样本将从感知和听觉两方面进行分析，以揭示任何细微的差异，这些差异表征了OM发作期间言语产生的变化。研究结果将有助于确定个体差异的限度，并确定在语音习得中遵循替代补偿途径的积极或消极影响。该项目的发现将为建立中耳炎后遗症的新模型、识别有言语延迟或障碍风险的儿童以及设计侧重于早期沟通干预的项目提供经验支持。

Early and extensive experience with middle ear infections (chronic otitis media, COM) has been linked to a number of negative developmental outcomes in young children including mild to moderate hearing losses, and problems with attention, behavior, language development and speech development. Studies specifically focusing on the nature of speech development with COM have been less abundant and results remain confusing and contradictory. The purpose of the proposed research is to describe the nature of early speech development in children with COM and its relationship to caregiver interactions. It is hypothesized that one of the earliest warning signs of negative outcomes is the emergence of atypical speech patterns as toddlers move from babbling to meaningful speech production. It is further hypothesized that unintelligible speech is a precursor of problematic verbal interactions with caregivers and limits a child's opportunities to practice newly learned speech sounds and develop an adult-like sound system. Two related studies are proposed. In Study 1, the speech development of 60 children who entered daycare as infants (approximately 6 months of age) will be measured longitudinally at ages 12, 18, 24, 30, and 36 months of age. Quantitative measures of speech production and intelligibility in those children with COM will be compared to those of otitis-free children to determine if early speech status mediates later verbal interactions. In Study 2, speech samples of a subset of 20 children, 10 with COM and 10 otitis-free, will be measured repeatedly (every two weeks) from the babbling period through the establishment of systematic sound correspondences with the adult phonology (about 30 months). Samples will be analyzed both perceptually and acoustically to reveal any subtle differences that characterize changes in speech production during episodes of OM. Results will assist in identifying the limits of individual variation and determining the positive or negative effects of following alternative compensatory routes in phonological acquisition. Findings from this project will provide empirical support for building new models of the sequelae of otitis media, identifying children at risk for speech delays or disorders, and the design of projects focusing on early communication intervention.