Childhood Development After Cochlear Implantation

描述（由申请人提供）：严重至严重的儿童 感音神经性听力损失（SNHL）的发生在 包括语音识别、语言、认知、 心理社会互动和学术技能。为了避免 发育迟缓，超过4,000名美国儿童患有严重到严重的 SNHL在5岁之前接受了人工耳蜗植入， 植入正在加速。有前景的临床研究通常 支持在儿童中更广泛地应用人工耳蜗。然而，童年 种植体研究通常涉及病例系列设计， 该中心评估了使用不同植入技术的儿童。 此外，很少有研究检查人工耳蜗植入对患者的影响。 “完整”的孩子，特别是与认知，社会， 行为发展也没有多少资料， 从成本的角度来看，儿童植入的好处- 有效性 有必要建立更有力的预测指标， 儿童人工耳蜗植入以下事实突出了这一需要： 寻求早期耳蜗植入的临床决定通常是由以下因素引起的 父母的选择聋哑儿童的父母在各种选择中做出选择， 不同的影响，使用医疗，（相对），教育， 其他社会资源。一个紧迫的问题是， 将在幼儿中观察到的益处推广到年龄更小的人群， 聋哑婴儿 拟议的研究将系统地评估 变量，因为它们与口语习得的结果有关， 识别技能，选择性注意和解决问题的技能，行为 社会发展、亲子互动和生活质量测量 在六个美国植入中心植入的儿童中。本研究的数据将 有助于我们理解预测种植体相关性的因素 语言使用，幼儿沟通能力，社会心理 发展，以及早期人工耳蜗植入的感知价值， 相关费用。结论将使一个完善的方法植入 候选人资格时，考虑（重新）竞争战略，旨在优化 严重至极重度SNHL儿童的发展。

DESCRIPTION (provided by applicant): Children with severe-to-profound sensorineural hearing loss (SNHL) experience significant delays across developmental domains including speech recognition, language, cognition, psychosocial interactions, and academic skills. In an attempt to avert further developmental delays, more than 4,000 American children with severe-to-profound SNHL have undergone cochlear implantation prior to the age of five and rates of implantation are accelerating. Promising clinical studies have generally supported wider application of cochlear implants in children. However, childhood implant research has often involved case-series designs, based in a single center, that evaluated children who used different implant technologies. Further, few studies have examined the impact of cochlear implants on the "whole" child, particularly with longitudinal measures of cognitive, social, and behavioral development. There is also little information available on the perceived benefit of childhood implantation from a perspective of cost- effectiveness. There is a need to establish more powerful predictors of the benefits of childhood cochlear implantation. This need is underscored by the fact that clinical decisions to pursue early cochlear implantation are often prompted by parental choice. Parents of deaf children choose among options that have vastly different implications for the use of medical, (re)habilitative, educational, and other societal resources. A pressing issue concerns the validity of generalizing observed benefits in young children to populations of ever-younger deaf infants. The proposed study will systematically evaluate the predictive value of variables as they relate to outcomes of oral language acquisition, speech recognition skills, selective attention and problem-solving skills, behavioral and social development, parent-child interactions, and quality-of-life measures in children implanted in six U.S. implant centers. Data from this study will contribute to our understanding of the factors predicting implant-associated language use, communication competence in early childhood, psychosocial development, and the perceived value of early cochlear implantation in light of associated costs. Conclusions will enable a refined approach to implant candidacy when considering (re)habilitative strategies designed to optimize the development of children with severe-to-profound SNHL.