Functional Abilities in Children With Bilateral Hearing

描述（申请人提供）：听力受损儿童在复杂的多源环境中工作的能力将被研究。佩戴人工耳蜗（CIs）和助听器（HAs）的儿童每天在教室等嘈杂环境中度过数小时，但人们对他们在这些环境中的听力能力知之甚少。此外，与单耳听力相比，双侧CI或CI和HA在多大程度上可能提供益处尚不清楚。最近，制造商、外科医生和家长们对双侧植入越来越感兴趣。然而，这个推力必须用客观的度量来验证，并且必须有执行度量的工具。这项工作将集中在4-10岁的儿童中，分为三组：(1)单侧植入单个CI，(2)双侧植入两个CI，(3)多模态，一只耳朵植入CI，另一只耳朵植入HA。将采用一种可用于临床环境的测量系统，该系统可快速可靠地评估儿童的方向性听力，该系统最近在Pl实验室开发。电脑游戏与拼图和动画的实施，以吸引孩子和保持他们的注意力和动力。针对每个儿童群体提出了四个具体目标。目的1将提供有关HA或第二个CI对儿童检测声源是在右侧还是左侧的能力的潜在益处的信息。目标2将测量儿童识别源位置的能力。目的3将测量反射干扰性能的程度，这可以评估双耳听觉通路的功能。目标4将测量存在竞争声音的语音接收阈值（SRT）。这项研究有可能改善听力损失儿童的诊断、选择和适合程序。此外，该研究可能会对双CI或CI/HA组合的双侧听力应该或不应该进行的情况提供一些见解。

DESCRIPTION (provided by applicant): The ability of hearing impaired children to function in complex multi-source environments will be studied. Children with cochlear implants (CIs) and hearing aids (HAs) spend hours every day in noisy environments such as classrooms, but their ability to hear in these environments is poorly understood. In addition, the extent to which bilateral CIs or a CI and a HA might provide a benefit compared with monaural hearing is not known. Recent thrusts by manufacturers, surgeons and parents have created a growing interest in bilateral implantation. However, this thrust must be validated with objective measures, and the tools for performing the measures must be available. This work will focus on children ages 4-10 from three groups: (1) Unilaterally implanted with a single CI, (2) Bilaterally implanted with two CIs, (3) Multi-modal with a CI in one ear and a HA in the second ear. A measurement system that can be applied in clinical setting to assess directional hearing in children rapidly and reliably, recently developed in the Pl's lab, will be employed. Computer games with puzzles and animations are implemented in order to engage the children and maintain their attention and motivation. Four specific aims are proposed with each population of children. Aim 1 will provide information regarding the potential benefits of a HA or a second CI for children's ability to detect whether a sound source is to the right or left. Aim 2 will measure the children's ability to identify source locations. Aim 3 will measure the extent to which reflections interfere with performance, which can assess the functionality of the binaural auditory pathway. Aim 4 will measure speech reception threshold (SRT) in the presence of competing sounds. This research has the potential to improve the diagnosis, selection and fitting procedures for children with hearing loss. In addition, the research might provide some insight into situations in which bilateral hearing, with dual CIs, or with a CI/HA combination, should or should not be pursued.