Childhood Development After Cochlear Implantation

描述(申请人提供)：重度至重度儿童 感觉神经性听力损失(SNHL)在以下方面有显著的延迟 发展领域包括语音识别、语言、认知、 心理社会互动和学术技能。在试图避免进一步 发育迟缓，4000多名美国儿童患有严重到严重的 SNHL在5岁之前接受过人工耳蜗术， 植入正在加速。前景看好的临床研究总体上 支持在儿童中更广泛地应用人工耳蜗术。然而，童年 植入物研究经常涉及病例系列设计，基于单一的 该中心评估了使用不同植入技术的儿童。 此外，很少有研究研究人工耳蜗植入对 “完整的”儿童，尤其是在认知、社交和 行为发育。也几乎没有什么信息可以在 从成本的角度看儿童植入的感知收益- 有效性。 有必要建立更强大的预测因子来预测 儿童人工耳蜗术。这一需求突出表现在以下事实上： 临床决定进行早期人工耳蜗植入通常是由 父母的选择。失聪儿童的父母在很多选择中做出了选择 对医疗、康复、教育、 和其他社会资源。一个紧迫的问题涉及到 将观察到的幼儿受益推广到更年轻的人群 失聪的婴儿。 拟议的研究将系统地评估 变量，因为它们与口头语言习得、言语 识别技能、选择性注意和解决问题的技能、行为能力 和社会发展、亲子互动和生活质量测量 在美国六个植入中心植入的儿童。这项研究的数据将 有助于我们理解预测种植相关因素 语言使用、儿童早期沟通能力、心理社会 早期人工耳蜗术的发育和感知价值 关联成本。结论将使植入物的改进方法成为可能 在考虑(重新)旨在优化 儿童重度至深部SNHL的发育。

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.