Effect of Very Early Cochlear Implantation on Language

早期人工耳蜗植入对语言的影响

• 批准号: 7318893
• 负责人: JOHANNA G NICHOLAS
• 金额: $ 44.54万
• 依托单位: WASHINGTON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2000
• 资助国家: 美国
• 起止时间: 2000-09-27 至 2012-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7318893
• 关键词: 10 year old; Achievement; Acoustic Stimulation; Age; Age-Months; Age-Years; Auditory; Birth; Brain; Child; Child Development; Childhood; Cochlear Implants; Cochlear implant procedure; Cognitive; Communication; Communities; Coupled; Data; Development; Diagnosis; Educational Intervention; Enrollment; Exhibits; Family; Foundations; Goals; Grant; Guidelines; Hearing; Hearing Impaired Persons; Implant; Joints; Language; Language Development; Language Disorders; Length; Linguistics; Long-Term Effects; Mainstreaming; Measurable; Measures; Newborn Infant; Nursery Schools; Operative Surgical Procedures; Outcome; Parents; Partner in relationship; Pattern; Performance; Phonetics; Placement; Policy Maker; Process; Production; Protocols documentation; Reading; Research Personnel; Role; Ruthenium Ben; Sampling; School-Age Population; Schools; Screening procedure; Social Environment; Speech; Speech Development; Speech Intelligibility; Speech Perception; Speech Sound; Surgeon; Testing; Time; Training; United States Food and Drug Administration; Work; auditory deprivation; cognitive function; day; early childhood; elementary school; experience; follow-up; hearing impairment; implantation; infancy; literacy; phonology; relating to nervous system; skills; sound; teacher

DESCRIPTION (provided by applicant): Recent developments in the field of newborn hearing screening and pediatric cochlear implantation have led to extraordinary benefits for many children with born with severe-profound sensori-neural hearing loss. Receiving a cochlear implant by 12-18 months of age coupled with early training in spoken language communication often leads to spoken language skills which are similar to that of typical, hearing children by kindergarten age. While some language deficits may still exist, these children are proficient enough in the language of the surrounding "hearing" community to be able to fully participate in mainstream educational, family and community experiences. The broad objective of this continuation project is to explore the new boundaries of cochlear implantation and to establish long-term outcomes of evolving surgical practices. In Aim 1, we will diagnose the specific spoken language deficits that remain after implantation between the ages of 1-3 years and to examine the role of even earlier cochlear implantation - below the age of 12 months -- in the amelioration of those deficits. In Aim 2, we will assess the role of the specific timing of implantation in infancy on the child's acquisition of a normal speech sound repertoire. While spoken language skills may be adequate, speech articulation may still have room for improvement. Finally, we will determine the long-term benefits of very early cochlear implantation on the speech perception, production, language and literacy skills of 10-year-old children who received a cochlear implant in infancy in Aim 3. Currently, we can measure significant differences in spoken language skills conferred to preschoolers who receive an implant closer to their first birthday than to their second birthday. These advantages are significant even when controlling for length of cochlear implant use. It is important to know whether these advantages remain evident during the elementary school years or whether those who receive the implant somewhat later are able to catch up. Across the U.S., there are children currently receiving implants between the ages of 6-12 months - below the current FDA guideline. It is crucial to gather outcome data to understand whether this evolving practice is warranted. We will test 25 children nationwide who have received an implant below 12 months of age. Detailed speech/language analyses will determine whether this practice produces measurable and meaningful benefits for children. For longterm outcomes, we will test 60 children (from our longitudinal sample) who will undergo a 2-day battery of tests to evaluate differences due to age at implantation and to establish their current level of skill in speech, language and cognitive functioning. The findings of this study will inform parents, surgeons, teachers, clinicians and policy-makers in their efforts to determine the protocol for early cochlear implantation with the highest likelihood of leading to optimal spoken language skills.

描述（由申请人提供）：新生儿听力筛查和小儿耳蜗领域的最新发展已为许多出生的患有严重的传感神经性听力损失的儿童带来了非凡的福利。在12-18个月大的时候接受人工耳蜗植入物，再加上口语交流中的早期培训通常会导致口语技能，这与幼儿园时代的典型，听到的孩子相似。尽管某些语言缺陷可能仍然存在，但这些孩子足够精通周围的“听力”社区的语言，能够充分参与主流教育，家庭和社区经验。这个延续项目的广泛目标是探索人工耳蜗的新界限，并建立不断发展的手术实践的长期结果。在AIM 1中，我们将诊断植入1-3岁之间植入后仍然存在的特定口语缺陷，并检查甚至早期的人工耳蜗植入（低于12个月的年龄）在改善这些缺陷中的作用。在AIM 2中，我们将评估植入期在婴儿期特定时间安排对儿童获得正常语音曲目的作用。尽管语言技能可能足够，但语音发音可能仍然有改进的余地。最后，我们将确定非常早期的人工耳蜗对10岁儿童的语音感知，生产，语言和识字能力的长期益处，这些儿童在AIM 3中接受了一个婴儿期的耳蜗植入物。目前，我们可以衡量与第二天生日相比，在接近他们的第一个生日更接近植入的学龄前儿童的口语技能上的显着差异。即使控制人工耳蜗的使用时间，这些优点也很重要。重要的是要知道这些优势在小学时期是否仍然显而易见，或者那些以后接受植入物的人是否能够赶上。 在美国，目前有儿童在6-12个月之间收到植入物，低于目前的FDA指南。收集结果数据至关重要，以了解是否有必要这种不断发展的实践。我们将在全国范围内测试25名儿童，他们接受了12个月以下的植入物。详细的语音/语言分析将确定这种做法是否为儿童带来可衡量和有意义的好处。对于长期结局，我们将测试60名儿童（来自我们的纵向样本），他们将经过2天的测试，以评估由于植入时的年龄而导致的差异，并确定他们当前的语音，语言和认知功能技能水平。这项研究的结果将为父母，外科医生，教师，临床医生和政策制定者提供努力，以确定早期人工耳蜗的协议，并具有最高的可能性，从而提高了最佳的口语能力。