Long-Term Outcomes of Cochlear Implantation in Early Childhood

描述(申请人提供)：这项拟议的研究测量了在学龄前接受人工耳蜗术的聋人青少年的听觉、言语、认知和学习发展以及自尊。在过去，即使在认知能力正常的情况下，语前深度耳聋的人也经常表现出很大的教育延迟。这些学生在整个高中期间表现出英语语言和识字能力发展的4-6年的平均延迟，以及没有经验的听众最不能理解的语言。这些延误与职业机会减少和与多数人的听力文化隔绝有关。人工耳蜗技术的出现可能会构成聋人教育的新纪元。记录在案的年轻人工耳蜗者的听觉、言语和英语语言技能远远超过听力损失程度相近的助听器使用者。这项研究将通过跟踪来自北美各地的181名儿童来检验长期使用人工耳蜗的青少年的表现，这些儿童是世界上第一批在学龄前接受人工耳蜗植入的儿童之一。这些儿童在小学早期(8-9岁)进行了第一次测试。这项拟议的研究将在他们高中后期(16-17岁)重新评估他们。由于聋生和听障学生之间的成绩差距往往会随着年龄的增长而扩大，年轻的人工耳蜗者的早期优势可能会在青春期减弱。人们对听觉言语感知技能在高中词汇和语言理解中的作用知之甚少，因为高中期间，语言除了通过听和看之外，还通过阅读获得。我们将测试学生接近成年时识字的结构模型，并检验语音感知能力的提高对预测结果的影响。尽管在8岁和9岁时进行的自尊测试显示出高水平的自我能力，但在高中阶段，自我形象评分可能会下降，特别是对于那些既不认同聋人也不认同听力社区的人。这项拟议的研究的目的是确定那些对植入人工耳蜗的高中生和促进这些结果的教育项目的积极结果有贡献的因素。此外，我们还将记录与停止使用人工耳蜗术相关的发生率和结果。

DESCRIPTION (provided by applicant): The proposed study measures auditory, speech, cognitive and academic development and self-esteem in deaf adolescents who received a cochlear implant in preschool. In the past, individuals with prelingual profound deafness have often exhibited substantial educational delays, even in the presence of normal cognitive ability. Such students exhibit 4-6-year average delays in English language and literacy development throughout high school and speech that is minimally understood by inexperienced listeners. These delays have been associated with reduced vocational opportunities and isolation from the majority hearing culture. The advent of cochlear implant technology may constitute a new era in deaf education. The documented auditory, speech and English language skills of young cochlear implant users greatly exceed those of hearing aid users with similar degree of hearing loss. This study will examine performance of adolescents who are long-term cochlear implant users by following a group of 181 children from across North America who were among the first in the world to receive cochlear implants in preschool. These children were first tested when they were in early elementary school (age 8-9). The proposed study will re-evaluate them when they are in late high school (age 16-17). Because the achievement gap between deaf and hearing students tends to increase with age, the early advantages seen in young cochlear implant users may be found to diminish in adolescence. Little is known about the role of auditory speech perception skills in vocabulary and language comprehension during high school, when language is acquired by reading in addition to listening and watching. We will test a structural model of literacy as students approach adulthood and examine the effects of improved speech perception on predicted outcome. Although self-esteem measures conducted at age 8 and 9 year revealed high levels of perceived self-competence, self-image ratings may decrease in high school, particularly for those who identify with neither a Deaf nor a hearing community. The purpose of the proposed study is to identify those factors that contribute to positive outcomes in high school students with cochlear implants and educational programs that promote these outcomes. In addition we will document the incidence and outcomes associated with discontinued use of a cochlear implant.