Acquiring language with a cochlear implant: The role of sequential learning

描述（由申请人提供）：人工耳蜗植入领域取得进展的一个关键障碍是了解学习和记忆的基本机制在语言结果中的作用。长期目标是更好地理解和帮助治疗许多植入人工耳蜗的失聪儿童所表现出的语言延迟。这个特殊的研究项目的总体目标是了解语言延迟在这一人群中的困难与潜在的认知序列学习能力。我们的中心假设是，这些儿童的语言延迟部分是由于顺序学习的干扰造成的-由于听觉和/或语言在发展早期的剥夺-通过加强顺序学习，语言功能可以得到改善。提出这项研究的理由是，我们希望在这个项目结束时，不仅确定了这一人群语言延迟的主要原因，而且还制定了一个新的和有前途的干预措施，专门针对顺序学习技能的发展。我们计划通过以下三个具体目标来验证中心假设并达到本申请的目的：1）确定先天性耳聋对顺序学习的神经机制的影响; 2）确定顺序学习技能和语言结果之间的关系; 3）通过提高顺序学习能力来改善人工耳蜗植入聋儿的语言结果。对于第一个目标，我们将比较神经生理（事件相关电位，ERP）相关的视觉顺序学习的聋儿与人工耳蜗植入的年龄匹配的正常听力儿童。对于第二个目标，我们将比较正常听力和聋人组的语言处理的两个措施，被认为是依赖于排序技能-单词的可预测性和语法的知识-然后经验性地确定与顺序学习能力的关联。对于第三个目标，失聪儿童与人工耳蜗植入将接受计算机化的视觉序列训练方案;培训和转移效果将通过比较培训组与对照组的学习和语言的非培训措施进行评估。在我们看来，这项研究是创新的，因为它提供了一种完全不同的方法，专注于非听觉的，领域一般的学习能力，这些能力在以前的研究中被忽视了。拟议的研究项目的贡献预计将证明，顺序学习能力的干扰解释了为什么许多植入人工耳蜗的聋哑儿童难以获得语言。此外，我们期望通过计算机化的培训技术来提高这些学习能力，从而改善语言和沟通功能。这一贡献将是重大的，因为它有可能改善数千名聋哑儿童的生活质量，这些儿童目前因基本和关键的学习能力困难而从植入物中获益最少。 公共卫生相关性：这项拟议中的研究与公共卫生有关，因为它不仅有助于我们理解为什么植入人工耳蜗的失聪儿童在语言习得方面遇到困难，而且还将向我们展示如何提高他们的语言技能。这种侧重于评估和训练领域一般学习和语言能力的方法将为植入人工耳蜗的聋儿的生活质量提供直接的好处。因此本 该项目与NIH/NIDCD的使命相关，因为它将产生新的知识来帮助解释语言结果，以及一种新的干预策略，将改善这一人群的语言学习。

DESCRIPTION (provided by applicant): A critical barrier to progress in the field of cochlear implantation understands the role that fundamental mechanisms of learning and memory play in language outcomes. The long-term goal is to better understand and help treat the language delays exhibited by many deaf children with cochlear implants. The overall objective of this particular research project is to understand language delays in this population in terms of difficulties with underlying cognitive sequence learning abilities. Our central hypothesis is that language delays in these children are caused in part by disturbances to sequential learning- due to auditory and/or linguistic deprivation early in development -- and that by enhancing sequential learning, language function can be improved. The rationale that motivates the proposed research is that we expect at the conclusion of this project to have not only identified a major cause of language delays in this population but to also have formulated a new and promising intervention that specifically targets the development of sequential learning skills. We plan to test the central hypothesis and attain the objective of this application by pursuing the following three specific aims: 1) Determine the effects that congenital deafness has on the neural mechanisms of sequential learning; 2) Identify the relation between sequential learning skill and language outcomes; 3) Improve language outcomes in deaf children with cochlear implants by enhancing sequential learning abilities. For the first aim, we will compare the neurophysiologic (event-related potential, ERP) correlates of visual sequential learning in deaf children with cochlear implants to those of age-matched normal-hearing children. For the second aim, we will compare normal-hearing and deaf groups on two measures of language processing that are thought to rely on sequencing skills -- knowledge of word predictability and syntax -- and then empirically determine the association with sequential learning abilities. For the third aim, deaf children with cochlear implants will receive a computerized visual sequence training regimen; training and transfer effects will be assessed by comparing the training group to a control group on non-trained measures of learning and language. The proposed research is innovative, in our opinion, because it offers an entirely different approach that focuses on non- auditory, domain-general learning abilities that have been neglected in previous research with this population. The contribution of the proposed research project is expected to be the demonstration that disturbances to sequential learning abilities explain why many deaf children with cochlear implants struggle with acquiring language. Furthermore, we expect that by enhancing these learning abilities through computerized training techniques, language and communication function can be improved. This contribution will be significant because it has the potential to improve the quality of life for thousands of deaf children who currently exhibit minimum benefit from their implants because of difficulties with fundamental and crucial learning abilities. PUBLIC HEALTH RELEVANCE: The proposed research is relevant to public health because it will help us not only understand why deaf children with cochlear implants struggle with language acquisition, but will also show us how to improve their language skills. This approach that focuses on assessing and training domain-general learning and language abilities will provide immediate benefits to the quality of life for deaf children with cochlear implants. Therefore, this project is relevant to the mission of the NIH/NIDCD because it will result both in new knowledge to help explain language outcomes as well as a novel intervention strategy that will improve language learning in this population.