Childhood Development after Cochlear Implantation

耳蜗植入后儿童发育（CDaCI）研究是一项多中心、前瞻性研究，对美国人工耳蜗植入儿童进行了大量不同队列研究。我们的主要目标是评估植入后影响语言学习的变量的效果。 口语的成功是一个在多个发展领域之间流动的成功问题。因此，我们的目标是由假设驱动的，这些假设将植入后语言结果的变化与环境，社会，干预和生物影响联系起来。这类幼儿研究的一个主要挑战是如何可靠地收集交流和语言数据。我们解决这个任务与分层措施和视频分析技术，使我们能够跟踪沟通技巧，因为他们出现。我们继续建立在这项研究的经验，以研究如何在儿童参与研究，评估他们的语言技能展开：1。表达性和接受性语言，2.语音生成，3。语音识别，4.认知技能，5.社会互动与行为，6。与家人的关系; 7。与健康相关的生活质量。 CDaCI研究参与者包括在5岁之前接受人工耳蜗植入（CI）的儿童（n=188）和正常听力（NH）同龄人的对照组（n=97）。入组时的平均年龄为2.2岁（CI）和2.3岁（NH）。因此，当CDaCI参与者从学龄前儿童开始研究时，他们现在将开始他们的中学经历，在未来五年内进入高中。CI儿童和NH儿童的持续数据累积保留率分别为85%和84%，尽管过去8年以上收集的所有数据均已纳入已发表的分析中。 尽管早期人工耳蜗植入的益处得到了广泛的认可，但在临床、康复和教育策略方面仍然存在平衡，这些策略使人工耳蜗植入技术能够最大限度地发挥其在语言习得方面的潜力。语言结果的修饰语变得更加引人注目的CI儿童面临的表现和社会需求的早期青少年。这项具有并行对照的前瞻性、多维度研究为语言学习变化的来源和早期人工耳蜗植入后观察到的心理社会结果提供了新颖的、可概括的见解。在医疗改革时代，经济影响对决策至关重要，将通过纵向成本数据进行评估，这些数据与参与者及其父母报告的结果相结合。

The Childhood Development after Cochlear Implantation (CDaCI) Study is a multisite, prospective investigation of a large and diverse cohort of US children with cochlear implants. Our primary objective is to evaluate the effect of variables that influence language learning after implantation. Success in spoken language is a matter of success flowing between multiple spheres of development. Thus our aims are driven by hypotheses that relate variability in post-implant language outcome to environmental, social, interventional, and biological influences. A major challenge in such early childhood research relates to the reliable elicitation of communication and linguistic data. We address this task with hierarchical measures and video analytic techniques that allow us to track communicative skills as they emerge. We continue to build on this research experience to examine how language skills unfold in children participating in the study, evaluating their: 1. expressive & receptive language, 2. speech production, 3. speech recognition, 4. cognitive skills, 5. social interaction & behavior, 6. relationships with family members, and 7. health-related quality of life. CDaCI Study participants consist of children who received a cochlear implant (CI) before the age of 5 years (n=188) and a control group (n=97) of normal hearing (NH) age-mates. Average ages at enrollment were 2.2 years (CI) and 2.3 years (NH). So, as CDaCI participants began the study as preschoolers, they will now embark on their middle school experience, entering high school over the next five years. Retention rates for ongoing data accrual are 85% for CI children and 84% for NH children, although all data collected over the past 8+ years have been included in published analyses. Despite wide recognition of the benefits of early cochlear implantation, there remains equipoise with respect to clinical, rehabilitative, and educational strategies that enable cochlear implant technology to be used to its fullest potential for language acquisition. Modifiers of linguistic outcome become even more compelling as CI children face the performance and social demands of their early teens. This prospective, multidimensional study with concurrent controls offers prospects for novel, generalizeable insights into the sources of variation in language learning and the psychosocial outcomes observed after early cochlear implantation. Economic impact, crucial to decision-making in an era of healthcare reform, will be assessed with longitudinal cost data that are merged with outcomes reported by participants and their parents.