Childhood Development after Cochlear Implantation

人工耳蜗术后儿童发育研究(CDaCI)是一项多点、前瞻性的研究，对接受人工耳蜗术的美国儿童进行了大规模和多样化的队列调查。我们的主要目标是评估影响植入后语言学习的变量的效果。 口语的成功是在多个发展领域之间流动的成功问题。因此，我们的目标是由假说驱动的，这些假说将植入后语言结果的变异性与环境、社会、干预和生物影响联系起来。这类儿童早期研究的一个主要挑战是如何可靠地获得交流和语言数据。我们通过分层测量和视频分析技术来解决这一任务，使我们能够在沟通技能出现时跟踪这些技能。我们继续以这一研究经验为基础，考察参与研究的儿童的语言技能是如何展开的，评估他们：1.表达和接受性语言，2.言语产出，3.言语识别，4.认知技能，5.社会互动和行为，6.与家庭成员的关系，以及7.与健康相关的生活质量。 CDaCI研究参与者包括5岁前接受人工耳蜗术的儿童(n=188)和听力正常(NH)年龄伙伴的对照组(n=97)。登记时的平均年龄分别为2.2岁(CI)和2.3岁(NH)。因此，随着CDaCI参与者从学龄前儿童开始这项研究，他们现在将开始他们的中学经历，在接下来的五年里进入高中。持续积累数据的保留率在CI儿童中为85%，在NH儿童中为84%，尽管过去8年以上收集的所有数据都已被纳入已发表的分析中。 尽管人们广泛认识到早期植入人工耳蜗术的好处，但在临床、康复和教育策略方面仍然保持平衡，使人工耳蜗术能够最大限度地发挥其语言习得的潜力。随着CI儿童面临青少年早期的表现和社会需求，语言结果的修饰语变得更加令人信服。这项同时对照的前瞻性多维度研究为语言学习中变异的来源和早期人工耳蜗术后观察到的心理社会结果提供了新的、可推广的见解。在医疗改革时代，对决策至关重要的经济影响将通过纵向成本数据进行评估，这些数据将与参与者及其父母报告的结果合并。

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.