THE EFFECTS OF EARLY ACOUSTIC HEARING FOR PEDIATRIC COCHLEAR IMPLANT RECIPIENTS

早期声学听力对儿童人工耳蜗植入者的影响

• 批准号: 8578247
• 负责人: Lisa Surber Davidson
• 金额: $ 49.76万
• 依托单位: WASHINGTON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-08-01 至 2018-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8578247
• 关键词: Accounting; Acoustic Stimulation; Acoustics; Age; Bilateral; Child; Childhood; Cochlear Implants; Cochlear implant procedure; Cognitive; Consensus; Cues; Devices; Discrimination; Ear; Exposure to; Guidelines; Hearing; Hearing Aids; Implant; Infant; Intelligence; Language; Language Development; Lead; Learning; Length; Maintenance; Measures; Mediating; Memory; Outcome; Patients; Perception; Performance; Recommendation; Records; Reporting; Residual state; Resolution; Socioeconomic Status; Specific qualifier value; Speech Perception; Stress; Testing; Time; Word Processing; cognitive function; cohort; experience; hearing impairment; novel; phonology; public health relevance; research study; skills; time interval; time use

DESCRIPTION (provided by applicant): Currently the decision to proceed from bimodal devices [cochlear implant (CI) plus hearing aid (HA) in the opposite ear] to bilateral CIs for pediatric patients is made in the absence of empirically driven guidelines. Through these research studies we will examine a continuum of residual hearing levels and length of hearing aid use by examining children with bimodal devices and two CIs. Perception of stress, pitch and prosody (suprasegmental cues) are early precursors that enable normal hearing (NH) infants to discern phonemes and ultimately perceive words. Although CIs support high levels of phoneme discrimination necessary for word recognition, the contribution of suprasegmental listening that bootstraps language development in normal hearing children may be lacking, partly due to reduced spectral resolution of current CIs. We seek to elucidate the reported benefits of early HA use for speech perception and language skills by examining a longitudinal cohort of 100 children tested when they are between 5 and 8 years and retested two years later when they are between 7 and 10 years. A continuum of early acoustic experience will be represented by children with varying degrees of residual hearing (aided thresholds) and varying durations of HA use. Some children will be bimodal users and thus have longer periods of HA use and presumably better acoustic hearing; others will have received their second CI (2CIs) either simultaneously or at varying time intervals since their first CI, and had some prior acoustic hearing experience. We hypothesize that early acoustic experience with a HA provides the very young CI user with suprasegmental cues that lead to perception of segmental cues (Aim 1). The effects of acoustic hearing on language will be mediated by speech perception, phonological processing, word learning and memory (Aim 2). Finally we seek to determine the duration of HA use and degree of aided hearing that are optimal for language level (Aim 3). These studies will eventually guide clinicians in making informed recommendations regarding early bimodal (HA/CI) use and the timing of potential bilateral cochlear implantation.

描述（由申请人提供）：目前，在缺乏经验指导的情况下，决定对儿科患者从双模态器械[人工耳蜗植入（CI）+对侧耳助听器（HA）]转向双侧CI。通过这些研究，我们将通过检查使用双峰设备和两个CI的儿童来检查剩余听力水平和助听器使用时间的连续性。重音、音高和韵律（超音段线索）的感知是使听力正常的婴儿辨别音素并最终感知单词的早期前体。虽然CI支持单词识别所需的高水平的音素歧视，超音段听力的贡献，引导正常听力儿童的语言发展可能会缺乏，部分原因是目前CI的频谱分辨率降低。我们试图通过检查由100名儿童组成的纵向队列，阐明早期使用HA对言语感知和语言技能的好处，这些儿童在5至8岁时接受测试，并在两年后7至10岁时重新测试。具有不同程度残余听力（辅助阈值）和不同HA使用持续时间的儿童将代表早期声学体验的连续性。一些儿童将是双峰用户，因此使用HA的时间更长，并且可能具有更好的声学听力;其他儿童将同时或自第一次CI以来以不同的时间间隔接受第二次CI（2 CI），并且之前有一些声学听力经验。我们假设，早期的声学经验与HA提供了非常年轻的CI用户与超音段线索，导致感知的分段线索（目的1）。听觉对语言的影响将通过言语感知、语音处理、单词学习和记忆来介导（目的2）。最后，我们试图确定HA使用的持续时间和辅助听力的程度是最佳的语言水平（目标3）。这些研究最终将指导临床医生就早期双模态（HA/CI）使用和潜在双侧人工耳蜗植入的时机提出明智的建议。