Childhood Development after Cochlear Implantation

描述(由申请人提供)：人工耳蜗术后儿童发育(CDaCI)研究是一项多点、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变量的影响 影响植入后语言学习的因素。口语的成功取决于多个发展领域之间的复杂互动。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。儿童研究中的一大挑战涉及到可靠地获取交流和语言数据。我们通过分层测量和视频分析技术来解决这一问题，并以固定的间隔记录下来，这使我们能够在沟通技能出现时跟踪它们。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)善于表达和接受的语言和学术成就，2)言语产出，3)言语识别，4)认知技能，5)社交和行为，6)与家庭成员的关系，以及7)与健康相关的生活质量和相关的经济结果。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)。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。因此，随着CDaCI参与者作为学龄前儿童进入这项研究，他们现在开始了他们的中学经历，在接下来的五年里进入高中，目前的平均年龄分别为11.0岁(CI)和10.8岁(NH)。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。随着植入人工耳蜗的儿童面临青少年早期的交流和社交需求，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研究为人工耳蜗植入后语言学习和社会行为发展的变异来源提供了新的、可推广的见解，为减少低表现和结局变异提供了临床指导。

DESCRIPTION (provided by applicant): 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 depends on complex interactions between multiple domains 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 childhood research relates to the reliable elicitation of communication and linguistic data. We address this task with hierarchical measures and videoanalytic techniques, recorded at fixed intervals, which 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 and receptive language and academic achievement, 2) speech production, 3) speech recognition, 4) cognitive skills, 5) social interaction and behavior, 6) relationships with family members, and 7) health-related quality of life and related economic outcomes. 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). 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. So, as CDaCI participants entered the study as preschoolers, they now embark on their middle school experience, entering high school over the next five years at current average ages of 11.0 (CI) and 10.8 (NH) years old. 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 children with cochlear implants face the communication and social demands of their early teens. This prospective, multidimensional study with concurrent controls offers prospects for novel, generalizable insights into the sources of variation in language learning and social and behavioral development after cochlear implantation, offering clinical guidelines to reduce low performance and variation in outcome.