Modeling Auditory Responses and Behavioral Outcomes in Preterm Infants

早产儿的听觉反应和行为结果建模

• 批准号: 9318492
• 负责人: LINDA J. HOOD
• 金额: $ 58.92万
• 依托单位: VANDERBILT UNIVERSITY MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-08-01 至 2019-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9318492
• 关键词: Acoustics; Address; Adopted; Affect; Age; Anatomy; Asses; Audiology; Auditory; Auditory Brainstem Responses; Auditory system; Behavior assessment; Behavioral; Brain Stem; Caring; Categories; Characteristics; Child health care; Chiroptera; Clinical; Cochlea; Cognition; Communication; Cross-Sectional Studies; Data; Dependence; Detection; Development; Diagnosis; Diagnostic; Diagnostic tests; Early Intervention; Equipment and supply inventories; Evaluation; Evidence based practice; Goals; Growth; Health; Healthcare; Hearing; Hearing problem; Incidence; Individual; Infant; Intervention; Knowledge; Language; Language Delays; Language Development; Laws; Life; Linear Models; Measurement; Measures; Medical; Modeling; Modernization; Neonatal Intensive Care Units; Neonatal Screening; Neonatology; Neurologic; Newborn Infant; Outcome; Outcome Study; Parents; Pediatrics; Performance; Peripheral; Physiological; Premature Birth; Premature Infant; Production; Provider; Public Health; Recommendation; Rehabilitation therapy; Research; Research Personnel; Response Latencies; Risk Factors; Sampling; Social Interaction; Speech-Language Pathology; Statistical Methods; Structure; Survival Rate; Techniques; Testing; Time; Toddler; base; behavior measurement; behavioral outcome; clinical Diagnosis; clinical practice; diagnostic accuracy; electrical potential; evidence base; experimental study; hearing impairment; hearing screening; high risk; improved; infancy; intervention program; middle ear; otoacoustic emission; public health relevance; relating to nervous system; response; skills; sound; systematic review; tool

DESCRIPTION (provided by applicant): Understanding the causes of variability in auditory neural responses is critical for effective diagnosis of hearing problems and evaluation of neural integrity early in life. Since the Children's Health Act of 2000 (Public Law 106-310) was adopted, most newborns in the US are screened for hearing loss, resulting in more than 65,000 infants being referred every year for further diagnostic auditory testing. Interpretation of these diagnostic tests in infants relies on a thorough understanding of measures from the peripheral and central auditory system. Current norms are based on cross-sectional studies collected from select groups of infants almost 3 decades ago. Because of dramatic changes in health care standards, increased survival rates of infants born prematurely, and new physiological tests that allow evaluation of different anatomical levels of the auditory system, more accurate descriptions of auditory neural responses and relevant normative data are necessary. The proposed research has three specific aims. In the first aim, we will construct models of auditory brainstem responses over time in a diverse and representative infant sample based on objective, physiological measurements reflecting peripheral and central processing. Relevant variables such as high risk factors, prematurity of birth, hearing screening outcome, neurodevelopmental delay and language skills will be used to explain variability in the physiological measures. Infants will be followed on an individual level, with responses recorded longitudinally on experimental measures. The statistical method of hierarchical linear modeling will be used to describe the physiological test data. The second aim is to recast the results in a way that predicts the likelihood of neurodevelopmental and language delay based on auditory and medical variables. In the third aim, we will model language growth and describe its trajectory in relationship to auditory factors. An expected outcome of this study is that modern, sensitive measures will be different for infants with normal hearing and development, infants with different categories of hearing loss, infants with delayed auditory development and infants with more global, neurodevelopmental delays. The results from this study will improve our scientific and clinical knowledge of various auditory measures and couple the auditory measures to language and developmental outcomes, influencing the fields of audiology, neonatology, pediatrics, speech-language pathology and early intervention. The proposed research will improve the public health by accelerating the identification of behavioral delays early in life as well as supplying parents and providers with improved information earlier so that they can make more efficient and timely rehabilitation decisions.

描述（由申请人提供）：了解听觉神经反应变异性的原因对于有效诊断听力问题和评估生命早期的神经完整性至关重要。自2000年《儿童健康法》（公法106-310）通过以来，美国大多数新生儿都接受了听力损失筛查，每年有超过65，000名婴儿被转诊接受进一步的诊断性听力测试。对婴儿进行这些诊断测试的解释依赖于对外周和中枢听觉系统测量的透彻理解。目前的标准是基于近30年前从选定的婴儿群体中收集的横断面研究。由于医疗保健标准的巨大变化，早产儿存活率的提高，以及允许评估听觉系统不同解剖水平的新生理测试，更准确地描述听觉神经反应和相关规范数据是必要的。拟议的研究有三个具体目标。在第一个目标中，我们将构建模型的听觉脑干反应随着时间的推移，在一个不同的和有代表性的婴儿样本的基础上，客观的，生理测量反映外周和中央处理。相关变量，如高风险因素，早产，听力筛查结果，神经发育迟缓和语言技能将被用来解释生理指标的变异性。将在个体水平上对婴儿进行随访，并在实验测量中纵向记录反应。将使用分层线性建模的统计方法来描述生理测试数据。第二个目标是根据听觉和医学变量来预测神经发育和语言延迟的可能性。在第三个目标中，我们将建立语言增长模型，并描述其与听觉因素的关系。本研究的预期结果是，现代灵敏的测量方法对于听力和发育正常的婴儿、不同类型听力损失的婴儿、听觉发育延迟的婴儿和更全面的神经发育延迟的婴儿将是不同的。这项研究的结果将提高我们对各种听觉措施的科学和临床知识，并将听觉措施与语言和发育结果相结合，影响听力学，听力学，儿科学，言语语言病理学和早期干预等领域。拟议的研究将通过加速识别生命早期的行为延迟来改善公共健康，并为父母和提供者提供更早的信息，以便他们能够做出更有效和及时的康复决策。