Spoken Language in Adolescents with Hearing Loss

项目总结/摘要 通过新生儿听力筛查，耳蜗植入物（CI）和早期干预变得可行， 显著改善了出生时患有听力损失（HL）的儿童能够发展口语的预后， 与听力正常（NH）的典型同龄人的语言相当。这两项进展意味着 小学的HL儿童现在表现出一系列口语能力， 这些指标仅比那些具有NH的典型同龄人的平均值低一个标准差。尽管这 在CI和早期干预如此容易之前，性能水平超过了可达到的语言能力 这些表现水平并不是一个普通的HL儿童在没有 HL和平均性能没有改善。这些事实加在一起构成了取得进展的严重障碍， 涉及HL儿童的研究和临床实践，正是这个障碍，本项目旨在 地址.这项工作的一个强烈动机是早期调查的发现，表明HL儿童 经历了不成比例的更大的语音赤字比赤字观察到的形态句法 能力.据推测，这种巨大的音系缺陷是由于可用的频谱表示不佳而产生的 对HL的听众，特别是如果他们使用CI。这一巨大的语音赤字预计将有级联 对其他后来获得的语言和识字功能的影响，这可能取决于具有敏锐的 对语音结构的敏感性。这个预测是在这个项目中探索的， 从婴儿期就开始了，现在已经到了青春期，被认为是第一语言习得的结束。的 这项工作的前提由3部分组成：（1）信号退化可以解释大部分持续的 HL儿童的语言差距;（2）退化不成比例地影响语音的获得， （3）语音敏感性差会导致差异 对后来学习的语言技能的影响。总共有124名儿童（76名听力损失儿童）参加了一项 从婴儿开始的纵向发展研究将在各种语言，识字， 在中学毕业时采取社会心理措施。该项目的四个具体目标是：（1） 评估124名儿童的言语感知、语言、读写能力、社交和学业表现， 从婴儿期到中学结束时，我就参加了一个纵向项目。(2)测试的假设 语音敏感性和形态句法能力至少是相互独立的 对HL儿童的治疗(3)检查早期的前体PS和MSA在8年级测量。(4)测试相关 假设MSA的获取在面对信号降级时可以接近正常，只要 孩子们有足够的语言经验，但发展高度精炼的PS需要有一些 更详细的声学信号。该项目的影响将是，它将告知未来 对聋儿进行听力和语言干预。

Project Summary/Abstract Cochlear implants (CIs) and early intervention – made feasible by newborn hearing screenings – have significantly improved the prognosis that children born with hearing loss (HL) will be able to develop spoken language commensurate to that of their typical peers with normal-hearing (NH). These two advances mean that the average child with HL in elementary school now demonstrates abilities on a range of spoken language measures that are just one standard deviation below the means of those typical peers with NH. Although that level of performance exceeds language abilities attainable before CIs and early intervention were so readily available, these performance levels are not what an average child with HL would be attaining in the absence of HL, and mean performance is not improving. Together those facts represent a critical barrier to progress for both research and clinical practice involving children with HL, and it is that barrier that this project seeks to address. A strong motivation for this work is the finding from earlier investigation showing that children with HL experience a disproportionately larger phonological deficit than the deficit observed for morphosyntactic abilities. That large phonological deficit is presumed to arise due to the poor spectral representations available to listeners with HL, especially if they use CIs. This large phonological deficit is predicted to have cascading effects on other, later-acquired language and literacy functions, which are likely dependent on having keen sensitivity to phonological structure. That prediction is explored on this project with children who have been followed since infancy and are now reaching puberty, believed to be the end of first-language acquisition. The premise underlying this work consists of 3 parts: (1) signal degradation can explain much of the continued language gap of children with HL; (2) that degradation disproportionately affects acquisition of phonological sensitivity, rather than morphosyntactic abilities; and (3) that poor phonological sensitivity will have differential effects on later-learned language skills. In all, 124 children (76 with hearing loss) who participated in a longitudinal study of development since they were infants will be tested on a variety of language, literacy, and psychosocial measures at the conclusion of middle school. The four Specific Aims of the project are to: (1) Assess the speech perception, language, literacy, social, and academic performance of 124 children who participated in a longitudinal project since infancy at the end of middle school. (2) Test the hypothesis that phonological sensitivity (PS) and morphosyntactic abilities (MSA) can be independent of each other, at least for children with HL. (3) Examine earlier precursors to PS and MSA measured in 8th grade. (4) Test the related hypotheses that the acquisition of MSA can be close to normal in the face of signal degradation, as long as children get adequate experience with language, but developing highly refined PS requires having had some experience with more detailed acoustic signals. The impact of the project will be that it will inform future audiological and language interventions for deaf children across childhood.