Image-Guided Cochlear Implant Programming: Pediatric Speech, Language, and Literacy

项目摘要 虽然最近的文献表明，接受人工耳蜗植入（CI）的儿童往往有 与前几代听力正常的儿童相比， 尽管早期植入，许多儿童CI接受者仍显示持续的言语和语言障碍 以及相关的言语/语言干预。有一个显着的缺乏和持续需要的研究， 系统地检查颅内电极位置、听力学特征和 随后的语音意识，言语，语言和识字的儿科CI收件人。这个项目 提供了一个独特的机会，以检查是否个性化，图像引导的CI编程（IGCIP） 显著改善儿童CI患者的结局。拟议的研究活动将审查 个性化IGCIP在儿童CI接受者中对基本听觉功能测量的影响（频谱， 时间和频谱时间分辨率），单词和非单词识别，语音产生，语言， 语音意识和阅读理解，采用双盲，等待名单对照随机临床 随机对照试验设计。总共有72名6至12岁的CI儿童样本将入组 项目：一半（n = 36）将随机分配至立即IGCIP条件，另一半随机分配至等待列表对照条件。 等待名单上的参与者（n = 36）将在12个月的监测后接受IGCIP，然后随访 干预后额外12个月（两组研究总时间：24个月）。那些立即 此外，IGCIP提供的产品也将随访24个月。所有参与者将接受广泛的 听力学评估以及语音意识、言语、语言和读写能力的测试， 基线以及定期：2、6、12、14、18和24个月。我们将使用预测分析， 确定即时和延迟IGCIP对随后的听觉，言语，语言和读写能力的影响 结果。

PROJECT SUMMARY Although the recent literature has indicated that children receiving cochlear implants (CIs) often have dramatically improved speech and language ability relative to previous generations of children with hearing loss, many pediatric CI recipients display persistent speech and language disorders despite early implantation and associated speech/language intervention. There is a striking paucity and ongoing need for studies that systematically examine the relationship between intracochlear electrode location, audiological profile, and subsequent phonological awareness, speech, language, and literacy in pediatric CI recipients. This project provides a unique opportunity to examine whether individualized, image-guided CI programming (IGCIP) significantly improves outcomes in pediatric CI patients. The proposed research activities will examine the impact of personalized IGCIP in pediatric CI recipients on measures of basic auditory function (spectral, temporal, and spectrotemporal resolution), word and non-word recognition, speech production, language, phonological awareness, and reading comprehension using a double blind, waitlist control randomized clinical trial (RCT) design. A total sample of 72 children with CIs aged six to twelve years old will be enrolled in the project: half (n = 36) will be randomized to an immediate IGCIP condition and half to a waitlist control condition. The waitlisted participants (n = 36) will undergo IGCIP after 12 months of monitoring and then followed for an additional 12 months after intervention (total time in the study for both groups: 24 months). Those immediately provided with IGCIP will also be followed for a total of 24 months. All participants will undergo extensive audiological assessment as well as tests of phonological awareness, speech, language, and literacy at baseline as well as at regular intervals: 2, 6, 12, 14, 18, and 24 months. We will use predictor analyses to determine the impact of immediate and deferred IGCIP on subsequent auditory, speech, language, and literacy outcomes.