Promoting Diversity in Health-Related Research

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ABSTRACT FROM PARENT PROJECT (Image Guided Programming: Pediatric Speech, Language and Literacy) Although the recent literature has indicated that children receiving cochlear implants often have dramatically improved speech and language ability relative to previous generations of children with hearing loss, many pediatric cochlear implant (CI) patients display persistent speech and language disorders despite early implantation and associated speech/language intervention [see (1,2)]. There is a striking paucity and ongoing need for studies that systematically examine the relationship between surgical implantation parameters, audiological profile, and subsequent speech, language, and literacy outcomes in pediatric CI [see (3)]. The proposed project provides a unique opportunity to examine whether individualized, image-guided CI programming (IGCIP) significantly improves outcomes in pediatric CI patients. The proposed research is a collaboration between an audiologist (Gifford) and a speech language pathologist (Camarata) and a biostatistician (Dietrich). The proposed research activities will examine the impact of personalized IGCIP in pediatric patients on measures of basic auditory function (spectral and temporal resolution), speech recognition, speech production, language, and measures of preliteracy and reading comprehension using a randomized wait-list control treatment design. A total of 60 children with CIs aged six to twelve years old will be enrolled in the project and one-half (n = 30) will be randomized to an immediate IGCIP condition and half to a 12 month waitlist control condition. The waitlisted participants (n = 30) will undergo IGCIP after 12 months of monitoring and followed up for an additional 12 months after the programming has been provided (total time in the study: 24 months). Those immediately provided with IGCIP will also be enrolled for a total of 24 months. All participants will undergo extensive audiological and speech and language assessments in addition to comprehensive audiological assessment 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.