Childhood Development after Cochlear Implantation

描述（由申请人提供）：耳蜗植入后儿童发育（CDaCI）研究是一项多中心、前瞻性研究，对美国人工耳蜗植入儿童的大型多样化队列进行研究。我们的主要目标是评估变量的影响 影响植入后的语言学习。口语的成功取决于多个发展领域之间的复杂互动。因此，我们的目标是由假设驱动的，这些假设将植入后语言结果的变化与环境，社会，干预和生物影响联系起来。儿童研究的一个主要挑战涉及可靠的沟通和语言数据的引出。我们解决这个任务的分层措施和视频分析技术，记录在固定的时间间隔，这使我们能够跟踪沟通技巧，因为它们出现。我们继续在此研究经验的基础上，研究语言技能如何在参与研究的儿童中展开，评估他们的：1）表达和接受语言和学业成绩，2）言语产生，3）言语识别，4）认知技能，5）社会互动和行为，6）与家庭成员的关系，以及7）健康相关的生活质量和相关的经济成果。CDaCI研究参与者包括在5岁之前接受人工耳蜗植入（CI）的儿童（n=188）和正常听力（NH）同龄人的对照组（n=97）。入组时的平均年龄为2.2岁（CI）和2.3岁（NH）。CI儿童和NH儿童的持续数据累积保留率分别为85%和84%，尽管过去8年以上收集的所有数据均已纳入已发表的分析中。因此，当CDaCI参与者作为学龄前儿童进入研究时，他们现在开始他们的中学经历，在未来五年内进入高中，目前平均年龄为11.0岁（CI）和10.8岁（NH）。尽管早期人工耳蜗植入的益处得到了广泛的认可，但在临床、康复和教育策略方面仍然存在平衡，这些策略使人工耳蜗植入技术能够最大限度地发挥其在语言习得方面的潜力。当植入人工耳蜗的儿童面临青少年早期的沟通和社会需求时，语言结果的修改变得更加引人注目。这项前瞻性、多维度的研究与同期对照研究为人工耳蜗植入后语言学习和社会行为发展的变化来源提供了新的、可推广的见解，为减少低性能和结果变化提供了临床指南。

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.