DEVELOPING EVIDENCE-BASED CLINICAL TOOLS FOR MANAGING MILD HEARING LOSS IN CHILDREN

项目概要/摘要 即使最近在早期识别听力损失方面取得了进展， 听力损失（MBHL）在沟通，社交和学术方面继续经历重大延迟 助听器的使用方法有哪些？缺乏临床协议 而对MBHL儿童听力需求敏感的工具则导致了这种不确定性。儿童 在当前临床结果测量中，MBHL患者的表现通常与听力正常的儿童相似。的目标 该提案旨在开发新的临床协议和工具，这些协议和工具对所面临的挑战敏感， 患有MBHL的儿童。目前基于听力图的助听器候选标准不能充分量化 儿童耳道声学和自身产生的噪声对他们的阈值的影响。目标1 一项提案将是为MBHL儿童开发基于听力的助听器候选人工具， 耳道声学和自生噪声。新的听力学评估方法将允许 这些因素的量化和基于语音的助听器候选标准的发展 用目前的方法是不可能的。该提案的目标2将是验证临床措施 语音识别的语音掩蔽，混响，和偷听，反映了现实世界的困难， 儿童MBHL低强度声音的可听度降低是MBHL的主要后果， 这导致难以将目标说话者与背景说话者分离、理解噪声中的语音 混响和偷听远处谈话者的问题。临床语音识别任务， 这些具体的倾听挑战将得到制定和验证。该提案的目标3将是执行 一种新的听力评估、助听器候选资格和 患有MBHL的儿童。与美国领先的儿童听力学中心合作，小说 评估和语音识别措施将用于验证这些措施与一个大的临床 MBHL儿童人群。从这项研究中产生的知识将从根本上改善 儿童期MBHL的诊断和管理。

PROJECT SUMMARY/ABSTRACT Even with recent improvements in the early identification of hearing loss, children with mild bilateral hearing loss (MBHL) continue to experience significant delays in communication, social, and academic outcomes due to uncertainty about the benefits of hearing aids for this population. The lack of clinical protocols and tools that are sensitive to the listening needs of children with MBHL contribute to this uncertainty. Children with MBHL often perform like children with normal hearing on current clinical outcome measures. The goal of this proposal is to develop novel clinical protocols and tools that are sensitive to the challenges faced by children with MBHL. Current hearing-aid candidacy criteria based on the audiogram do not adequately quantify the effects of the child’s ear-canal acoustics and self-generated noise on their thresholds. Aim 1 of the proposal will be to develop audibility-based hearing-aid candidacy tools for children with MBHL that account for ear-canal acoustics and self-generated noise. Novel audiological assessment methods will allow for quantification of these factors and for the development of hearing-aid candidacy criteria based speech audibility that are not possible with current methods. Aim 2 of the proposal will be to validate clinical measures of speech recognition with speech maskers, reverberation, and overhearing that reflect real-world difficulties of children with MBHL. The reduction in audibility for low-intensity sounds is the main consequence of MBHL, which leads to difficulty segregating a target talker from a background talker, understanding speech in noise with reverberation, and problems with overhearing distant talkers. Clinical speech recognition tasks that reflect these specific listening challenges will be developed and validated. Aim 3 of the proposal will be to perform a clinical validation of a new test battery for hearing assessment, hearing-aid candidacy, and outcomes for children with MBHL. In collaboration with leading pediatric audiology centers around the U.S., the novel assessment and speech recognition measures will be used to validate these measures with a large clinical population of children with MBHL. The knowledge generated from this research will fundamentally improve the diagnosis and management of MBHL during childhood.