Measuring hearing in children with developmental differences

近40%的听力损失儿童有继发性残疾，但听力专家缺乏适当的 不同发育或复杂发育儿童听力行为评估方法的研究 配置文件。这项研究的长期目标是改善患有听力障碍的儿童的听力健康护理。 通过改变行为听力测试方法来解决发育障碍问题。这方面的总体目标是 应用是找出当前临床护理中的差距，并分离影响 行为数据。我们的中心假设是，无法获得准确可靠的行为阈值 目前的行为程序反映的是方法论的局限性，而不是孩子的局限性。其基本原理是 这项工作是，通过隔离影响阈值的因素，我们可以开发出严格的方法来克服 当前临床实践的局限性；从而改善对发育迟缓儿童的听力保健 残疾人士。将通过追求两个具体目标来检验中心假设：(1)找出当前 发育性残疾儿童的临床评估做法的状况；以及(2)确定 影响行为阈值的准确性。在第一个目标下，使用公开的数据库进行大数据分析 将被用来评估目前的临床情况。对于第二个目标，使用了一种新的基于观察者的 心理声学程序，我们将评估方法和儿童因素，预计会影响 不同发育状态的1.5-5岁儿童的行为数据(自闭症谱系障碍， 唐氏综合症，或典型的发展)。本申请中提出的研究是创新的，在 申请人的意见，因为它(1)利用大数据分析的力量来加快研究步伐 在儿科听力学方面，以及(2)它使用了基于观察者的程序，克服了相关的挑战 与收集和解释发育障碍儿童的数据有关的工作。建议的工作是 意义重大，因为它将为修改目前的儿童临床程序提供强有力的科学证据 以及发展急需的方法进步，这些进步对于 消除现有的听力保健差距。

Nearly 40% of children with hearing loss have a secondary disability, yet audiologists lack the appropriate behavioral assessment procedures to measure hearing in children with diverse or complex developmental profiles. The long-term goal of this line of research is to improve hearing health care for children with developmental disabilities by transforming behavioral hearing testing methods. The overall objectives for this application are to identify gaps in current clinical care and to isolate methodological and child factors that affect behavioral data. Our central hypothesis is that the inability to obtain accurate and reliable behavioral thresholds with current behavioral procedures reflects methodology limitations, not limitations of the child. The rationale for this work is that by isolating factors that affect threshold we can develop rigorous methods that overcome the limitations of current clinical practices; thereby, improving hearing health care for children with developmental disabilities. The central hypothesis will be tested by pursuing two specific aims: (1)!identify gaps in the current state of clinical assessment practices for children with developmental disabilities; and (2) identify factors that influence behavioral threshold accuracy. Under the first aim, big data analytics with a publicly-available database will be used to assess the current clinical situation. For the second aim, using a novel observer-based psychoacoustics procedure, we will evaluate methodological and child factors that are expected to affect behavioral data from 1.5- to 5-year-old children with different developmental status (Autism Spectrum Disorder, Down syndrome, or typical development). The research proposed in this application is innovative, in the applicant’s opinion, because it (1) harnesses the power of big data analytics to accelerate the pace of research in pediatric audiology, and (2) it uses an observer-based procedure that overcomes the challenges associated with collecting and interpreting data from children with developmental disabilities. The proposed work is significant because it will provide strong scientific evidence for modifying current clinical procedures for children with developmental disabilities and for developing much-needed methodology advancements essential to eliminating existing hearing health care disparities.!