OTITIS MEDIA AND EARLY SPEECH DEVELOPMENT IN DAYCARE

早期和广泛的中耳感染（慢性中耳炎，COM）与幼儿的许多负面发展结果有关，包括轻度至中度听力损失，以及注意力、行为、语言发展和言语发展问题。专门针对COM的语音发展性质的研究较少，结果仍然令人困惑和矛盾。本研究的目的是描述COM儿童早期语言发展的本质及其与照顾者互动的关系。据推测，负面结果的最早警告信号之一是幼儿从牙牙学语到有意义的语言产生时出现的非典型语言模式。进一步的假设是，难以理解的言语是与照顾者有问题的言语互动的前兆，限制了儿童练习新学的语音和发展成人的声音系统的机会。提出了两项相关研究。在研究1中，60名婴儿（大约6个月大）进入日托中心的儿童将在12、18、24、30和36个月大时进行纵向测量。将COM患儿的言语产生和可理解性的定量测量与无中耳炎患儿进行比较，以确定早期言语状态是否会影响后来的言语互动。在研究2中，选取20名儿童的语音样本，其中10名患有COM， 10名无中耳炎，从幼儿学步期开始，直到与成人语音建立系统的语音对应关系（约30个月），重复（每两周）测量一次。将对样本进行感知和声学分析，以揭示在OM发作期间表征语音产生变化的任何细微差异。结果将有助于确定个体差异的限制，并确定语音习得中以下替代补偿途径的积极或消极影响。该项目的研究结果将为建立中耳炎后遗症的新模型、识别有言语迟缓或障碍风险的儿童以及设计侧重于早期沟通干预的项目提供实证支持。

Early and extensive experience with middle ear infections (chronic otitis media, COM) has been linked to a number of negative developmental outcomes in young children including mild to moderate hearing losses, and problems with attention, behavior, language development and speech development. Studies specifically focusing on the nature of speech development with COM have been less abundant and results remain confusing and contradictory. The purpose of the proposed research is to describe the nature of early speech development in children with COM and its relationship to caregiver interactions. It is hypothesized that one of the earliest warning signs of negative outcomes is the emergence of atypical speech patterns as toddlers move from babbling to meaningful speech production. It is further hypothesized that unintelligible speech is a precursor of problematic verbal interactions with caregivers and limits a child's opportunities to practice newly learned speech sounds and develop an adult-like sound system. Two related studies are proposed. In Study 1, the speech development of 60 children who entered daycare as infants (approximately 6 months of age) will be measured longitudinally at ages 12, 18, 24, 30, and 36 months of age. Quantitative measures of speech production and intelligibility in those children with COM will be compared to those of otitis-free children to determine if early speech status mediates later verbal interactions. In Study 2, speech samples of a subset of 20 children, 10 with COM and 10 otitis-free, will be measured repeatedly (every two weeks) from the babbling period through the establishment of systematic sound correspondences with the adult phonology (about 30 months). Samples will be analyzed both perceptually and acoustically to reveal any subtle differences that characterize changes in speech production during episodes of OM. Results will assist in identifying the limits of individual variation and determining the positive or negative effects of following alternative compensatory routes in phonological acquisition. Findings from this project will provide empirical support for building new models of the sequelae of otitis media, identifying children at risk for speech delays or disorders, and the design of projects focusing on early communication intervention.