Spatial hearing and language learning in toddlers who use cochlear implants

描述(申请人提供)：先天失聪的儿童通过使用 人工耳蜗术(Cis)，它直接为听神经提供电刺激。尽管大多数儿童可以通过单个植入物表现得相当好，但与早期植入相关的效果更好， 最近的一种临床趋势是为聋人提供双侧顺式耳机。尽管这种做法在老年患者中得到了广泛接受，但对于婴儿来说，这一做法仍在争论中。这场辩论的一个原因是 向婴儿提供双边顺位的益处尚未得到系统的研究。在年龄较大的儿童和成人中，双侧CI已被证明改善了噪声中的空间听力和语音识别， 这与双耳听力可以提高各种听力任务的表现这一观点一致。这些双耳的好处尚未在先天失聪和使用顺式耳机的婴儿身上表现出来。因此，有必要记录 在非常小的儿童中，特别是在语言学习和大脑可塑性最强的时候，双边CI的潜在好处。为了做到这一点，我们将测量两个依赖于听觉的过程，听觉单词学习 使用单一CI或双边CI的蹒跚学步儿童(三岁以下)的空间听力。心理物理和行为技术的结合，这些技术在典型的发育过程中被广泛使用 学步儿童，将在这项提案中使用。在旨在测试听觉单词学习的实验中，将使用注视偏好范式来评估在安静和有噪音的情况下的单词识别能力，以及 新奇单词学习将使用单词-对象联想任务进行评估。在旨在评估空间听力的实验中，将使用一种基于观察者的方法来确定幼儿的最小可听角度，即 声音定位能力的量化。这些实验的目的是记录非常年轻的CI使用者的语言和空间听力的发展，并检验患有双侧CI的儿童 会比那些在这些任务中使用单一配置项的孩子表现更好。从这个项目中可以获得的知识在临床上是适用的和必要的，因为目前关于提供 双边CI(与一个CI)。这项研究产生的数据将为使用CI的幼儿的语言和听觉技能的发展提供洞察力，并为有关提供 婴儿的单侧顺位与双侧顺位。

DESCRIPTION (provided by applicant): Children who are born deaf gain access to the auditory world through the use of cochlear implants (CIs), which provide electrical stimulation directly to the auditory nerve. Even though most children can perform quite well with a single implant, with better results associated with earlier implantation, there has been a recent clinical trend to provide patients who are deaf with bilateral CIs. Although this practice is becoming widely accepted for older patients, it is still under debate for infants. One reason for this debate is that the benefit of providing bilateral CIs to infants has not been systematically studied. In older children and adults, bilateral CIs have been shown to improve both spatial hearing and speech recognition in noise, consistent with the idea that binaural hearing can improve performance on various listening tasks. These binaural benefits have yet to be shown in infants who are born deaf and use CIs. Thus, there is a need to document the potential benefits of bilateral CIs in very young children, especially at a time when language learning and brain plasticity are greatest. To accomplish this, we will measure two auditory-dependent processes, auditory word learning and spatial hearing, in toddlers (under the age of three years) who use either a single CI or bilateral CIs. A combination of psychophysical and behavioral techniques, which are well-established for use in typically-developing toddlers, will be utilized in this proposal. In the experiments designed to test auditory word learning, word recognition ability in quiet and in the presence of noise will be assessed by using a looking-preference paradigm, and novel word learning will be evaluated using a word-object association task. In the experiments designed to assess spatial hearing, an observer-based method will be used to determine a toddler's minimum audible angle, which is a quantification of sound localization ability. The purpose of these experiments is to document the development of language and spatial hearing in very young CI users as well as to test the hypothesis that children with bilateral CIs will outperform children who use a single CI on these tasks. The knowledge that can be gained from this project is clinically applicable and necessary due to the current debate regarding the cost-effectiveness of providing bilateral CIs (versus one CI). The data generated from this study will provide insight into the development of language and auditory skills in very young children who use CIs, as well as serve to inform decisions about providing unilateral versus bilateral CIs to infants.