Spectral and Temporal Resolution in Infants with Cochlear Implants

描述(申请人提供)：这项K23申请的长期目标是提高我们对听觉能力如何驱动使用人工耳蜗(CI)的聋儿的言语和语言发展的理解。作为一名儿科耳鼻喉科医生和脑梗塞外科医生，候选人深知这一人群的临床结果差异很大，并需要更精确的临床工具来评估脑梗塞婴儿的益处和预测言语和语言结果。作为第一步，这项研究计划将使用行为学方法调查CI婴儿早期获得听觉频谱和时间分辨率的情况。波纹识别(SRD)和调幅检测是预测成人顺应性言语知觉能力的两个独立指标。这一应用的中心假设是，在植入后的头七个月，脑梗塞婴儿的频谱和时间分辨率将各自达到成熟，并将限制随后的言语感知和语言技能的获得。这一假说的基础是正常听觉系统的频谱和时间分辨率在生命的第一年就成熟了，反映了耳蜗神经和脑干神经机制的早期发展。有证据表明，这些早期发育的结构在植入后的第一年也会在CI婴儿中迅速成熟。这项拟议研究的基本原理是，提高我们对CI婴儿的频谱和时间技能是如何出现并与口语习得相关的理解，将有助于发展CI婴儿听觉能力的临床测量。在这份K23申请中描述的婴儿心理声学方法将形成一个正在进行的研究计划的核心，以研究CI婴儿的听觉发育。在听觉发展、言语和语言发展以及电生理学领域的当地课程和培训经验将使PI能够继续建立必要的技能集，将基本的心理声学研究成果转化为临床可行的措施。这一职业发展和研究计划，在一个极其支持和培育的学术环境中进行，将使候选人成为一名可持续资助的研究员，监督这一与临床相关的研究计划。

DESCRIPTION (provided by applicant): The long-term goal of this K23 application is to improve our understanding of how auditory capacity drives speech and language development in deaf infants who use cochlear implants (CIs). As a pediatric otolaryngologist and CI surgeon, the candidate is intimately aware of the wide variability in clinical outcomes in this population and the need for more precise clinical tools for assessing benefit and predicting speech and language outcomes in CI infants. As a first step, this research plan will investigate CI infants' early acquisition of auditory spectral and temporal resolution using behavioral methods. Spectral ripple discrimination (SRD) and amplitude modulation detection are two measures that are independent predictors of speech perception skills in adults with CIs. The central hypothesis of this application is that spectral and temporal resolution will each reach maturity in CI infants over the first seven months after implantation and will constrain subsequent acquisition of speech perception and language skills. The basis for this hypothesis is that spectral and temporal resolution of the normal auditory system mature during the first year of life, reflecting early development of cochlear and brainstem neural mechanisms. Evidence suggests that these early developing structures also mature rapidly in CI infants during the first post-implant year. The rationale for the proposed research is that improving our understanding of how spectral and temporal skills emerge and relate to spoken-language acquisition in CI infants will enable the development of clinical measures of auditory capacity in CI infants. The infant psychoacoustic methods described in this K23 application will form the core an ongoing research program to study auditory development in CI infants. Local coursework and training experiences in the fields of auditory development, speech and language development, and electrophysiology will enable the PI to continue to build the skill set necessary to translate basic psychoacoustic research findings into clinically feasible measures. This career development and research plan, conducted within an extremely supportive and nurturing academic environment will set the candidate up to succeed as a sustainably funded investigator overseeing this clinically relevant program of research.