Spoken Language in Adolescents with Hearing Loss

项目摘要/摘要 人工耳蜗(CI)和早期干预--通过新生儿听力筛查使之成为可能--有 显著改善预后，即出生时听力损失(HL)的儿童将能够发展口语 与听力正常(NH)的典型同龄人的语言相称。这两个进步意味着 现在，患有HL的小学儿童在一系列口语上表现出了能力 衡量标准差仅比那些典型的NH同龄人的平均值低一个标准差。尽管如此， 表现水平超过了在CI和早期干预如此容易之前就能获得的语言能力 这些表现水平并不是一个患有HL的儿童在没有 HL，平均表现没有改善。这些事实加在一起是取得进展的关键障碍 涉及HL儿童的研究和临床实践，正是这一障碍，本项目试图 地址。这项工作的一个强烈动机是来自早期调查的发现，表明患有HL的儿童 经历的语音缺陷比形态合成的缺陷大得不成比例 超能力。这种巨大的语音缺陷被认为是由于可用光谱表示不佳造成的。 对于HL的听众，特别是如果他们使用CI的话。据预测，这种巨大的语音赤字将产生级联效应 对其他后来获得的语言和识字功能的影响，这可能依赖于 对音位结构的敏感性。这一预测是在这个项目中探索的，孩子们已经 从婴儿期开始，现在进入青春期，被认为是第一语言习得的结束。这个 这项工作的前提包括三个部分：(1)信号退化可以解释大部分持续的 HL儿童的语言障碍；(2)退化对语音习得的影响不成比例 敏感度，而不是形态合成能力；(3)语音敏感度差会有差异 对后来学到的语言技能的影响。总共有124名儿童(76名听力损失)参加了一项 将对婴儿时期的发展进行纵向研究，测试他们的各种语言、识字和 中学结束时的心理社会测量。该项目的四个具体目标是：(1) 评估124名儿童的言语感知、语言、识字、社交和学习表现 从幼年到中学末，参加了一个纵向项目。(2)检验假设 语音敏感度(PS)和形态合成能力(MSA)至少可以相互独立 为患有霍奇金淋巴瘤的儿童准备的。(3)检查8年级PS和MSA的早期前兆。(4)测试相关的 假设在信号恶化的情况下，MSA的获取可以接近正常，只要 孩子们获得了足够的语言经验，但要发展高度精致的PS，需要有一些 有更详细的声音信号的经验。该项目的影响将是它将通知未来 对整个童年时期的聋儿进行听力和语言干预。

Project Summary/Abstract Cochlear implants (CIs) and early intervention – made feasible by newborn hearing screenings – have significantly improved the prognosis that children born with hearing loss (HL) will be able to develop spoken language commensurate to that of their typical peers with normal-hearing (NH). These two advances mean that the average child with HL in elementary school now demonstrates abilities on a range of spoken language measures that are just one standard deviation below the means of those typical peers with NH. Although that level of performance exceeds language abilities attainable before CIs and early intervention were so readily available, these performance levels are not what an average child with HL would be attaining in the absence of HL, and mean performance is not improving. Together those facts represent a critical barrier to progress for both research and clinical practice involving children with HL, and it is that barrier that this project seeks to address. A strong motivation for this work is the finding from earlier investigation showing that children with HL experience a disproportionately larger phonological deficit than the deficit observed for morphosyntactic abilities. That large phonological deficit is presumed to arise due to the poor spectral representations available to listeners with HL, especially if they use CIs. This large phonological deficit is predicted to have cascading effects on other, later-acquired language and literacy functions, which are likely dependent on having keen sensitivity to phonological structure. That prediction is explored on this project with children who have been followed since infancy and are now reaching puberty, believed to be the end of first-language acquisition. The premise underlying this work consists of 3 parts: (1) signal degradation can explain much of the continued language gap of children with HL; (2) that degradation disproportionately affects acquisition of phonological sensitivity, rather than morphosyntactic abilities; and (3) that poor phonological sensitivity will have differential effects on later-learned language skills. In all, 124 children (76 with hearing loss) who participated in a longitudinal study of development since they were infants will be tested on a variety of language, literacy, and psychosocial measures at the conclusion of middle school. The four Specific Aims of the project are to: (1) Assess the speech perception, language, literacy, social, and academic performance of 124 children who participated in a longitudinal project since infancy at the end of middle school. (2) Test the hypothesis that phonological sensitivity (PS) and morphosyntactic abilities (MSA) can be independent of each other, at least for children with HL. (3) Examine earlier precursors to PS and MSA measured in 8th grade. (4) Test the related hypotheses that the acquisition of MSA can be close to normal in the face of signal degradation, as long as children get adequate experience with language, but developing highly refined PS requires having had some experience with more detailed acoustic signals. The impact of the project will be that it will inform future audiological and language interventions for deaf children across childhood.