Complex Listening Skills in School-Age Hard of Hearing Children

描述（由申请人提供）：与前几代人相比，由于早期识别和干预，佩戴助听器的重听（CHH）儿童的早期儿童发育结果有所改善，但仍可能面临与不一致的听觉体验相关的特定能力延迟。早期的语言和认知能力形成了在小学课堂上倾听和学习的基础。因此，在这些技能方面有缺陷的CHH可能会在入学时面临重大的学术和社会挑战。然而，儿童早期不一致的听觉体验对在噪声和混响中理解语音的能力的影响尚未在佩戴助听器的CHH中得到广泛研究。该研究计划的长期目标是通过确定支持学术和社交场合听力的潜在过程来优化CHH中的放大和言语理解。这项建议的目的是研究如何不一致的听觉经验，在幼儿期影响语音理解的噪音和混响和复杂的任务，需要认知处理。目前的提案还将研究语言和认知技能如何通过在退化的声学条件下支持听力来帮助最大限度地减少有限听觉体验的负面影响。目前的建议的中心假设是，不一致的早期听觉经验，在3岁时将产生负面影响的语音理解在噪音和混响在CHH学龄。提出了三个具体目标来测试这一理论：目标1。为了验证这一假设，即不一致的听觉经验的CHH入学前的结果在学龄期较差的语音识别和认知和语言技能在一年级将调解这种关系在三年级。目标2.目的：检验儿童在调制噪声和混响环境中听觉受声学因素和工作记忆技能影响的假设。目标3.确定并发记忆、EF和语言技能在多大程度上与CHH中的言语感知和辨别相关，并评估听力任务要求的变化如何调节这种关系。在目标1中，辅助语音可听度，日常助听器使用量以及3岁时父母语言输入的数量和质量将用于预测一年级时教室噪音和混响水平下的句子识别。辅助听力，助听器的使用和一年级的语言技能，然后将用于预测语音识别在退化条件下在三年级。在目标2中，听觉和工作记忆将被用来预测儿童如何使用来自调制噪声的短暂间隙的语音信息来重建噪声和混响中的语音信号。在目标3中，并发的语言和认知能力将用于预测多说话者语音识别和门控句子识别任务的听力。从该提案中生成的数据将允许基于听力环境优化放大，并导致针对支持在现实环境中听力和学习的技能的干预措施。

DESCRIPTION (provided by applicant): Children who are hard of hearing (CHH) who wear hearing aids have experienced improved early childhood developmental outcomes due to early identification and intervention compared to previous generations, but may still face delays in specific abilities related to inconsistent auditory experience. Early language and cognitive abilities form the foundation for listening and learning in classrooms during elementary schools. Therefore, CHH who have deficits in these skills may face significant academic and social challenges as they enter school. However, the effect of inconsistent auditory experience during early childhood on the ability to understand speech in noise and reverberation has not been widely studied in CHH who wear hearing aids. The long-term goal of this research program is to optimize amplification and speech understanding in CHH by identifying the underlying processes that support listening in academic and social situations. The objective of this proposal is to examine how inconsistent auditory experience during early childhood affects speech understanding in noise and reverberation and on complex tasks that require cognitive processing. The current proposal will also examine how linguistic and cognitive skills may help minimize the negative consequences of limited auditory experience by supporting listening under degraded acoustic conditions. The central hypothesis of the current proposal is that inconsistent early auditory experience at age 3 will negatively impact speech understanding in noise and reverberation in CHH at school age. Three specific aims are proposed to test this theory: Aim 1. To test the hypothesis that inconsistent auditory experience of CHH prior to entering school results in poorer speech recognition at school-age and that cognitive and linguistic skills at 1st grade will mediate this relationship at 3rd grade. Aim 2. To test the hypothesis that acoustic factors and working memory skills affect listening in modulated noise and reverberation in children. Aim 3. To determine the extent to which concurrent memory, EF, and linguistic skills are related to speech perception and discrimination in CHH, and to evaluate how variations in listening task demands moderate that relationship. In Aim 1, aided speech audibility, amount of daily hearing aid use, and the quantity and quality of parental language input at age 3 will be used to predict sentence recognition in classroom levels of noise and reverberation at 1st grade. Aided audibility, hearing aid use and 1st grade language skills will then be used to predict speech recognition in degraded conditions at 3rd grade. In Aim 2, audibility and working memory will be used to predict how well children can use speech information from brief gaps of modulated noise to reconstruct the speech signal in noise and reverberation. In Aim 3, concurrent language and cognitive abilities will be used to predict listening on a multi-talker speech recognition and gated-sentence recognition tasks. The data generated from this proposal will allow optimization of amplification based on the listening environment and lead to interventions that target the skills the support listening and learning in realistic environments.