Neurocognitive Plasticity in Young Deaf Adults: Effects of Cochlear Implantation and Sign Language Exposure

根据NIDCD的最新数据，每1，000名出生的儿童中约有2至3名 美国人在出生时就有可测量的听力损失。对于其中一些孩子来说，听力损失是 深刻的，可以排除典型的口语习得。截至2012年， 美国接受了人工耳蜗植入（CI）。对于许多这样的孩子来说，植入物 允许使用口语。然而，口语最令人震惊的是， 人工耳蜗植入后的结果是可变性。了解这种可变性是第一步 制定有效的干预措施，使更多的儿童能够更成功地 结果。这里提出的研究将是第一个大规模的研究之一，以检查口语 在儿童时期接受植入物并现已入组的年轻聋人的语言结果 在纽约州罗切斯特的国家聋人技术学院（RIT/NTID）。大多数这些 学生们天生就有严重的听力损失，他们在是否使用CI方面各不相同， 他们接受CI的年龄和他们的主要沟通方式。该项目旨在 描述年轻耳聋成年人的认知缺陷作为其非典型中枢听觉功能的特征 发展，确定人工耳蜗植入对那些认知障碍的补救的影响， 缺陷，并仔细检查沟通模式（签名与口语）对认知的影响， 缺陷和口语结果。在480名年轻聋人的大样本中：（i）高密度脑电图 将用于记录先天性极重度耳聋对中枢听觉皮层的影响 通过记录皮层对听觉（CAEP）和视觉刺激（VEP）的反应来进行发育，以及 (ii)认知（序列处理，执行功能）和语言的领域一般措施 将取得成果。中介分析将被用来确定它是否是非典型的听觉 皮质发育或视觉对听觉脑区的跨模态募集， 认知缺陷和随后的口语发展。然后，我们将测试假设， 脑梗死预后变异性的一个来源是植入年龄调节的程度 听觉皮层成熟以修复认知缺陷。最后，年轻人的独特样本， RIT/NTID，他们中的许多人在婴儿期就学会了自然手语，并戴上了人工耳蜗， 提供了研究早期接触美国手语（ASL）的作用的可能性， 减轻序列处理和执行控制的缺陷，潜在地提高口语能力 结果。

According to the latest data from the NIDCD, approximately 2 to 3 out of every 1,000 children born in the United States have a measurable hearing loss at birth. For some of these children, that hearing loss is profound and can preclude typical acquisition of spoken language. As of 2012, around 38,000 children in the United States had received a cochlear implant (CI). For many of these children, the implant has permitted access to spoken language. However, what is perhaps most striking about spoken language outcomes following cochlear implantation is the variability. Understanding this variability is the first step in developing effective interventions to move a greater number of children towards a more successful outcome. The research proposed here will be one of the first large-scale studies to examine spoken language outcomes in young deaf adults who received their implants in childhood and are now enrolled at the National Technical Institute for the Deaf (RIT/NTID) in Rochester NY. The majority of these students were born with profound hearing losses, and they vary in terms of whether or not they use a CI, the age at which they received a CI and their primary mode of communication. This project aims to characterize cognitive deficits in young deaf adults as a function of their atypical central auditory development, determine the impact of cochlear implantation on the remediation of those cognitive deficits, and carefully examine the impact of communication mode (signed versus spoken) on cognitive deficits and spoken language outcomes. In a large sample of 480 young deaf adults: (i) high-density EEG will be used to document the effect of congenital profound deafness on central auditory cortical development by recording cortical responses to both auditory (CAEPs) and visual stimuli (VEPs), and (ii) domain-general measures of cognitive (sequence processing, executive function) and language outcomes will be obtained. Mediation analyses will be used to determine whether it is atypical auditory cortical development or cross-modal recruitment of auditory brain areas by vision that best predicts cognitive deficits and subsequent spoken language development. We will then test the hypothesis that one source of variability in CI outcomes stems from the extent to which age of implantation modulates auditory cortical maturation to remediate cognitive deficits. Finally, the unique sample of young adults at RIT/NTID, many of whom learned a natural sign language in infancy and wear a cochlear implant, affords the possibility of examining the role of early exposure to American Sign Language (ASL) in mitigating deficits in sequence processing and executive control, potentially boosting spoken language outcomes.