Unilateral Hearing Loss in Children

儿童单侧听力损失

• 批准号: 7338315
• 负责人: JUDITH Eunkyung Cho LIEU
• 金额: $ 18.03万
• 依托单位: WASHINGTON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-01-24 至 2009-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7338315
• 关键词: Academic achievement; Achievement; Audiometry; Behavior assessment; Behavioral; Case-Control Studies; Child; Clinical; Condition; Control Groups; Data; Drops; Ear; Educational Status; Goals; Hearing; Individual; Intervention; Interview; Knowledge; Language; Lead; Measures; Medical; Newborn Infant; Noise; Outcome; Outcome Measure; Parents; Patients; Performance; Prevalence; Problem behavior; Protocols documentation; Rate; Records; Recruitment Activity; Research; Research Personnel; Risk; Risk Factors; School-Age Population; Schools; Score; Screening procedure; Siblings; Signal Transduction; Speech; Standards of Weights and Measures; Students; Subgroup; Tail; Testing; Thinking; Time; Unilateral Hearing Loss; case control; cognitive control; hearing impairment; improved; peer; performance tests; programs; skills; socioeconomics

DESCRIPTION (provided by applicant): Unilateral hearing loss (UHL) in school-aged children has an estimated prevalence of 1/1000 to over 5%. The prevalence of UHL in newborns is estimated to be 0.4/1000 to 3.4%. In the past, UHL was thought to have little consequence because speech and language presumably developed appropriately with one normally hearing ear. Unless they have medical problems that lead to an early hearing screen or audiogram, children with UHL are often undetected until they enter school and undergo hearing screenings. Earlier studies have suggested that a significantly increased proportion (22-59%) of children with UHL may have educational and/or behavioral problems, compared to their normally hearing peers. Limited data exists about the effect of UHL on acquisition of speech and language skills. Similarly, little is known about which children with UHL might benefit from intervention or amplification to avoid academic delay, or whether children who have early difficulties in school "catch up." The broad, long-term objective of this research is to increase the knowledge about UHL in children. The specific aims of this present study are: 1) Determine the rate of educational risk in children with UHL as compared to a control group of siblings with normal hearing, using a standardized achievement assessment; 2) Determine whether educational performance or behavioral problems increase or decrease in children with UHL over time; and 3) Determine whether performance on speech-in-noise tests predicts academic achievement in children with UHL. Our primary hypothesis is that children with UHL have a 30% rate of educational risk compared with an expected 16% rate of educational risk in children with normal hearing. We defined educational risk as performance on standardized achievement tests that is 1.0 standard deviation or more below the mean. Our secondary hypotheses are: 1) Children with UHL who are at educational risk do not improve their performance in school over time; and 2) Poor performance on speech-in-noise tests is a significant risk factor for poor academic achievement in children with UHL. This study proposes a case-control study comparing children who have UHL with control siblings on standardized measures of educational and behavioral risk, using a standardized achievement assessment (WIAT-II-A) as the primary outcome measure. Assuming a 10% drop out rate, a one-tailed alpha level of 0.05 and beta level of 0.20 for 80% power, 126 subjects for each group will be recruited. Secondary outcomes will include repeating one or more grades, requiring additional educational assistance, and behavioral problems. A subgroup of children with UHL will be followed over 3 years to obtain longitudinal data about changes in achievement trajectory and behavioral problems. Speech-in-noise test performance will be obtained through an audiologic protocol developed for this study. Bivariate and multivariable analyses will be used to determine which socioeconomic, clinical or patient factors are independently associated with our outcomes. The results from this study will enlighten the epidemiologic and clinical impact UHL has on a student's educational achievement.

描述（由申请人提供）：学龄儿童的单方面听力损失（UHL）的患病率估计为1/1000至5％以上。新生儿中UHL的患病率估计为0.4/1000至3.4％。过去，UHL被认为几乎没有后果，因为言语和语言可能会适当地使用通常听到的耳朵发展。除非他们遇到导致早期听力屏或听力图的医疗问题，否则患有UHL的儿童经常被发现，直到他们进入学校并进行听力放映为止。早期的研究表明，与正常听力的同龄人相比，患有UHL的儿童的比例显着增加（22-59％）可能存在教育和/或行为问题。关于UHL对言语和语言技能的效果的数据有限。同样，对于哪些UHL的孩子可能会受益于干预或放大以避免学术延迟，或者在学校遇到早期困难的孩子“追赶”中，几乎知之甚少。这项研究的广泛长期目标是增加有关儿童UHL的知识。本研究的具体目的是：1）使用标准化的成就评估，与正常听力的对照组相比，确定UHL儿童的教育风险率； 2）确定随着时间的推移，UHL儿童的教育表现或行为问题是否会增加或减少； 3）确定在噪声测试中的表现是否可以预测UHL儿童的学术成就。我们的主要假设是，UHL儿童的教育风险率为30％，而正常听力的儿童预期的教育风险为16％。我们将教育风险定义为标准化成就测试的绩效，其标准偏差低于平均值。我们的次要假设是：1）患有教育风险的UHL儿童不会随着时间的流逝而提高其在学校的表现； 2）在语音中，噪声测试的表现不佳是UHL儿童学业成绩不佳的重要危险因素。这项研究提出了一项案例对照研究，将拥有UHL与对照兄弟姐妹进行的儿童进行了对控制和行为风险的标准化措施，使用标准化的成就评估（WIAT-II-A）作为主要结果指标。假设下降率为10％，一个80％功率的单尾α水平为0.05，Beta水平为0.20，将招募126个受试者。次要结果将包括重复一个或多个成绩，需要额外的教育帮助和行为问题。在3年的时间里，将遵循一组UHL儿童的子组，以获取有关成就轨迹和行为问题变化的纵向数据。将通过为本研究开发的听力学协议来获得语音测试性能。双变量和多变量分析将用于确定哪些社会经济，临床或患者因素与我们的结果独立相关。这项研究的结果将启发UHL对学生的教育成就产生的流行病学和临床影响。