Family Processes in Developmental Outcomes of Pediatric Hearing Loss

儿童听力损失发育结果的家庭过程

• 批准号: 9753715
• 负责人: Rachael Frush Holt
• 金额: $ 59.6万
• 依托单位: OHIO STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-08-01 至 2021-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9753715
• 关键词: 8 year old; Address; Adopted; Affect; Age; Audiology; Auditory Perception; Behavior; Behavior Control; Caregivers; Child; Child Development; Child Rearing; Childhood; Clinical; Cochlear Implants; Cochlear implant procedure; Cognitive; Collaborations; Communication; Competence; Complex; Detection; Development; Devices; Discipline; Early Diagnosis; Early Intervention; Environment; Executive Dysfunction; Family; Family Characteristics; Family Process; Family dynamics; Floor; Foundations; Future; Growth; Hearing; Hearing Aids; Home environment; Individual; Individual Differences; Infant; Intervention; Intervention Studies; Knowledge; Language; Language Delays; Language Development; Language Disorders; Life; Linguistics; Link; Measures; Mediating; Medical; Modeling; Mothers; Neurocognitive; Nursery Schools; Outcome; Parent-Child Relations; Parents; Performance; Population; Questionnaires; Recording of previous events; Request for Applications; Research; Research Design; Research Personnel; Risk; Role; Schools; Science; Self Efficacy; Source; Speech; Speech Perception; Structure; System; Technology; Time; Work; base; childhood hearing loss; clinically significant; design; early childhood; educational atmosphere; elementary school; executive function; experience; family influence; hearing impairment; hearing loss risk; information processing; maternal stress; multidisciplinary; normal hearing; novel; programs; psychosocial; signal processing; skills; social; social cognitive theory; teacher; theories; trait

Project Summary/Abstract This revised application requests support for a new program of research on the influence of family processes on core developmental outcomes in children with hearing loss. Despite widely available technology to identify hearing loss as early as the first week of life and significant signal processing advancements in hearing aids and cochlear implants, enormous individual differences still remain in the degree to which children fully benefit from these medical interventions. A critical barrier to achieving optimal outcomes and developing new interventions is a lack of knowledge and understanding of the relevant contributing factors and mechanisms that affect variability in developmental outcomes in children with hearing loss. Extending the work on typically developing children and other clinical populations, emerging research suggests that a potent, yet ignored source of variance - the family environment - contributes to outcomes in children with hearing loss. However, the extent of these associations, their underlying developmental mechanisms, and how they differ from families of children with normal hearing are unknown. This significant knowledge gap will be addressed in the proposed study, which will use a multi-source (parent, child, and teacher), multi-trait (questionnaires, direct observation, and child and caregiver performance measures) longitudinal research design to measure 3- to 8-year-old normal-hearing and hearing-impaired children's spoken language and executive function development over two years and investigate the most relevant family factors in cognitive and linguistic development at the same time points to uncover the family mechanisms linking hearing loss risk to these core developmental outcomes. The specific aims of the proposed research are to: 1) identify differences in family environment and parenting factors in families of young children with different hearing histories; and 2) to uncover the developmental mechanisms through which family and parenting factors influence spoken language and executive function development in children with hearing loss in early childhood. Our findings will be significant for development of understanding and explaining the contributing role of hearing, speech perception and family dynamics in the children's development of language and executive function. Our findings also will be clinically significant by providing new, requisite, foundational knowledge that will guide the design of future intervention studies by identifying not only which family environment constructs are related to at-risk outcomes, but also their mechanisms of action. In future intervention studies, novel treatments that target known aspects of family environment responsible for protecting from or exacerbating cumulative risk to spoken language and executive function competence in children with hearing loss will fundamentally change current models of intervention for pediatric hearing loss.

项目概要/摘要 此修订后的申请请求支持一项关于家庭影响的新研究计划 听力损失儿童核心发育结果的过程。尽管广泛可用 早在生命第一周就识别听力损失的技术和重要的信号处理 助听器和人工耳蜗的进步，仍然存在巨大的个体差异 儿童从这些医疗干预措施中充分受益的程度。实现最佳目标的关键障碍 结果和制定新的干预措施是缺乏相关知识和理解 影响儿童发育结果变异性的因素和机制 听力损失。扩大对典型发育儿童和其他临床人群的工作，新兴 研究表明，一个有效但被忽视的差异来源——家庭环境——会导致 听力损失儿童的结果。然而，这些关联的程度及其潜在的 发育机制以及它们与听力正常儿童的家庭有何不同尚不清楚。 这一重大的知识差距将在拟议的研究中得到解决，该研究将使用多源 （家长、孩子和老师）、多特征（问卷、直接观察、孩子和看护者） 性能测量）纵向研究设计，测量 3 至 8 岁儿童的正常听力和 听障儿童两年内口语和执行功能的发展 同时调查认知和语言发展中最相关的家庭因素 揭示将听力损失风险与这些核心发育结果联系起来的家庭机制。这 拟议研究的具体目标是：1）确定家庭环境和养育方式的差异 具有不同听力史的幼儿的家庭因素； 2）揭示发展过程 家庭和养育因素影响口语和执行功能的机制 幼儿期听力损失儿童的发育。我们的发现对于发展具有重要意义 理解和解释听力、言语感知和家庭动态在家庭中的贡献作用 儿童语言和执行功能的发展。我们的研究结果也将具有临床意义 通过提供新的、必要的基础知识来指导未来干预研究的设计 不仅要确定哪些家庭环境结构与风险结果相关，还要确定它们的 行动机制。在未来的干预研究中，针对家庭已知方面的新疗法 负责防止或加剧口语累积风险的环境，以及 听力损失儿童的执行功能能力将从根本上改变当前的模式 小儿听力损失的干预。