Development of Sensitivity to Acoustic Modulation in Infants who use Cochlear Implants

使用人工耳蜗的婴儿对声学调制的敏感性的发展

• 批准号: 10606617
• 负责人: David Louis Horn
• 金额: $ 69.77万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-04-01 至 2026-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10606617
• 关键词: 10 year old; 4 year old; 8 year old; Acoustics; Address; Adult; Age; Auditory; Auditory Perception; Child; Chronology; Clinical; Clinical Management; Cochlear Implants; Communication; Development; Devices; Early Intervention; Early identification; Early treatment; Frequencies; Goals; Habilitation; Hearing; Implant; Individual; Infant; Intervention; Lead; Longitudinal Studies; Measures; Methods; Modification; Noise; Outcome; Patients; Pattern; Perception; Peripheral; Procedures; Psychoacoustics; Research; Resolution; Signal Transduction; Speech; Speech Perception; Speech Sound; Testing; Time; Work; auditory deprivation; behavior test; clinical care; congenital hearing loss; deaf; experience; experimental study; hearing impairment; implantation; infancy; normal hearing; oral communication; postnatal; programs; skills; temporal measurement

PROJECT SUMMARY/ABSTRACT The ability of patients with cochlear-implants (CI) to discriminate speech sounds is the fundamental measure of efficacy that clinicians use to create personalized clinical interventions. Given the universal importance of early identification and treatment for children born with hearing loss, the most appropriate clinical intervention for children with CIs should be initiated at the earliest possible age. Despite the routine implantation of prelingually-deaf infants as young as 9-months-old, there are currently no established clinical measures of CI efficacy for children younger than approximately 4-years-old. The long-term goal of the proposed research is to develop new measures of device efficacy in cochlear-implanted infants that can be used to drive clinical decisions at a much earlier age than is currently possible. The ability to perceive patterns of temporal or spectral intensity modulation in a noise, or “acoustic modulation perception”, is known to predict speech understanding in adult CI users. In previous work, the PI adapted tests of acoustic modulation perception for testing infants and young children. The next step, proposed in this application, will be to investigate how acoustic modulation perception develops, and relates to speech perception, in implanted infants. This will involve examining the development of two independent factors with markedly different trajectories: the ability to resolve the spectral place or timing of modulation, and sensitivity to intensity modulation across frequency or time. The central hypothesis is that both normal hearing and implanted infants will show an asymmetry in development of these factors. Frequency and temporal resolution is expected to mature by 6-months postnatal hearing-age whereas sensitivity to intensity modulation is expected to remain immature through 7-10 years old. The basis for this hypothesis is that frequency and temporal resolution reflect early-developing peripheral auditory mechanisms whereas sensitivity to intensity modulation reflects later-developing central auditory mechanisms. There are 3 specific aims to this proposal. The first is to characterize the developmental trajectory for frequency and temporal resolution in implanted and normal hearing infants during the first 6 months of post- natal hearing experience. The second is to compare the developmental trajectory of spectral and temporal modulation sensitivity in children implanted during infancy with that of normal hearing children through 10- years-of-age. The third is to determine if frequency and temporal resolution independently predict speech perception outcomes in implanted children. This work is a necessary step toward the goal of developing age- appropriate, nonlinguistic measures of acoustic modulation perception that reflect CI efficacy in implanted infants. If the long-term goal of the proposed research is realized, the positive impact will be to enable earlier, more effective, clinical interventions for young patients who use CIs.

项目概要/摘要 人工耳蜗 (CI) 患者辨别语音的能力是其基本能力 鉴于普遍性，追随者用来创建个性化临床干预措施的疗效衡量标准。 对先天性听力损失儿童进行早期识别和治疗的重要性，最合适的临床 尽管有常规干预措施，但应尽早开始对 CI 儿童进行干预。 9个月大的语前聋婴儿的植入，目前尚无成熟的临床证据 约 4 岁以下儿童的 CI 疗效测量 该项目的长期目标。 拟议的研究旨在开发新的措施来衡量植入人工耳蜗的婴儿的装置功效，这些措施可以 用于在比目前可能更早的年龄做出临床决策。 感知噪声或“声学”中的时间或频谱强度调制模式的能力 在之前的工作中，PI 可以预测成年 CI 用户的语音理解。 用于测试婴儿和幼儿的声学调制感知测试下一步， 在本申请中提出的，将研究声学调制感知如何发展，并与 植入婴儿的言语感知这将涉及检查两个独立的发育。 具有明显不同轨迹的因素：解析调制的频谱位置或时间的能力，以及 对跨频率或时间的强度调制的敏感性 中心假设是正常听力。 植入婴儿在这些因素的发育上会表现出不对称性。 分辨率预计在出生后 6 个月听力年龄时成熟，而对强度调制的敏感性 预计在 7-10 岁时仍处于不成熟状态。这一假设的基础是频率和。 时间分辨率反映了早期发育的外周听觉机制，而对强度的敏感性 调制反映了后来发展的中枢听觉机制。 该提案有 3 个具体目标，第一个目标是描述发展轨迹。 植入后听力正常的婴儿在植入后前 6 个月内的频率和时间分辨率 第二是比较频谱和时间的发育轨迹。 婴儿期植入的儿童的调制灵敏度与正常听力儿童的调制灵敏度相同，直到 10- 第三个是确定频率和时间分辨率是否独立预测语音。 这项工作是实现年龄发育目标的必要步骤。 反映植入物中 CI 功效的适当的、非语言的声学调制感知测量 如果所提出的研究的长期目标得以实现，积极的影响将是能够更早地、 对使用 CI 的年轻患者进行更有效的临床干预。