Audiological Rehabilitation of Children With Unilateral Hearing Loss (SHINE)
The goal of this study is to examine the effects of hearing aids and early intervention on hearing, language, and neural development in children with hearing loss in one ear, known as unilateral hearing loss. Our main research questions are:
- Do children with unilateral hearing loss with earlier access to hearing aids and early intervention have better speech understanding in noise than children with unilateral hearing loss with later or no access to intervention?
- Do children with unilateral hearing loss with earlier access to intervention have more typical responses in the brain than children with late or no access to intervention?
- Do children with unilateral hearing loss with earlier access to intervention have better speech and language skills than children with late or no access to intervention?
Researchers will collect hearing, language, and neural data and information about each child's access to intervention to examine the longitudinal impact of auditory experience on these outcomes.
Participants and their caregivers will:
- Answer questions about the child's health, developmental, and hearing histories.
- Receive hearing tests and speech recognition tests.
- Complete tests of speech and language abilities.
- A subset of eligible participants will undergo magnetic resonance imaging (MRI) and magneotencephalography (MEG).
調査の概要
詳細な説明
More than 5 million children in the United States have hearing loss in one ear, known as unilateral hearing loss (UHL). The primary consequence of UHL is reduced spatial hearing, which is crucial for communication and functioning in everyday listening conditions. Children with UHL (CUHL) are at risk for delays in language and academic outcomes compared to peers with normal hearing in both ears. However, there are large individual differences in developmental outcomes that cannot be explained by the degree of hearing loss in the affected ear. CUHL also have a wide range of spatial hearing abilities, and there is currently limited evidence to link individual differences in spatial hearing to the wide range of developmental outcomes that are observed in CUHL. The lack of predictable patterns of risk for CUHL leads to inconsistent recommendations for audiological intervention or intervention that commences only after a child demonstrates fails to progress in language or academic outcomes. Audiologists have the option to improve spatial hearing in CUHL through fitting a hearing aid on the affected ear, but hearing aids are often not provided or are only provided at later ages, even when UHL is identified in the first few months of life. The lack of consistent practices around provision of hearing aids for CUHL is due to limited evidence that hearing aids can support binaural processing in CUHL. This project seeks to provide mechanistic evidence to support earlier and more timely intervention for CUHL. We will use a metric referred to as auditory dosage to quantify auditory input to the affected ear based on aided and unaided speech audibility and consistency of hearing aid use. We anticipate auditory dosage is the primary predictor of individual differences in outcomes for CUHL. The core hypothesis of the proposal is that CUHL who have higher auditory dosage in their affected ear will have better spatial hearing, which in turn leads to better language and academic outcomes than peers with lower auditory dosage in their affected ear. Experiments will combine behavioral and neuroimaging measures of spatial hearing with and without amplification to assess how auditory dosage in the affected ear influences spatial hearing, language, and academic outcomes in CUHL. We will analyze the effects of hearing aid distortion and auditory dosage on behavioral measures of spatial hearing with and without amplification. Structural and functional neuroimaging, including magnetoencephalography and magnetic resonance imaging, will be used to assess the impact of auditory dosage on spatial hearing in CUHL. We will also use an accelerated longitudinal design to assess the mediating effects of spatial hearing on the association between hearing aid distortion and auditory dosage and language and academic outcomes in CUHL. These experiments will provide mechanistic evidence to help guide decisions about audiological intervention for CUHL and lead to individualized interventions to improve spatial hearing, language, and academic outcomes for CUHL.
研究の種類
入学 (推定)
連絡先と場所
研究連絡先
- 名前：Ryan McCreery, PhD
- 電話番号：531-355-6668
- メール：Ryan.McCreery@boystown.org
研究連絡先のバックアップ
- 名前：Amanda Knihal
- 電話番号：531-355-6533
- メール：Amanda.Knihal@boystown.org
研究場所
-
-
Iowa
-
Iowa City、Iowa、アメリカ、52242
- まだ募集していません
- University of Iowa
-
コンタクト：
- Wendy Fick
- 電話番号：319-335-8749
- メール：wendy-fick@uiowa.edu
-
主任研究者：
- Elizabeth Walker, PhD
-
-
Nebraska
-
Omaha、Nebraska、アメリカ、68131
- 募集
- Boys Town National Research Hospital
-
コンタクト：
- Amanda Knihal
- 電話番号：531-355-6533
- メール：Amanda.Knihal@boystown.org
-
主任研究者：
- Ryan McCreery, PhD
-
副調査官：
- Nicole Corbin, PhD
-
副調査官：
- Dawna Lewis, PhD
-
-
North Carolina
-
Chapell Hill、North Carolina、アメリカ、27599
- まだ募集していません
- University of North Carolina, Chapell Hill
-
コンタクト：
- Caitlin Sapp, PhD
- 電話番号：984-974-4479
- メール：Caitlin.Sapp@unchealth.unc.edu
-
主任研究者：
- Emily Buss, PhD
-
副調査官：
- Caitlin Sapp, PhD
-
-
参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
サンプリング方法
調査対象母集団
Children with normal hearing and children with unilateral hearing loss will be recruited from hospitals, audiology clinics, and education agencies across the United States.
説明
Inclusion Criteria:
- Children with normal hearing will have hearing thresholds from 0.25 - 8 kHz ≤15 dB HL in both ears with no history of neurodevelopmental, communication, or sensory disorders.
- Children with unilateral hearing loss will have hearing thresholds that meet the criterion for CNH in the better ear and three-frequency (.5, 1, & 2 kHz) pure-tone average ≥ 20 - <70 dB HL or two or more hearing thresholds ≥ 20 - < 70 dB HL from 2-8 kHz in the poorer ear. Hearing loss can be conductive, mixed, or sensorineural.
Exclusion Criteria:
- Children with unilateral hearing loss who have a cochlear implant, rerouting device, or an implanted bone conduction device will be excluded due to neuroimaging restrictions with implantable devices.
- For neuroimaging experiments only, there are additional exclusion criteria. Participants will be excluded from MEG and MRI experiments if they have 1) Current use of the following medications: psychotropic medications or other medications with significant CNS effects (e.g., antidepressants, antipsychotics, anticonvulsants, alpha-agonists, adrenergic blockers, lithium, and sedating antihistamines), or other excluded medication, 2) current major psychiatric diagnosis, 3) current substance abuse or substance dependence at any time, 4) diagnosis of a known neurological disorder or any major medical illness or injury impacting neurological/psychiatric function (e.g., diabetes, epilepsy, cerebral palsy, HIV, traumatic brain injury, significant environmental/toxic injury, neurodegenerative disorder, past meningitis/encephalitis) 5) general medical conditions: any major medical conditions that would interfere with involvement in the study or may affect CNS function as judged by the investigative team or 6) presence of any ferrous metal implant, including orthodonture or pacemaker, which may interfere with the MEG data acquisition and/or be an MRI safety concern.
研究計画
研究はどのように設計されていますか？
デザインの詳細
- 観測モデル：COHORT
- 時間の展望：PROSPECTIVE
コホートと介入
グループ/コホート |
介入・治療 |
|---|---|
|
Unilateral hearing loss
Children with unilateral hearing loss with hearing aids and children with unilateral hearing loss without hearing aids. |
Hearing aids amplify acoustic sound to provide access to acoustic cues for communication and spatial hearing. |
この研究は何を測定していますか？
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Spatial release from masking
時間枠：At enrollment
|
Spatial release from masking is the difference in the speech recognition threshold when a target talker and masker are co-located and when the target and masker are spatially separated. |
At enrollment
|
|
Morphosyntax
時間枠：At enrollment, 12 months after enrollment and 24 months after enrollment.
|
Morphosyntax is the combination of morphology (the internal structure of words) and syntax (the rules for arranging words into sentences), which quantifies how word forms and sentence structures work together to encode meaning |
At enrollment, 12 months after enrollment and 24 months after enrollment.
|
二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Localization
時間枠：At enrollment
|
Localization is the ability to identify the direction that a sound originates in the horizontal plane without visual cues. |
At enrollment
|
|
Vocabulary
時間枠：At enrollment, 12 months after enrollment, and 24 months after enrollment.
|
Vocabulary is the ability to understand and use word meaning. |
At enrollment, 12 months after enrollment, and 24 months after enrollment.
|
協力者と研究者
協力者
捜査官
- 主任研究者：Ryan McCreery, PhD、Father Flanagan's Boys' Home
研究記録日
主要日程の研究
研究開始 (実際)
一次修了 (推定)
研究の完了 (推定)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (実際)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
本研究に関する用語
追加の関連 MeSH 用語
その他の研究ID番号
- R01DC023371 (米国 NIH グラント/契約)
個々の参加者データ (IPD) の計画
個々の参加者データ (IPD) を共有する予定はありますか?
IPD プランの説明
All IPD will be shared.
IPD 共有時間枠
The study protocol, statistical analysis plan, and informed consent forms will be made available at the beginning of the study. The analytic code will be made available as soon as data analysis commences. These will be made available via the project registry and will be maintained until 5 years after the study end date.
IPD 共有アクセス基準
The IPD will be publicly available through a repository.
IPD 共有サポート情報タイプ
- STUDY_PROTOCOL
- SAP
- ICF
- ANALYTIC_CODE
医薬品およびデバイス情報、研究文書
米国FDA規制医薬品の研究
米国FDA規制機器製品の研究
この情報は、Web サイト clinicaltrials.gov から変更なしで直接取得したものです。研究の詳細を変更、削除、または更新するリクエストがある場合は、register@clinicaltrials.gov。 までご連絡ください。 clinicaltrials.gov に変更が加えられるとすぐに、ウェブサイトでも自動的に更新されます。