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Lund E, Werfel KL. Influence of Child-Level Factors and Lexical Characteristics on Vocabulary Knowledge of Children With Cochlear Implants and Hearing Aids. Dev Sci 2025; 28:e70007. [PMID: 40066854 PMCID: PMC11894921 DOI: 10.1111/desc.70007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2024] [Revised: 02/13/2025] [Accepted: 02/15/2025] [Indexed: 03/15/2025]
Abstract
Recent studies indicate children who are deaf and hard of hearing who use cochlear implants or hearing aids know fewer spoken words than their peers with typical hearing, and often those vocabularies differ in composition. To date, however, the interaction of a child's auditory profile with the lexical characteristics of words he or she knows has been minimally explored. The purpose of the present study is to evaluate how audiological history, phonological memory, and overall vocabulary knowledge interact with growth in types of spoken words known by children who are deaf and hard of hearing compared to children with typical hearing. Children with cochlear implants (n = 36) and hearing aids (n = 39) were compared to children with typical hearing (n = 47) at ages 4 and 6. Children participated in measures of phonological memory and vocabulary knowledge, inclusive of an experimental measure with words of varying phonotactic probability and neighborhood density. Results indicate that children with hearing aids and with cochlear implants tend to know fewer words across all lexical conditions than children with typical hearing. For children with cochlear implants, overall vocabulary knowledge was the best predictor of a mis-matched probability and density condition, whereas it was the best predictor of matched condition for children with hearing aids. Children with cochlear implants and children with hearing aids, then, appear to have different underlying skills that interact with the lexical characteristics of words to support vocabulary growth.
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Affiliation(s)
- Emily Lund
- Davies School of Communication Sciences and DisordersTexas Christian UniversityFort WorthTexasUSA
| | - Krystal L. Werfel
- Center for Childhood Deafness, Language, and LearningBoys Town National Research HospitalOmahaNebraskaUSA
- Department of Communication Sciences and DisordersUniversity of South CarolinaColumbiaSouth CarolinaUSA
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Nittrouer S. Perceptual weighting strategies of adolescents with normal hearing or cochlear implants. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2025; 157:1742-1760. [PMID: 40080608 PMCID: PMC11908816 DOI: 10.1121/10.0036128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2024] [Revised: 01/29/2025] [Accepted: 02/14/2025] [Indexed: 03/15/2025]
Abstract
The distribution of perceptual attention across the myriad acoustic properties of speech undergoes developmental shifts through the first decade of life, changing from a focus on dynamic spectral structure to other kinds of temporal, amplitude, and static spectral properties. These developmental changes accompany a gradual enhancement in sensitivity to phonological structure. A central question concerning spoken language acquisition by children with hearing loss who use cochlear implants (CIs) concerns how they navigate these developmental changes and what effect signal degradation has on developing language abilities, especially sensitivity to phonological structure. To explore these questions, this report describes outcomes of data collected from adolescents with normal hearing and adolescents with CIs. Perceptual weighting factors were computed for static and dynamic spectral properties using a fricative-vowel labeling paradigm. Measures of speech recognition, language abilities, word reading, and phonological processing were also obtained. Results showed that the adolescents with CIs weighted dynamic spectral structure hardly at all. Weighting of static spectral structure was largely related to their abilities to manipulate and retain phonological structure in memory. Overall, these findings indicate that supporting developmental shifts in perceptual weighting strategies should remain a goal of intervention for children with hearing loss who use CIs.
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Affiliation(s)
- Susan Nittrouer
- Speech, Language, and Hearing Sciences, Speech Development Laboratory, University of Florida, 1395 Center Drive, Gainesville, Florida 32610, USA
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DeFreese A, Camarata S, Sunderhaus L, Holder J, Berg K, Lighterink M, Gifford R. The impact of spectral and temporal processing on speech recognition in children with cochlear implants. Sci Rep 2024; 14:14094. [PMID: 38890428 PMCID: PMC11189542 DOI: 10.1038/s41598-024-63932-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Accepted: 06/03/2024] [Indexed: 06/20/2024] Open
Abstract
While the relationships between spectral resolution, temporal resolution, and speech recognition are well defined in adults with cochlear implants (CIs), they are not well defined for prelingually deafened children with CIs, for whom language development is ongoing. This cross-sectional study aimed to better characterize these relationships in a large cohort of prelingually deafened children with CIs (N = 47; mean age = 8.33 years) by comprehensively measuring spectral resolution thresholds (measured via spectral modulation detection), temporal resolution thresholds (measured via sinusoidal amplitude modulation detection), and speech recognition (measured via monosyllabic word recognition, vowel recognition, and sentence recognition in noise via both fixed signal-to-noise ratio (SNR) and adaptively varied SNR). Results indicated that neither spectral or temporal resolution were significantly correlated with speech recognition in quiet or noise for children with CIs. Both age and CI experience had a moderate effect on spectral resolution, with significant effects for spectral modulation detection at a modulation rate of 0.5 cyc/oct, suggesting spectral resolution may improve with maturation. Thus, it is possible we may see an emerging relationship between spectral resolution and speech perception over time for children with CIs. While further investigation into this relationship is warranted, these findings demonstrate the need for new investigations to uncover ways of improving spectral resolution for children with CIs.
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Affiliation(s)
- Andrea DeFreese
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, 1215 21st Avenue South, Nashville, TN, 37232, USA.
| | - Stephen Camarata
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, 1215 21st Avenue South, Nashville, TN, 37232, USA
| | - Linsey Sunderhaus
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, 1215 21st Avenue South, Nashville, TN, 37232, USA
| | - Jourdan Holder
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, 1215 21st Avenue South, Nashville, TN, 37232, USA
| | - Katelyn Berg
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, 1215 21st Avenue South, Nashville, TN, 37232, USA
| | - Mackenzie Lighterink
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, 1215 21st Avenue South, Nashville, TN, 37232, USA
| | - René Gifford
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, 1215 21st Avenue South, Nashville, TN, 37232, USA
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Masri S, Mowery TM, Fair R, Sanes DH. Developmental hearing loss-induced perceptual deficits are rescued by genetic restoration of cortical inhibition. Proc Natl Acad Sci U S A 2024; 121:e2311570121. [PMID: 38830095 PMCID: PMC11181144 DOI: 10.1073/pnas.2311570121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 04/25/2024] [Indexed: 06/05/2024] Open
Abstract
Even a transient period of hearing loss during the developmental critical period can induce long-lasting deficits in temporal and spectral perception. These perceptual deficits correlate with speech perception in humans. In gerbils, these hearing loss-induced perceptual deficits are correlated with a reduction of both ionotropic GABAA and metabotropic GABAB receptor-mediated synaptic inhibition in auditory cortex, but most research on critical period plasticity has focused on GABAA receptors. Therefore, we developed viral vectors to express proteins that would upregulate gerbil postsynaptic inhibitory receptor subunits (GABAA, Gabra1; GABAB, Gabbr1b) in pyramidal neurons, and an enzyme that mediates GABA synthesis (GAD65) presynaptically in parvalbumin-expressing interneurons. A transient period of developmental hearing loss during the auditory critical period significantly impaired perceptual performance on two auditory tasks: amplitude modulation depth detection and spectral modulation depth detection. We then tested the capacity of each vector to restore perceptual performance on these auditory tasks. While both GABA receptor vectors increased the amplitude of cortical inhibitory postsynaptic potentials, only viral expression of postsynaptic GABAB receptors improved perceptual thresholds to control levels. Similarly, presynaptic GAD65 expression improved perceptual performance on spectral modulation detection. These findings suggest that recovering performance on auditory perceptual tasks depends on GABAB receptor-dependent transmission at the auditory cortex parvalbumin to pyramidal synapse and point to potential therapeutic targets for developmental sensory disorders.
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Affiliation(s)
- Samer Masri
- Center for Neural Science, New York University, New York, NY10003
| | - Todd M. Mowery
- Department of Otolaryngology, Rutgers, New Brunswick, NJ08901
| | - Regan Fair
- Center for Neural Science, New York University, New York, NY10003
| | - Dan H. Sanes
- Center for Neural Science, New York University, New York, NY10003
- Department of Psychology, New York University, New York, NY10003
- Department of Biology, New York University, New York, NY10003
- Neuroscience Institute at New York University Langone School of Medicine, New York, NY10016
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Cychosz M, Xu K, Fu QJ. Effects of spectral smearing on speech understanding and masking release in simulated bilateral cochlear implants. PLoS One 2023; 18:e0287728. [PMID: 37917727 PMCID: PMC10621938 DOI: 10.1371/journal.pone.0287728] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 06/11/2023] [Indexed: 11/04/2023] Open
Abstract
Differences in spectro-temporal degradation may explain some variability in cochlear implant users' speech outcomes. The present study employs vocoder simulations on listeners with typical hearing to evaluate how differences in degree of channel interaction across ears affects spatial speech recognition. Speech recognition thresholds and spatial release from masking were measured in 16 normal-hearing subjects listening to simulated bilateral cochlear implants. 16-channel sine-vocoded speech simulated limited, broad, or mixed channel interaction, in dichotic and diotic target-masker conditions, across ears. Thresholds were highest with broad channel interaction in both ears but improved when interaction decreased in one ear and again in both ears. Masking release was apparent across conditions. Results from this simulation study on listeners with typical hearing show that channel interaction may impact speech recognition more than masking release, and may have implications for the effects of channel interaction on cochlear implant users' speech recognition outcomes.
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Affiliation(s)
- Margaret Cychosz
- Department of Linguistics, University of California, Los Angeles, Los Angeles, CA, United States of America
| | - Kevin Xu
- Department of Head and Neck Surgery, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States of America
| | - Qian-Jie Fu
- Department of Head and Neck Surgery, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States of America
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Nittrouer S, Lowenstein JH. Recognition of Sentences With Complex Syntax in Speech Babble by Adolescents With Normal Hearing or Cochlear Implants. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023; 66:1110-1135. [PMID: 36758200 PMCID: PMC10205108 DOI: 10.1044/2022_jslhr-22-00407] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 10/17/2022] [Accepted: 11/22/2022] [Indexed: 05/25/2023]
Abstract
PURPOSE General language abilities of children with cochlear implants have been thoroughly investigated, especially at young ages, but far less is known about how well they process language in real-world settings, especially in higher grades. This study addressed this gap in knowledge by examining recognition of sentences with complex syntactic structures in backgrounds of speech babble by adolescents with cochlear implants, and peers with normal hearing. DESIGN Two experiments were conducted. First, new materials were developed using young adults with normal hearing as the normative sample, creating a corpus of sentences with controlled, but complex syntactic structures presented in three kinds of babble that varied in voice gender and number of talkers. Second, recognition by adolescents with normal hearing or cochlear implants was examined for these new materials and for sentence materials used with these adolescents at younger ages. Analyses addressed three objectives: (1) to assess the stability of speech recognition across a multiyear age range, (2) to evaluate speech recognition of sentences with complex syntax in babble, and (3) to explore how bottom-up and top-down mechanisms account for performance under these conditions. RESULTS Results showed: (1) Recognition was stable across the ages of 10-14 years for both groups. (2) Adolescents with normal hearing performed similarly to young adults with normal hearing, showing effects of syntactic complexity and background babble; adolescents with cochlear implants showed poorer recognition overall, and diminished effects of both factors. (3) Top-down language and working memory primarily explained recognition for adolescents with normal hearing, but the bottom-up process of perceptual organization primarily explained recognition for adolescents with cochlear implants. CONCLUSIONS Comprehension of language in real-world settings relies on different mechanisms for adolescents with cochlear implants than for adolescents with normal hearing. A novel finding was that perceptual organization is a critical factor. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.21965228.
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Affiliation(s)
- Susan Nittrouer
- Department of Speech, Language, and Hearing Sciences, University of Florida, Gainesville
| | - Joanna H. Lowenstein
- Department of Speech, Language, and Hearing Sciences, University of Florida, Gainesville
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Masri S, Fair R, Mowery TM, Sanes DH. Developmental hearing loss-induced perceptual deficits are rescued by cortical expression of GABA B receptors. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.01.10.523440. [PMID: 36711464 PMCID: PMC9882079 DOI: 10.1101/2023.01.10.523440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Even transient periods of developmental hearing loss during the developmental critical period have been linked to long-lasting deficits in auditory perception, including temporal and spectral processing, which correlate with speech perception and educational attainment. In gerbils, hearing loss-induced perceptual deficits are correlated with a reduction of both ionotropic GABAA and metabotropic GABAB receptor-mediated synaptic inhibition in auditory cortex, but most research on critical period plasticity has focused on GABAA receptors. We developed viral vectors to express both endogenous GABAA or GABAB receptor subunits in auditory cortex and tested their capacity to restore perception of temporal and spectral auditory cues following critical period hearing loss in the Mongolian gerbil. HL significantly impaired perception of both temporal and spectral auditory cues. While both vectors similarly increased IPSCs in auditory cortex, only overexpression of GABAB receptors improved perceptual thresholds after HL to be similar to those of animals without developmental hearing loss. These findings identify the GABAB receptor as an important regulator of sensory perception in cortex and point to potential therapeutic targets for developmental sensory disorders.
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Affiliation(s)
- Samer Masri
- Center for Neural Science, New York University, 4 Washington Place, New York, NY 10003
| | - Regan Fair
- Center for Neural Science, New York University, 4 Washington Place, New York, NY 10003
| | - Todd M. Mowery
- Brain Health Institute & Department of Otolaryngology, Rutgers University
| | - Dan H. Sanes
- Center for Neural Science, New York University, 4 Washington Place, New York, NY 10003
- Department of Psychology, New York University
- Department of Biology, New York University
- Neuroscience Institute, New York University Langone Medical Center
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