No changes have been made since the original submission. Project Summary The overarching theme of this K23 application is to develop a research program with the aim of improving outcomes for children with hearing loss (HL) and to further my career as a clinician-scientist. In order to develop a career as a clinician scientist, together with my mentors, we have developed a training program that includes three goals: 1) utilizing evoked potential responses to develop a biomarker of infant speech discrimination, 2) learning techniques to establish predictive validity, and 3) in-depth training in longitudinal statistical analysis. This training will be accomplished through mentorship, didactic course work, and a research project. This research project was developed due to the considerable variation in speech and language outcomes in children with HL. While many gains have been made since the beginning of newborn hearing screenings, there is still significant work that needs to be done to optimally fit amplification in infants with HL, to decrease the gap in listening and spoken language abilities between normal hearing and hard-of- hearing children. Behavioral techniques such as a conditioned head turn are available to assess speech discrimination in infants. These techniques, however, are limited both by a minimum age limit and by impracticality for the large group of infants with secondary disabilities. Development of a biomarker for infant speech discrimination would significantly impact the 3 out of 1000 infants per year identified with permanent HL. As a first step, this application seeks to validate a biomarker of infant speech perception that can be measured shortly after the fitting of amplification, using an event-related potential known as the mismatch response/negativity (MMR/N). Our longitudinal study design will allow examine the relationship of MMR/N (measured at 3 months) with behavioral speech perception (measured at 9 months), and later language abilities (measured at 16, 24, and 30 months). The proposed research will advance MMR/N approaches in infants with HL and determine if MMR/N can be used as a measure of speech discrimination in this population. The central hypothesis of this proposal is that MMR/N, measured at 3 months of age, will be a related to language abilities 30 months of age. The research training provided by the K23 funding mechanism will allow me to widen my knowledge base in auditory evoked potentials as a model for biomarker development, learn new approaches to establishing validity between two different measures, including longitudinal follow-up, as well as develop an independent line of research. The ultimate goal of this research and training program is to prepare the PI for a career as a sustainably funded clinician-scientist who focuses on the need for translational research linking mechanisms of infant speech perception to evidence based clinical practice.
No changes have been made since the original submission. Project Narrative Even with the advent of universal newborn hearing screenings and the significant gains as a result of early intervention, children with hearing loss continue to exhibit delayed spoken language. Research with normal- hearing infants has demonstrated that early exposure to speech is critical to language development. Infants with hearing loss are likely to experience delays in the first year of life if hearing aids do not provide full access to spoken language. These delays are evident in spoken language abilities and may explain later challenges with literacy. However, methods of assessment do not allow us to determine whether a hearing aid fit is optimal in infants younger than 6 months of age. The research project proposed here seeks to develop a non-invasive, objective index of infant speech perception that can be used to determine if children can discriminate speech in early infancy shortly following the initial fit. The outcomes of this project have the potential to influence critical habilitation decisions for infants with hearing loss and thus holds high public health relevance for the fields of Audiology, Speech/Language Pathology, Deaf Education and Otolaryngology.
| Uhler, Kristin M; Gifford, René H; Forster, Jeri E et al. (2018) Refining Stimulus Parameters in Assessing Infant Speech Perception Using Visual Reinforcement Infant Speech Discrimination in Infants with and without Hearing Loss: Presentation Level. J Am Acad Audiol 29:847-854 |
| Uhler, Kristin M; Hunter, Sharon K; Tierney, Elyse et al. (2018) The relationship between mismatch response and the acoustic change complex in normal hearing infants. Clin Neurophysiol 129:1148-1160 |
| Gilley, Phillip M; Uhler, Kristin; Watson, Kaylee et al. (2017) Spectral-temporal EEG dynamics of speech discrimination processing in infants during sleep. BMC Neurosci 18:34 |
| Uhler, Kristin M; Baca, Rosalinda; Dudas, Emily et al. (2015) Refining Stimulus Parameters in Assessing Infant Speech Perception Using Visual Reinforcement Infant Speech Discrimination: Sensation Level. J Am Acad Audiol 26:807-14 |
