A critical barrier to progress in the field of cochlear implantation understands the role that fundamental mechanisms of learning and memory play in language outcomes. The long-term goal is to better understand and help treat the language delays exhibited by many deaf children with cochlear implants. The overall objective of this particular research project is to understand language delays in this population in terms of difficulties with underlying cognitive sequence learning abilities. Our central hypothesis is that language delays in these children are caused in part by disturbances to sequential learning- due to auditory and/or linguistic deprivation early in development -- and that by enhancing sequential learning, language function can be improved. The rationale that motivates the proposed research is that we expect at the conclusion of this project to have not only identified a major cause of language delays in this population but to also have formulated a new and promising intervention that specifically targets the development of sequential learning skills. We plan to test the central hypothesis and attain the objective of this application by pursuing the following three specific aims: 1) Determine the effects that congenital deafness has on the neural mechanisms of sequential learning; 2) Identify the relation between sequential learning skill and language outcomes; 3) Improve language outcomes in deaf children with cochlear implants by enhancing sequential learning abilities. For the first aim, we will compare the neurophysiologic (event-related potential, ERP) correlates of visual sequential learning in deaf children with cochlear implants to those of age-matched normal-hearing children. For the second aim, we will compare normal-hearing and deaf groups on two measures of language processing that are thought to rely on sequencing skills -- knowledge of word predictability and syntax -- and then empirically determine the association with sequential learning abilities. For the third aim, deaf children with cochlear implants will receive a computerized visual sequence training regimen; training and transfer effects will be assessed by comparing the training group to a control group on non-trained measures of learning and language. The proposed research is innovative, in our opinion, because it offers an entirely different approach that focuses on non- auditory, domain-general learning abilities that have been neglected in previous research with this population. The contribution of the proposed research project is expected to be the demonstration that disturbances to sequential learning abilities explain why many deaf children with cochlear implants struggle with acquiring language. Furthermore, we expect that by enhancing these learning abilities through computerized training techniques, language and communication function can be improved. This contribution will be significant because it has the potential to improve the quality of life for thousands of deaf children who currently exhibit minimum benefit from their implants because of difficulties with fundamental and crucial learning abilities.
The proposed research is relevant to public health because it will help us not only understand why deaf children with cochlear implants struggle with language acquisition, but will also show us how to improve their language skills. This approach that focuses on assessing and training domain-general learning and language abilities will provide immediate benefits to the quality of life for deaf children with cochlear implants. Therefore, this project is relevant to the mission of the NIH/NIDCD because it will result both in new knowledge to help explain language outcomes as well as a novel intervention strategy that will improve language learning in this population.
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