Hearing is a vital part of learning language. Important for a child’s speech development, it also influences literacy skills. For children born with significant hearing loss, listening and language ability are boosted by a device called a cochlear implant (which amplifies sounds and makes them more clear).
“The literacy of deaf children on average in the era before cochlear implants was fourth grade, which is not functional literacy,” said Dr. Nancy Young, medical director of audiology and cochlear implant programs at Lurie Children’s Hospital and Northwestern University professor.
While cochlear implants have improved language learning in deaf children since being approved by the FDA in 1991, some still lag behind their normal hearing peers. Researchers are hoping to bridge that gap with the help of a new tool. In a recent study, it was able to predict language learning in deaf children after they received a cochlear implant.
“The ability to predict language development is important because it allows clinicians and educators to intervene with therapy to maximize language learning for the child,” said Patrick C. M. Wong, a cognitive neuroscientist, professor and director of the Brain and Mind Institute at The Chinese University of Hong Kong, in a press release.
“Since the brain underlies all human ability, the methods we have applied to children with hearing loss could have widespread use in predicting function and improving the lives of children with a broad range of disabilities.”
About 38,000 cochlear implants have been surgically placed in American children since December 2012, according to the National Institute on Deafness and Other Communication Disorders. Decades of research shows early cochlear implantation is vital because early hearing loss deprives the auditory areas of the brain of stimulation, Young said.
“You want to minimize the period of auditory deprivation, and therefore, younger age of implantation is advantageous,” she added. (Cochlear implants work by capturing sound via an external microphone and sound processor, which are fed into an implanted device that stimulates nerves responsible for hearing.) “It makes sense that if you have that gap you have to catch up a bit.”
While cochlear implants allow many children with hearing loss to develop and understand language, some still lag behind their peers despite receiving an implant as an infant or a toddler. “So far, we have not had a reliable way to predict which children are at risk to develop poorer language,” Young said.
“Our study is the first to provide clinicians and caregivers with concrete information about how much language improvement can be expected given the child’s brain development immediately before surgery. The ability to forecast children at risk is the critical first step to improving their outcome. It will lay the groundwork for future development and testing of customized therapies.”
Scientists used brain MRIs of normal hearing and deaf children to capture abnormal patterns in children with hearing loss before they received cochlear implants. These MRIs were used to construct a machine-learning algorithm to predict language development with a relatively high degree of accuracy, specificity and sensitivity, according to Wong.
Young says prediction is just the first step. “The overarching goal is to use this to change these children’s lives by coming up with hearing, speech and music therapy that can be individualized in terms of the type of therapy and dose of therapy so we can improve outcomes,” she said. “We’re trying to create precision therapy.”
The study was published in the Proceedings of the National Academy of Sciences and was a collaboration between Ann & Robert H. Lurie Children’s Hospital of Chicago, Northwestern University Feinberg School of Medicine and the Chinese University of Hong Kong.
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