1) FASTRAK (NIH/NIDCD R01 DC018330; PI: Ryan McCreery)

Children with mild bilateral hearing loss (MBHL) continue to experience significant delays due to uncertainty about the benefits of hearing aids for this population. The lack of clinical protocols and tools that are sensitive to the listening needs of children with MBHL contribute to this uncertainty. The goal of this NIH-funded grant is to develop novel clinical protocols and tools that are sensitive to the challenges faced by children with MBHL. In collaboration with leading pediatric audiology centers around the U.S. (Boys Town National Research Hospital, Arkansas Children's Hospital, Boston Children's Hospital, Washington University), the novel assessment and speech recognition measures will be used to validate these measures with a large clinical population of children with MBHL. The knowledge generated from this research will fundamentally improve the diagnosis and management of MBHL during childhood.

2) Complex Listening (NIH/NIDCD R01 DC013591; PI: Ryan McCreery)

Complex Listening in School-Age Hard of Hearing Children is a longitudinal study funded by the National Institute for Deafness and Other Communication Disorders. It is a collaborative project with researchers from Boys Town National Research Hospital and the University of Iowa. We posit that early language and cognitive abilities form the foundation for listening and learning in classrooms during elementary school. Children who are hard of hearing who have deficits in these skills may face significant academic and social challenges as they enter school. The long-term goal of the Complex Listening project is to optimize amplification and speech understanding in children who are hard of hearing by identifying the underlying processes that support listening in academic and social situations. We strive to understand how inconsistent auditory experience during early childhood affects speech understanding in noise and reverberation and on complex tasks that require cognitive processing. Results of this study will inform scientific theories about the developmental consequences of inconsistent early auditory experience. Clinically, the results will guide evidence-based practice and health policy for the clinical management of children who are hard of hearing.


3) Listening Effort (NIH/NIDCD R21 DC015832; PI: Elizabeth Walker)

Many children with mild to severe hearing loss are identified and receive early intervention at very young ages. Even with this early intervention, however, children who are hard of hearing (CHH) experience challenges with communication due to reduced access to the auditory signal. When listening in adverse conditions, CHH must exert additional cognitive resources compared to children with normal hearing (CNH) to perceive an incoming message. Consequently, they have fewer cognitive resources available to perform additional tasks and must expend increased listening effort. Listening effort requires the coordination of low-level, bottom-up processes, and higher-level, top-down processes. There is a lack of evidence regarding the interplay between auditory access and higher-level cognitive skills in influencing individual differences in listening effort for CHH. This knowledge gap hinders the understanding of the underlying mechanisms that drive listening effort in children with hearing loss, which in turn, limits the ability to develop evidence-based interventions for this population. The current proposal seeks to determine the factors that underlie increased listening effort in school-age CHH. This NIH-funded R21 grant tests the hypothesis that top-down processing, quantified by working memory and linguistic skills, is associated with listening effort in school-age CHH, and this relationship is moderated by bottom-up processing, measured via aided audibility.

4) Sequential Learning in Children with Cochlear Implants (American Speech and Hearing Foundation Clinical Research Grant; PI:  Elizabeth Walker)

In this study, we test the hypothesis that auditory deprivation prior to cochlear implantation leads to delays in domain-general learning processes. To investigate this topic, we use dynamic learning tasks that assess children’s ability to learn non-linguistic visual and motor patterns. These paradigms will allow us to determine whether there is an association between grammar abilities and learning in verbal, visual, and motor contexts. The specific aims of this project include 1) evaluating performance on a sequential non-verbal learning task in children with cochlear implants, and 2) evaluating performance on a motor learning task in children with cochlear implants. The outcomes of this study will provide empirical evidence regarding neurocognitive and learning processes in children with cochlear implants. Understanding these processes will lead to the development of effective interventions for children with hearing loss. This study is funded by the American Speech, Language, Hearing Foundation.

5) Outcomes of School-Age Children who are Hard of Hearing (NIH/NIDCD R01 DC009560, PIs:  J. Bruce Tomblin and Mary Pat Moeller)

Although children with mild-to-severe hearing loss compose the majority of children with hearing loss, most research has focused primarily on children with severe-to-profound hearing losses.  The small number of studies on children who are hard of hearing suggest that they are at risk for delays in language and academic achievement. However, most studies related to children who are hard of hearing were conducted prior to the implementation of universal newborn hearing screening. There is a critical need to examine the outcomes of a new generation of early-identified children with access to current amplification systems. The Outcomes of School-Age Children who are Hard of Hearing (OSACHH) project is a longitudinal study conducted by investigators representing three primary sites: the University of Iowa, Boys Town National Research Hospital, and the University of North Carolina-Chapel Hill. In this project, we examine how early intervention and children’s preschool communication abilities influence school-age academic and literacy outcomes. The results of this project have important implications for determining risk and protective factors for children with mild-to-severe hearing loss.