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Principal Investigator: Jareen Meinzen-Derr
Organization: CINCINNATI CHILDRENS HOSP MED CTR
Fiscal Year: 2024
Award: $588,358
Funding agency: National Institute on Deafness and Other Communication Disorders
PROJECT SUMMARY
Upon diagnosis of hearing loss, parents/caregivers of children who are deaf/hard-of-hearing (DHH) make
decisions around numerous approaches to language and communication development. Despite strong efforts
to improve long-term outcomes, DHH children continue to fall short of age-appropriate language levels, placing
them at risk for reduced academic achievement, behavioral problems, and poor social abilities that persist into
adulthood. The lack of research supporting innovative intervention strategies leaves a gaping hole in our
ability to fully support DHH children. Thus, we are unable to provide families with the quality information
regarding intervention options. Evidence supports augmentative and alternative communication (AAC) for
enhancing language development, yet technology-based AAC has not been applied or effectively studied in
DHH children. To address the substantial and pervasive language deficits among DHH children that have
persisted despite advances in amplification technology and early identification, we designed a technology-assisted language intervention (TALI) that incorporates high-tech AAC into speech-language therapy as a
language teaching tool specifically adapted for DHH children. Our central hypothesis is that DHH children who
participate in the TALI will have greater gains in spoken language outcomes compared to DHH children who
receive treatment-as-usual (TAU) speech-language therapy. In a small randomized trial to test the
effectiveness of the TALI, our preliminary data show that the TALI significantly improves spoken language
outcomes for DHH children and is more effective than TAU. However, there remains a need to (a) provide
evidence for reproducibility and generalizability in a larger population and (b) understand the TALI
effectiveness on additional language outcome measures. We propose a randomized controlled trial of 114
DHH children at 2 recruitment sites (Cincinnati Children’s Hospital Medical Center and Children’s Hospital of
Colorado). Children will be randomized to either receive 24 weeks of the TALI or 24 weeks TAU therapy. We
will expand our current work to include additional language outcomes, creating a more complete picture of the
effectiveness of the proposed intervention. We will test our central hypothesis through the following specific
aims: (1) Compare spoken (expressive) language outcomes in DHH children and participating in the TALI with
those participating in TAU therapy; (2) Compare language outcomes measured on standardized assessments
between children who are DHH participating in the TALI with those participating in TAU; (3) Evaluate whether
the benefits of the TALI on language outcomes is maintained 6 months post-intervention. Primary outcomes
include syntax, semantics and discourse collected from language samples measured every 6 weeks and
receptive/expressive standardized language scores measured pre and post intervention. AAC use will be
monitored to measure adherence to the TALI while at home. This project directly aligns with NIDCD’s strategic
plan’s overarching goal of improving outcomes in human communication.
Terms: <0-11 years old><21+ years old><AAC Device><AAC Intervention><Academic achievement><Address><Adherence><Adult><Adult Human><Age><Area><Auditory><Augmentative and Alternative Communication><Care Givers><Caregivers><Child><Child Development><Child Youth><Children (0-21)><Children's Hospital><Clinical Trials Design><Cognitive><Colorado><Communication><Complex><Computer software><Coupled><Data><Decision Making><Development><Diagnosis><Disadvantaged><Early identification><Educational process of instructing><Effectiveness><Effectiveness of Interventions><Emergent Technologies><Emerging Technologies><Evidence based intervention><Family><Feedback><Future><Goals><Hearing Loss><Home><Human><Hypoacuses><Hypoacusis><Infant><Infant and Child Development><Intervention><Intervention Strategies><Language><Language Delays><Language Development><Language Disorders><Language Therapy><Measures><Medical center><Modeling><Modern Man><Monitor><NIDCD><National Institute on Deafness and Other Communication Disorders><Outcome><Outcome Measure><Outcome Study><Outcomes Research><Parents><Pediatric Hospitals><Population><Problem behavior><Psychology><Public Health><Randomization trial><Randomized><Randomized, Controlled Trials><Reproducibility><Research Design><Research Support><Risk><Sampling><Semantics><Severities><Site><Social Behavior><Social Functioning><Software><Speech><Standardization><Strategic Planning><Study Type><Teaching><Techniques><Technology><Testing><Visual><Work><acquiring language skills><adulthood><ages><alternative communication><behavior outcome><behavioral outcome><behavioral problem><care as usual><care delivery><childhood hearing loss><cognitive ability><deaf><deafened><design><designing><developmental><dysfunctional hearing><early hearing loss><effective therapy><effective treatment><effectiveness testing><evidence base><function socially><functioning social><hard of hearing><hearing challenged><hearing defect><hearing deficient><hearing deficit><hearing difficulty><hearing dysfunction><hearing impairment><hearing loss in children><homes><improved><improved outcome><innovate><innovation><innovative><intervention program><interventional strategy><kids><language acquisition><language deficit><language learning><language outcome><measurable outcome><multidisciplinary><outcome measurement><parent><pediatric hearing loss><post intervention><primary outcome><profound hearing loss><programs><randomisation><randomization><randomized control trial><randomized trial><randomly assigned><recruit><skills><social><sociobehavior><sociobehavioral><standard care><standard treatment><study design><syntactic><syntax><tool><treatment as usual><usual care><youngster>