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Hearing loss is one of the most common birth defects in the United States, affecting approximately 3 in 1,000 newborns. Depending on the degree of hearing loss, deaf and hard-of-hearing (DHH) infants receive interventions that may include cochlear implants (CI). Nevertheless, there is a huge amount of variability in these children’s linguistic and academic outcomes. The amount/type of therapy that children receive, as well as the language input they are exposed to, are thought to contribute (to some degree) to this variability. Additionally, the age of implantation is considered one of the strongest predictors of language outcomes for DHH children, since lack of exposure to sound early in life affects the development of the brain’s auditory processing areas. But not all children implanted at the same age achieve the same language skills. Could there be factors at the neural level that make it easier (or harder) to process speech and acquire language once the brain gains access to sound through the CI? The mechanism by which the brain adapts to a new sensory modality following implantation and begins to perceive the relevant speech stream in a range of listening environments (including noisy contexts that may negatively impact speech processing) and the implication for developing language skills remain poorly understood. We combine two cutting-edge technologies (fNIRS and eye-tracking) to examine dynamic changes in neuroplasticity and organization of neural pathways for speech perception and language skills right after implantation. Our research may help predict language outcomes and explain the high degree of individual variability observed in children with CIs. Children requiring additional support could be identified earlier, preventing language delays and later academic problems.

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Funding: UD Research Foundation