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“Language-Guided Looking at CHOP's Center for Childhood Communication”

Rachel Romeo, 2010,

Each year, over one million children under the age of five have chronic middle ear infections, and despite these often showing no symptoms, the fluid buildup frequently causes temporary hearing loss. If this hearing impairment continues over prolonged periods of time during the first and formative years of life, the child’s speech and language development may be delayed and/or distorted, possibly persisting even after the ear infection has cleared.

With support from CURF and a College Alumni Society Research Grant, in the summer of 2010 I began research on the developmental language skills of children with a history of these persistent middle ear infections during their first year of life, working in Penn’s Infant Language Center with Professor Daniel Swingley and with audiologist Dr. Eileen Rall at The Children’s Hospital of Philadelphia’s Center for Childhood Communication. To study these children’s comprehension, I used “language-guided looking,” a relatively recent methodology in which children are shown pairs or sets of pictures, one is named in a sentence (e.g., “Where’s the dog?”), and a video recorder tracks the children’s visual fixations to the pictures. Since eye movements are an automatic, direct reflection of language processing, speech discrimination abilities can be measured by looking patterns in response to simple mispronunciations (e.g., “Where’s the tog?”), years before the child can reliably respond to more mature language tasks.

However, this technique has never been used to study very young children with potential hearing impairments, who might show a deviation in the way they perceive word sounds and categorize them cognitively. Even though the children I’m studying have been cured of their ear infections, their poor hearing in the past may have disrupted language learning during the critical first months of life, and could continue to impair the way they learn language throughout childhood. I began my study with infants 14 months old, comparing the language perception of infants with and without a history of chronic ear infections, and am continuing to test them at 3.5 month intervals until they are twice that age to see how the differences in language development change over time. While the study is still in progress, and will be for quite some time, I have learned invaluable information about the severe detriment that such a nearly imperceptible ailment can cause.

A second goal of this research was to evaluate language-guided looking as a clinical assessment tool for detecting audiological impairments in very young children. Though hearing problems can be diagnosed as young as birth, the long-term effects on mental language learning skills is not obvious until much later, and usually not until after the child turns three. Without interventional treatment, these children could endure long-term adverse outcomes in speaking, reading, and even widespread cognitive and social disorders—possibly irreparably. However, the earlier that these impairments can be diagnosed, the earlier that intervention can take place, and the more effective it will be in erasing damage to language skills. Language-guided eye-tracking paradigms such as the one I am studying could be the key to this early diagnosis, possibly even as early as six months of age.

What’s more, this project has provided an invaluable foundation for my personal pursuit of a career in researching childhood language disorders of all types, in effort to develop innovative clinical methods for the earliest possible detection and effective intervention. While I work on this study for the rest of my senior year at Penn, I will also be working towards overcoming medicine’s tendency to simply address symptoms of language abnormalities rather than discovering and treating the actual causes. My ultimate goal is to work towards preventing childhood language disorders entirely and ensure language accessibility to all children.

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