Research News

 

 

New App Measures Attention in 2 to 5-Year-Olds<img alt="Girl playing game on tablet computer" src="https://assets.boystown.org/hosp_peds_images/Bear-app-rollup.jpg" style="BORDER:0px solid;" />https://www.boystownhospital.org/news/research-app-measures-attention-in-childrenNew App Measures Attention in 2 to 5-Year-Olds2020-11-13T06:00:00Z<p>​Designed with an engaging theme and graphics, the Visual Attention Processing Protocol (VAPP) application collects research data on how children between the ages of 2 and 5 process visual information in their environment.</p><p>Created by Anastasia Kerr-German, Ph.D., Director of the Brain, Executive Function and Attention Research Laboratory at Boys Town<sup>®</sup>, this app measures visual attention and brain processing efficiency during play, while keeping kids entertained and interactive. Available in the App Store, the VAPP application is accessible to researchers wishing to participate in normative data collection.</p><p>In keeping with the under-the-sea game format, the first thing children are asked to do is click on sea creatures as quickly as they see them. In the next tier of the game, children will have to make choices about the direction the fish are going and drag them to the right location on the screen. In the third part of the game, children will sort visual stimuli (sea creatures and sea trash) to the appropriate locations based on their labels.</p><p>This game tells us about how children see things and how they make choices about visual information in their environment. To keep the engagement level high, there are also parts of the game that are just for entertainment like a pop-the-bubbles segment and the ability to earn underwater treasure games. </p><p>The Child Visual Attention Protocol application gauges how children use categorical labels and visual attention to guide decision-making, both in the moment and during a task that requires attention skills. The Protocol tests what children know and how quickly they can process and make decisions about that visual information.</p><p> <img src="https://assets.boystown.org/hosp_peds_images/Bear-App-1.png" alt="Child Visual Attention Protocol app" class="ms-rtePosition-1" style="margin:5px 15px 5px 5px;width:370px;height:278px;" />For example, in the “<em>Find the Fish"</em> exercise, children can quickly tap a creature with little thought in one portion of the task, which allows us to gauge how quickly they can process those visual stimuli. During <em>“</em><em>Where Are They Going?"  </em>and<em> “Rescue or Recycle?"</em> children must not only see the object but must label it and then do something with it. That is where decision-making comes in. Both pieces are important when understanding the development of attention in young children.</p><p>So far, the Child Visual Attention Protocol has been piloted with a dozen or so 2 to 5-year-olds and the children have been enthusiastic about using the application. There is still a large amount of normative data to collect before this can become a potential diagnostic tool to identify children who may be at risk for developing disorders such as ADHD. But the information collected to date is promising and might eventually help identify risk for ADHD much earlier than is now possible.</p><p>This application may eventually allow for diagnosis and care of those at risk for ADHD long before the behavioral and psychological struggles these children face become disruptive to their day-to-day lives. If interventions could start early, before school age, these children may have an easier time adjusting and there may be less of an impact on their academic achievement and social-emotional health.</p><p>“My hope is that we can use this app to better understand typically developing children prior to school age so that we may begin to understand the evolution of disorders of attention and executive functioning such as ADHD. A portion of our children in the Boys Town Residential Treatment Center, as well as outpatient clinics, have ADHD, and this line of research is aimed at early identification of risk and earlier interventions," said Dr. Kerr-German.</p><p>Researchers interested in helping to collect data for this ongoing project should contact Dr. Kerr-German through the Brain, Executive Function and Attention Research Lab at Boys Town National Research Hospital<sup>®</sup>.​</p> <a href="https://apps.apple.com/app/id1523758420" target="_blank"><img src="https://assets.boystown.org/hosp_peds_images/apple-store-badge.png" alt="Download on the iOS App Store" /></a>​<br>
Ears On! An Evidence-Based Program to Improve Hearing Device Use in Children<img alt="Child with hearing aid participates in research study" src="https://assets.boystown.org/hosp_peds_images/ears-on-rollup.jpg" style="BORDER:0px solid;" />https://www.boystownhospital.org/news/ears-on-program-improve-hearing-device-use-in-childrenEars On! An Evidence-Based Program to Improve Hearing Device Use in Children2020-11-03T06:00:00Z<p> <img src="https://assets.boystown.org/hosp_peds_images/ears-on-page.jpg" alt="Child with hearing aid participates in research study" class="ms-rtePosition-2" style="margin:5px 10px;width:344px;height:333px;" />For children with hearing loss, hearing devices such as hearing aids and cochlear implants provide access to speech sounds that are critical to their development of spoken language. Ho<span class="ms-rteThemeFontFace-1">wever, children m</span>ust regularly wear their devices to receive the full language development benefits [1]. </p><p>Ears On is a program developed and evaluated by Sophie Ambrose, Ph.D., Coordinator of the Clinical Measurement Program and her team at Boys Town National Research Hospital. Ears On is designed to help parents ensure regular device use for their children. The program focuses on educating families of the importance of children consistently wearing their hearing devices and provides practical tips to help with compliance of wearing them. </p><h2>Practical Concerns Affect Hearing Device Use</h2><p>When it comes to getting children to wear hearing devices, there are some common challenges. We know children take them off without parents' knowledge. Parents may choose not to have kids wear their devices during some activities. Other caregivers may not realize the importance of the devices and may fail to encourage or enforce wearing them. And, families sometimes just forget [2-3]. </p><p>Some of these factors are made worse by a lack of understanding of the developmental importance of consistent hearing device use. Hearing the sounds of speech and language during critical developmental periods supports brain development that will affect a child's long-term academic, social and professional success.</p><h2>Ears On Education to Help Families Manage Hearing Device Use</h2><p>Ears On starts with ensuring parents understand their child's individual hearing loss, including the speech sounds their child will miss without amplification and the impact it can have on language development. The intervention also seeks to show parents how much of a difference they can expect in hearing and language development with regular device use and to empower parents to believe they can establish consistent device use.</p><p>To meet these goals, Ears On methods include reviewing the results of the child's previous hearing assessments, using simulations of the child's hearing with and without hearing devices, presenting video examples of the language development of children with hearing losses similar to their child's and discussion of related topics. </p><p>Finally, to help parents improve their child's hearing device use, Ears On includes sessions that support parents in identifying and becoming confident in using strategies to address each of the barriers the family faces in establishing consistent device use. For examples, parents may learn strategies to encourage their child not to remove his or her devices or advocacy strategies to use with other caregivers. </p><h2>Ears On Program Evaluation</h2><p>Dr. Ambrose and her team tested Ears On with three parent-child pairs, with the three children being from 16 to 33 months old at the time of entry into the study. After Ears On, they found that all three improved in hearing aid compliance, with two them meeting the program goal of eight hours of average daily device use [2].  This study shows early promise for supporting parents and children by offering an intensive intervention focused on hearing device use. One of the keys to the success of the intervention was the individualization based on each family's needs. Additional work by the research team has included developing and validating a measure of parents' perceived beliefs, knowledge, confidence, and actions related to supporting their children's hearing device use and language development. This tool, which is available in <a href="https://digitalcommons.usu.edu/jehdi/vol5/iss1/9/" target="_blank">a recent article in the Journal of Early Hearing Detection and Intervention</a>, can help clinicians individualize their efforts to support families in increasing device use. </p><p>Boys Town National Research Hospital is recognized around the world as a leader in hearing and language research. </p><h2>References</h2><ol><li>Ambrose, S. E., Appenzeller, A., Al-Salim, S., & Kaiser, A. P. (2020). Effects of an intervention designed to increase toddlers' hearing aid use. <em>Journal of Deaf Studies and Deaf Education, 25</em>(1), 55-67. doi:10.1093/deafed/enz032</li><li>Moeller, M. P., Hoover, B., Peterson, B., & Stelmachowicz, P. (2009). Consistency of hearing aid use in infants with early identified hearing loss. <em>American Journal of Audiology</em>, <em> </em>(1), 14–23. doi:1059-0889_2008_08-0010</li><li>Muñoz, K., Rusk, S. E. P., Nelson, L., Preston, E.,White, K. R., Barrett, T. S., & Twohig, M. P. (2016). Pediatric hearing aid management: Parent-reported needs for learning support. <em>Ear and Hearing</em>, 37(6), 703–709. doi:10.1097/AUD.0000000000000338</li></ol>
Researchers and Kids Work Together to Create Scientific Article on Hearing Research<img alt="girl with glasses" src="https://assets.boystown.org/hosp_peds_images/step-hearing-research-rollup.jpg" style="BORDER:0px solid;" />https://www.boystownhospital.org/news/research-kids-create-scientific-article-on-hearing-researchResearchers and Kids Work Together to Create Scientific Article on Hearing Research2020-10-09T05:00:00Z<p>Imagine if kids were offered the opportunity to give input and ask questions for a scientific journal. </p><p>Boys Town researchers Angela AuBuchon, Ph.D., and Ryan McCreery, Ph.D., Director of Research, are doing just that in a similar manner with the publication <em>Frontiers for Young Minds</em>, which offers a unique approach to do this in a scientific journal that is aimed at young audiences. What makes it remarkable is that this journal emulates other peer-reviewed scientific publications, but with kids serving alongside scientist mentors as the editors and reviewers of submitted papers.</p><p>In their article, <a href="https://kids.frontiersin.org/article/10.3389/frym.2020.00104" target="_blank"><em>When Choosing NOT to Listen Helps You Hear and Learn</em></a><em>, </em>Dr. AuBuchon and Dr. McCreery explain the science of sound and perception related to their research. Kids learn that decibels (dB) are the scale that scientist use to quantify sound levels. They learn things about the anatomy inside the ear that turn sound waves into information signals that the brain understands, and they learn the parts of the brain that allow us to understand and pay attention to the sounds that matter to us.</p><p>The researchers also present a piece of data in the article that shows one area where science is helping to improve hearing experience for kids and adults with hearing loss. Our brains help us focus on someone speaking, as kids must do in the classroom, even when surrounding noises could distract from or distort the speaker. For children with hearing loss, it is harder to separate a speaker from a noisy background as is shown in their article. The figure itself, can be found in <a href="https://kids.frontiersin.org/article/10.3389/frym.2020.00104">the article</a>, and serves as an example for the reviewers and readers of how to present data in a quickly understandable visual summary.</p><p>To complete the article, kids review the submission with their own scientific mentors. The young reviewers asked their questions and offered suggestions to Dr. AuBuchon and Dr. McCreery in the same way that scientific peers would review papers in other journals. According to Dr. AuBuchon, “This is a really great opportunity for our researchers to work with the kids to create educational scientific content. They learn about the scientific process and we have the privilege to help develop the next generation of scientists that will continue the pursuit of new knowledge."</p><p>During the current COVID-19 pandemic, families in search of educational materials for home have also discovered this article, and the Frontiers for Young Minds journal. Dr. McCreery and Dr. AuBuchon have been contacted by some of these families and are happy to learn that they are using the content as an enrichment activity with their kids. This is exactly what we would hope for and it is possible because <a href="https://kids.frontiersin.org/article/10.3389/frym.2020.00104" target="_blank">the Frontiers for Young Minds article</a> is also open access, so anyone can read it!<br></p><p>Boys Town National Research Hospital is a global leader in hearing research and works extensively with children with a range of hearing needs. It regularly communicates technical findings through a variety of professional research and clinical publications. The hospital also works to provide educational content that is accessible to patients and families.​<br></p><h2>References<br></h2><ol><li>AuBuchon A. and McCreery R. (2020) When Choosing NOT to Listen Helps You Hear and Learn. Front. Young Minds. 8:104. doi: 10.3389/frym.2020.00104</li></ol><h2>Research Newsletter</h2><p>Please sign up to receive occasional research news and events emails from Boys Town National Research Hospital.</p><div align="center"> <a class="button is-primary" href="https://www.boystownhospital.org/research/newsletter" target="_blank">Newsletter Sign-Up</a></div>
Shining a Light on Developmental Language Disorder<img alt="" src="https://assets.boystown.org/hosp_peds_images/dldl-shines-a-light-rollup.jpg" style="BORDER:0px solid;" />https://www.boystownhospital.org/news/shining-a-light-on-developmental-language-disorderShining a Light on Developmental Language Disorder2020-10-07T05:00:00Z<p>​Developmental language disorder (DLD) is a highly prevalent neurodevelopmental condition that limits a person's ability to learn and use language. Despite the importance of spoken language for success in school, social settings, career and quality of life, there remains major obstacles in securing the quality and quantity of care needed to help children with DLD to reach their full potential.  </p><p>Considering its prevalence and impact, DLD is greatly under researched relative to other neurodevelopmental disorders, a situation that has not improved over the past decade. The number of children with DLD who receive clinical services also falls far short of prevalence estimates. In a recent article, Karla McGregor, Ph.D., Director of the Center for Childhood Deafness, Language and Learning at Boys Town Hospital, explores reasons for the relative neglect of DLD in research and clinical realms [1]. She maintains that increasing public awareness of DLD is a key step forward. </p><h2>DLD Awareness is an Ongoing Problem </h2><p>Despite being recognized and studied by speech-language experts for many years, Dr. McGregor points out that DLD remains an “unknown disorder". A lot of the confusion arises because of the large mix of terms used for DLD. If your child has been described as having a language delay, specific language impairment, expressive-receptive language disorder, speech-language impairment, or language learning disability they may have DLD. Organizations like Raising Awareness of Developmental Language Disorder (RADLD) are working to implement more uniform terminology and a greater understanding of the settings and reasons why one might encounter one term or another. </p><p>Another problem with awareness, as Dr McGregor describes it, is that DLD is “a hidden disorder". Children with DLD often don't stand out as different. They “can carry on a basic conversation, follow a simple command, and answer a routine question [1]." Many children who are identified with DLD are diagnosed because they have a co-occurring condition such as a speech impairment, or a behavioral concern that is more noticeable than immature language patterns to adults. However, the consequences for academic success with DLD are often greater than those of co-occurring conditions. </p><h2>Improving DLD Care for Future Generations </h2><p>Progress will almost certainly accelerate if we can help parents and educators understand the critical importance of spoken language development to academic and social success and to alert them to potential signs of DLD. Speech-language researchers and clinicians must ensure that evidence-based information is accessible to educators, families and policy makers.  </p><p> <a href="https://dldandme.org/" target="_blank">DLDandMe.org</a> is a website founded by a nation-wide panel of experts to help. DLDandMe.org provides brief, readable summaries of evidence on a range of topics related to DLD such as <em>Causes of DLD</em>, <em>Gender Differences in Language Development</em>, the <em>Difference between DLD and Autism</em>, and <em>Test Score Interpretation</em>. Since 2017, RADLD.org has organized <a href="https://radld.org/dld-awareness-day/" target="_blank">DLD Awareness Day</a>, including events and multi-media campaigns designed to improve awareness. </p><p>This year's DLD Awareness Day is Friday, October 16, 2020. Keep an eye out for news, information and events on twitter and Facebook by following the hashtags #DLDseeMe and #DLDandMe. </p><h2>References </h2><ol><li>McGregor, K. A. (2020) How We Fail Children with Developmental Language Disorder. <em>Lang Speech Hear Serv Sch</em>. 5; 1–12. doi: 10.1044/2020_LSHSS-20-00003. </li></ol><h2>Research Newsletter</h2><p>Please sign up to receive occasional research news and events emails from Boys Town National Research Hospital.</p><div align="center"> <a class="button is-primary" href="https://www.boystownhospital.org/research/newsletter" target="_blank">Newsletter Sign-Up</a></div>
Boys Town Collaborates to Expand Diversity in Speech Language Pathology and Audiology<img alt="" src="https://assets.boystown.org/hosp_peds_images/IMPACT-Announcement-rollup.jpg" style="BORDER:0px solid;" />https://www.boystownhospital.org/news/impact-efforts-expand-diversity-in-speech-language-pathology-audiology-fieldsBoys Town Collaborates to Expand Diversity in Speech Language Pathology and Audiology2020-10-06T05:00:00Z<p class="MsoNormalCxSpFirst">​Boys Town National Research Hospital is pleased to announce that we are supporting faculty at Hampton University and Case Western Reserve University in a program designed to improve minority representation in speech language pathology and audiology graduate programs, clinics, and research. </p><p class="MsoNormalCxSpMiddle">The IMPACT (Innovative Mentoring and Professional Advancement through Cultural Training) Program is a 1-year program that will provide formal mentoring to students in communication sciences programs from underrepresented backgrounds. Mentorship will be provided by diverse faculty at research-intensive universities and hospitals to enhance practical learning opportunities through research training, communication skills development, and formal test preparation to improve the students’ readiness in graduate school.</p><p class="MsoNormalCxSpMiddle">The overarching goal of the IMPACT Program, according to co-collaborators Jessica Sullivan, Ph.D. at Hampton University and Lauren Calandrucio, Ph.D., at Case Western Reserve University “is to begin to train the next generation of speech-language pathology and audiology leaders who encompass inclusion, diversity, and compassion.”</p><p class="MsoNormalCxSpMiddle">Boys Town Hospital researchers, Monita Chatterjee, Ph.D. and Daniel Rasetshwane, Ph.D. will join students in September for a virtual “family dinner” where they will discuss their experiences as prominent scientists from underrepresented minority groups. On October 22, multiple investigators from Boys Town Hospital Research will be conducting virtual lab tours and providing an overview of what it’s like to be part of our research team.</p><p class="MsoNormalCxSpMiddle">Ryan McCreery, Ph.D., Director of Research, and Lori Leibold, Ph.D., Director of Hearing Research, will be supporting IMPACT Program initiatives at Boys Town National Research Hospital. Dr. Leibold explains that “Boys Town Hospital is committed to promoting inclusion and diversity. The IMPACT Program will give students who are traditionally underrepresented in hearing and language sciences insight into their fields of interest and prepare them to join the next generation of researchers and clinicians. We are proud to be a part of this effort, which will serve as a model for similar local programs in the future, supported by the IMPACT Program team.”</p><p class="MsoNormalCxSpMiddle">The IMPACT Program is funded by the American Speech-Language-Hearing Association.</p><h2>About Boys Town National Research Hospital</h2><p>Boys Town National Research Hospital offers a broad range of hospital and clinic services, backed by 40 years of life-changing research to provide the latest, most innovative care to our patients. The Hospital is internationally recognized as a leader in hearing research and clinical care and is leading research efforts in language and neuroscience to improve the lives of children and families across America.</p><h2>Research Newsletter</h2><p>Please sign up to receive occasional research news and events emails from Boys Town National Research Hospital.</p><div align="center"> <a class="button is-primary" href="https://www.boystownhospital.org/research/newsletter" target="_blank">Newsletter Sign-Up</a></div>
Language Benefits of Hearing Aid Use are Significant in Fourth-Grade Children<img alt="" src="https://assets.boystown.org/hosp_peds_images/Hearing-Speech-Perception-Research-rollup.jpg" style="BORDER:0px solid;" />https://www.boystownhospital.org/news/language-benefits-hearing-aid-useLanguage Benefits of Hearing Aid Use are Significant in Fourth-Grade Children2020-09-08T05:00:00Z<p>​While it is not the only factor, the quality of our children's hearing plays a pivotal role in how well they understand speech and develop spoken language skills. However, there is some ambiguity when it comes to assessing and treating kids with mild, bilateral hearing loss. In these cases, there is not always a strong clinical opinion for early fitting or consistent wearing of hearing devices. This is partly because these kids do not always appear noticeably different from their classmates in every day conversation, or on language tests, so clinicians and families may take a “wait-and-see" approach to hearing devices.</p><p>Scientists at Boys Town National Research Hospital and the University of Iowa have been collaborating on a series of studies to see what the real benefits of consistently worn and early fit hearing aids are for kids, and especially those with mild hearing loss. As part of this collaboration, Elizabeth Walker, Ph.D., Assistant Professor at the University of Iowa, and others recently assessed both written and spoken language skills of fourth-grade children to identify the language risks associated with mild hearing loss [1].</p><p>In this study, the team compared 60 children with mild, bilateral hearing loss and 69 peers with typical hearing. All participants were tested the summer after fourth grade. Dr. Walker and her team found that kids with hearing loss had significant deficits in spoken language comprehension and understanding of morphology—the structural parts of words that indicate verb tense or plurality, such as  the word endings in “He is play<em>ing</em>" or “She walk<em>ed</em>" or “many cat<em>s"</em>. In contrast, vocabulary and reading were not significantly different between the kids with hearing loss and typical hearing.</p><p>The goal of this study was not just to see what the language differences were, but also to see how intervention with hearing aids affected these outcomes. Therefore, Dr. Walker's team also needed to know from caregivers how much the kids in the hearing loss group wore their hearing aids. Kids with milder hearing loss, whose caregivers reported more time wearing hearing aids, did better with comprehension of spoken language than kids with more severe hearing loss and/or lower hearing aid usage.</p><h2>What These Findings Tell Us</h2><p>Findings from this study show us that consistent hearing aid use is important for kids to reach their full language potential. Furthermore, waiting to see how kids with mild, bilateral hearing loss do before recommending hearing amplification could come at the cost of some language ability. This is something clinicians should emphasize to families of children with mild hearing loss. Along with educating families, clinicians should strongly consider early hearing testing and intervention for children with mild hearing loss.</p><h2>Related reading</h2><p>Last year, Ryan McCreery Ph.D., Director of Research at Boys Town Hospital, and co-authors published a paper titled, <em>Audibility-based hearing aid fitting criteria for children with mild bilateral hearing loss [2]</em>. That paper outlines a set of guidelines for assessing when children with mild, bilateral hearing loss should be fitted with hearing aids based on language outcomes. <a href="/news/checking-speech-audibility-importance-when-assessing-hearing-loss">Read more about that study</a>.</p><h2>References</h2><ol><li>Walker E. A., Sapp C., Dallapiazza M., Spratford M., et. al. (2020) Language and Reading Outcomes in Fourth-Grade Children With Mild Hearing Loss Compared to Age-Matched Hearing Peers. <em>Lang Speech Hear Serv Sch</em>. 51(1):17–28. <a href="https://doi.org/10.1044/2019_LSHSS-OCHL-19-0015" target="_blank">https://doi.org/10.1044/2019_LSHSS-OCHL-19-0015</a>. </li><li>McCreery R.W., Walker E.A., Stiles D.J., Spratford M., et. al. (2020) Audibility-based hearing aid fitting criteria for children with mild bilateral hearing loss. <em>Lang Speech Hear Serv Sch</em>.​ 51(1): 55–67. <a href="https://doi.org/10.1044/2019_LSHSS-OCHL-19-0021" target="_blank">https://doi.org/10.1044/2019_LSHSS-OCHL-19-0021</a>.</li></ol><h2>Research Newsletter</h2><p>Please sign up to receive occasional research news and events emails from Boys Town National Research Hospital.</p><div align="center"> <a class="button is-primary" href="https://www.boystownhospital.org/research/newsletter">Newsletter Sign-Up</a></div> ​<br>
Alcohol and Cannabis Use Alter Emotional Processing of Future Events<img alt="" src="https://assets.boystown.org/hosp_peds_images/OB_Picture-rollup.jpg" style="BORDER:0px solid;" />https://www.boystownhospital.org/news/alcohol-cannabis-use-disruptionAlcohol and Cannabis Use Alter Emotional Processing of Future Events2020-08-27T05:00:00Z<p>​​Alcohol and cannabis are two of the most commonly abused drugs, and early use puts kids at higher risk of long-term cannabis and alcohol use disorders. Because their brains are still developing, there are substantial concerns about the long-term impacts of substance use. At Boys Town National Research Hospital, we often work with kids with substance use issues and our neurobehavioral research team is working to provide clinicians with a better understand of the impacts of substance use on the brain.<br></p><p>While most people understand that our short-term judgement is impaired under the influence of alcohol or cannabis, there is also evidence that regular substance use leads to longer term impairment in judging good or bad outcomes. With this in mind, the neurobehavioral research team, led by Joseph Aloi, M.D., Ph.D. and James Blair, Ph.D. recently conducted a study of 112 adolescents, 14 to 18 years old.  Their goal was to determine the extent the teens' prior alcohol and cannabis use affected how their processing of possible future outcomes.<br></p><div class="is-clearfix"><div class="inline-image is-size-7"> <img src="https://assets.boystown.org/hosp_peds_images/OB_Picture.png" alt="brain activity" style="max-width:100%;" /> <p>Figure 1. Brain regions involved in responding to emotional outcomes that are less responsive in those with heavier prior cannabis use.</p></div><p style="margin-bottom:1rem;">The researchers found that severity of prior cannabis use, in particular, changed how the adolescent’s brains responded to high-intensity good, or high-intensity bad possible futures. This activity can be seen on brain scans in brain regions known to respond to emotional outcomes.<br></p><p>Representing emotional outcomes well is important. To live well, we need to act to avoid highly negative futures and work towards highly positive ones. The data from this study showed that cannabis use significantly impairs this ability.. </p><p>This problem also has implications for treatment. When someone comes in for treatment, one of the tools clinicians rely on is the person’s motivation to change drug use. A diminished capacity to imagine and and work towards a positive future identifies yet another difficulty faced by adolescents with a history of high cannabis use.​</p></div><p>One thing we don't yet know is how long these changes are. It will be important to determine the extent to which successful treatment, including the Boys Town model, reverses this difficulty. </p><h2>References</h2><ol><li>Aloi, J., Blair, K. S., Meffert, H., et. al. (2020) Alcohol use disorder and cannabis use disorder symptomatology in adolescents is associated with dysfunction in neural processing of future events. Addict Biol; epub ahead of print. <a href="https://doi.org/10.1111/adb.12885" target="_blank">https://doi.org/10.1111/adb.12885</a> </li></ol><h2>Research Newsletter</h2><p>Please sign up to receive occasional research news and events emails from Boys Town National Research Hospital.</p><div align="center"> <a class="button is-primary" href="https://www.boystownhospital.org/research/newsletter">Newsletter Sign-Up</a></div> ​<br>
Ryan McCreery, Ph.D., Recognized for Professional Achievement with Prestigious ASHA Award<img alt="" src="https://assets.boystown.org/hosp_peds_images/Ryan-McCreery-rollup.jpg" style="BORDER:0px solid;" />https://www.boystownhospital.org/news/prestigious-asha-professional-achievement-award-ryan-mccreeryRyan McCreery, Ph.D., Recognized for Professional Achievement with Prestigious ASHA Award2020-08-03T05:00:00Z<p>​​​​We are very pleased to recognize our Director of Research, <a href="https://www.boystownhospital.org/research/faculty/ryan-mccreery">Ryan McCreery, Ph.D.</a>, for his selection as a Fellow of the American Speech-Language-Hearing Association (ASHA). ASHA has more than 211,000 members and is the primary professional, credentialing and scientific organization for speech-language pathologists, audiologists and speech/language/hearing scientists. Fellowship is the most prestigious recognition they can award for professional contribution and achievement. </p><div class="is-clearfix"><div class="inline-image is-size-7">​​​​​​​​<img src="https://assets.boystown.org/hosp_peds_images/McCreeryRyan.jpg" alt="Ryan McCreery, Ph.D." class="inline-image__image" /> <h2 class="is-size-5">Ryan McCreery, Ph.D.</h2><p>Director of Research, Boys Town</p></div>​ ​ <p>Dr. McCreery was nominated by his colleagues, including ASHA Fellow Mary Pat Moeller, Ph.D. Among his many leadership strengths, Dr. Moeller emphasizes that “Dr. McCreery brings a rare combination of clinical and scientific expertise, people skills, management knowledge, the ability to make tough decisions and a strong vision for the future of the organization he is leading.” </p><p>Ryan joined Boys Town National Research Hospital in 2004 as a research audiologist. He worked with Pat Stelmachowicz, Ph.D., former Director of Audiology at Boys Town Hospital, who realized that Ryan would make an excellent researcher and encouraged him to pursue his doctorate. Ryan earned his Ph.D. from the University of Nebraska-Lincoln in 2011, researching hearing and top-down processing of auditory information in children. </p><p>Along with being Director of Research, Dr. McCreery is also Director of the Audibility, Perception, and Cognition Laboratory. His current research is advancing our understanding of the importance of auditory experience, including optimal hearing amplification in kids with hearing loss, for the proper development of language. </p><p>Dr. McCreery’s research helps families and clinicians understand the importance of consistently wearing hearing aids to facilitate a rich sound environment that supports healthy brain development. Ryan also recently published guidelines that emphasize language understanding and development when fitting hearing aids in children. Dr. McCreery also notes that “children who lack sufficient sound exposure early on, may not attain their full language potential even if they get that experience later in life.” </p><p>One of Dr. McCreery’s regular collaborators, Beth Walker, Ph.D., at the University of Iowa describes his research by saying, “Ryan McCreery has accomplished more in terms of promoting evidence-based practice in pediatric audiology in 10 years than most people accomplish in a lifetime.” </p><p>To understand why Dr. McCreery deserves this award, you simply need to look at how versatile he is as an investigator, leader and administrator. Brenda M. Ryals, Ph.D., is a professor at James Madison University and a colleague of Dr. McCreery. She sums up her support for his award with: “A brief review of Dr. McCreery’s resume provides easy evidence for his skill and success at administration. It is nothing less than astounding to review the speed with which Dr. McCreery moved from Research Audiologist in the Boys Town Hospital Hearing Aid Research Laboratory (2007) to Director of Research in 2017. Such a speedy advancement is a strong indication of his superior skills in administration, as well as the high degree of regard with which he is held by peers and higher administration.” </p><p>Ryan also takes a special interest in mentoring researchers who are at the beginning of their careers and helping them to meet their full potential. Many of his peers would likely agree with Adam Bosen, Ph.D., who said, “He is willing to commit resources, both institutional and his own time, to ensure the success of researchers at Boys Town. Despite his numerous responsibilities, he has never turned down a request to meet with me and has always provided high quality advice on anything I have asked him about. I have said numerous times that I think Boys Town National Research Hospital is the best place in the world for me to start my career, and I believe that Ryan's leadership is an essential component of what makes Boys Town excel in hearing science.”​</p><p>Dr. McCreery is highly sought after for his ability to communicate clinical and scientific information. He has given over 160 talks. His schedule is always full but never too full to find time to look out for the needs of his colleagues. Perhaps most importantly, Dr. McCreery remains energetic and committed and likely has many years ahead in a career that has already benefitted so many. </p><p>​On behalf of Boys Town National Research Hospital, we would like to congratulate Dr. McCreery for being recognized for his research, clinical care and leadership and for his contributions to advancing the fields of audiology and speech-language pathology to improve the lives of children and families. </p><h2>Research Newsletter</h2><p>Please sign up to receive occasional research news and events emails from Boys Town National Research Hospital.</p><div align="center"> <a class="button is-primary" href="https://www.boystownhospital.org/research/newsletter">Newsletter Sign-Up</a></div></div>
Developmental Language Disorder Affects Adult Learning Too<img alt="" src="https://assets.boystown.org/hosp_peds_images/Dev-Language-Disorder-Affects-Adult-rollup.jpg" style="BORDER:0px solid;" />https://www.boystownhospital.org/news/developmental-language-disorder-affects-adult-learningDevelopmental Language Disorder Affects Adult Learning Too2020-07-24T05:00:00Z<p>​<a href="/knowledge-center/red-flags-developmental-language-disorder">​Developmental language disorder (DLD)</a> is a common condition, affecting around 7% of the population. A key feature of DLD is that it cannot be explained by other conditions that affect language learning like intellectual disability, <a href="/knowledge-center/autism-spectrum-disorder">autism s​pectrum disorder</a>, or <a href="/knowledge-center/about-hearing-loss">hearing impairment</a>. In other words, the primary problem is difficulty learning, understanding, and using language. The problem arises in childhood; however, DLD persists into adulthood, interfering with language learning in ways that can affect educational and professional achievement. </p><p>Most research on DLD is focused on school-aged children ​where the goal is to support effective strategies for educational programs. For adults with DLD, there is much less awareness and information. <a href="https://www.boystownhospital.org/research/faculty/karla-mcgregor">Karla McGregor, Ph.D.</a>, and her team at Boys Town National Research Hospital have been working to address this information disparity. </p><p>In a series of studies they hav​e examined the ability of young adults with DLD to learn and recall new words. Dr. McGregor explained that “there are many parts to learning a new word, including its sounds, spelling, meaning, grammatical role, and its appropriate use”. Her research shows that adults with DLD have strengths and well as weaknesses in various aspects of word learning. </p><p>In their most recent study [1], the team found that learning new words is a challenge for young adults with DLD but, once learned, their memory for the new words was generally good. There is also an interesting finding from this study that the women demonstrated stronger retention of the words than men, although this finding varies across studies. When it comes to new words, learning the sounds and their order is difficult for people with DLD, but learning word meaning is also a relative strength. </p><p>One of the biggest challenges with DLD is awareness. It is a prevalent condition, but many people have never heard of it. Researchers at Boys Town Hospital and around the world are working to educate people, develop resources, and raise awareness. If you are interested in learning more about these efforts, check out Raising Awareness of Developmental Language Disorder (RADLD) and <a href="https://www.dldandme.org/" target="_blank">DLDandMe.org</a> for more articles and information.</p>​ <h2>References</h2><ol><li>McGregor, K.K., Arbisi-Kelm, T., Eden, N., Oleson, J. (2020) The word learning profile of adults with developmental language disorder; Autism & Developmental Language Impairment; 5(1) 1–19. DOI:10.1177/2396941519899311</li></ol><h2>Research Newsletter</h2><p>Please sign up to receive occasional research news and events emails from Boys Town National Research Hospital.</p><div align="center"> <a class="button is-primary" href="https://www.boystownhospital.org/research/newsletter">Newsletter Sign-Up</a></div>
Researchers Investigating How Isolation is Stressing Kids During the COVID-19 Pandemic<img alt="" src="https://assets.boystown.org/hosp_peds_images/Research-Isolation-Stress-Kids-During-Pandemicrollup.jpg" style="BORDER:0px solid;" />https://www.boystownhospital.org/news/how-isolation-social-distancing-affect-kids-mental-healthResearchers Investigating How Isolation is Stressing Kids During the COVID-19 Pandemic2020-07-22T05:00:00Z<p>​​There are many societal impacts associated with the COVID-19 pandemic, beyond just the viral illness. One of the most widespread impacts of the COVID-19 pandemic is the sudden, unexpected social isolation resul​ting from adults and children being encouraged or forced to stay at home, sometimes with accompanying job loss. W​hile isolation helps to slow the spread of the virus, it also creates another stressful and unhealthy set of problems.</p><p>Researchers at Boys Town National Research Hospital, led by <a href="https://www.boystownhospital.org/research/faculty/stuart-white">Stuart White, Ph.D.</a> and <a href="https://www.boystownhospital.org/research/faculty/anastasia-kerr-german">Anastasia Kerr-German, Ph.D.</a>, are attempting to determine how the sudde​n shift this spring has been affecting children who, without any transition, went from highly social school environments to at-home isolation. According to Dr. White, this pandemic is unprecedented in modern times, and technology and media make it unlike any historic comparisons. </p><p>Since COVID-19 virus transmission is still a concern, Dr. White and Dr. Kerr-German designed <a href="https://www.boystownhospital.org/research/neurobehavioral/current-studies/covid-19-isolation-study">an online study to assess how the stress of this pandemic is affecting kids</a>. The study has several components to help us get a clear idea of how kids are handling stress. Kids who participate will fill out a survey that asks relevant questions about things like how they are coping, how they feel about being at home, and their relation​ships. Parents will also complete a survey asking questions about how the family is coping with the pandemic. </p><p>Along with these quality of life indicators, youth will complete a series of downloadable computer tasks. Dr. Kerr-German says that their task performance will quantify things like emotion regulation, attention, and adaptive thinking. Finally, the data from the assessments will be put into biological context with hormone levels from a small hair sample. </p><p>Dr. White explains that human hair stores certain biological markers of stress that can be reliably analyzed for up to 3 months after a stressful event. Hair samples are also ideal for this study because they can be easily done at home and sent through the mail with minimal precautions. </p><p>This research will support our own extensive youth care programs, as well as supporting best practices at other organizations. School administrators and other policy makers are also in need this kind of critical information as they weigh the importance of returning to school and assessing what complicating factors they will need to deal with when they are allowed to return. If you are interested in finding out more about this study, you can contact the lab at <a href="mailto:DCN.lab@boystown.org">DCN.lab@boystown.org</a>.</p><h2>Research Newsletter</h2><p>Please sign up to receive occasional research news and events emails from Boys Town National Research Hospital.</p><div align="center"> <a class="button is-primary" href="https://www.boystownhospital.org/research/newsletter">Newsletter Sign-Up</a></div>
Childhood Sexual Trauma Alters Emotional Regulation and Brain Development<img alt="" src="https://assets.boystown.org/hosp_peds_images/BTNRH-Downtown-2-rollup.jpg" style="BORDER:0px solid;" />https://www.boystownhospital.org/news/childhood-sexual-trauma-alters-emotional-regulation-brain-developmentChildhood Sexual Trauma Alters Emotional Regulation and Brain Development2020-06-25T05:00:00Z<p>​​​​​Traumatic experiences during childhood have the ability to disrupt long-term brain development and function. Advances in imaging technology have shown us that not all traumatic experiences do this in the same way. Sexual trauma, in particular, severely alters how the brain responds to perceived threats as the child learns to deal with the terrible experience.</p><p> <a href="https://www.boystownhospital.org/research/faculty/karina-blair">Karina Blair, Ph.D​</a>. is a behavioral neuroscientist at Boys Town National Research Hospital, and an e​xpert in the area of how trauma affects brain development. She has been using functional brain imaging (fMRI) to investigate the areas of the brain that are involved in trauma, and especially looking for changes that persist long after specific events and relative to different types of trauma.</p><p>Much of the literature on post-traumatic stress is focused on the amygdala, a small, almond-shaped region in the brain that is associated with emotional responding and fear. In a recent paper, Dr. Blair was interested in how other regions that may also be involved might also be altered.</p><p>For this study, Dr. Blair worked with 23 adolescents who had reported sexual trauma, and 24 adolescents who had not experienced significant trauma as comparisons. Participants were placed in an fMRI scanner that allowed her to measure increases or decreases in brain function in specific anatomical regions while they were shown either threatening or neutral images.</p><p>Dr. Blair and her team identified several areas of increased activation during threatening stimuli. These areas of the brain were in the frontal lobe that we know are involved in emotional responding and regulation that are also necessary for understanding social situations. The data appears to suggest that past sexual abuse may cause exaggerated responses when these kids are exposed to stimuli that are perceived as threatening, or potentially threatening.</p><p>Dr. Blair's work helps clinicians at Boys Town Hospital, and elsewhere, understand what has happened to the brains of children after trauma. It's a useful tool for selecting and developing appropriate treatment plans. Unfortunately, these kids also end up in trouble more frequently. Understanding that, unless they get the right help, their brains have been altered for the long-term, if not permanently. This shows the critical need to help children get the right help and not punish them for things beyond their control. </p><p>For over 100 years Boys Town has been treating and advocating for children under these and other terribl​e circumstances. Our research team is critical to our efforts to provide the best care possible for these youth.​<br></p><p>Read more about the <a href="https://www.boystownhospital.org/research/neurobehavioral">Center for Neurobehavioral Research</a> at Boys Town.</p><h2>References</h2><ol><li>Blair, K. S., Bashford-Largo, J., Shah, N., et. al. (2020) <i>Sexual Abuse in Adolescents Is Associated With Atypically​ Increased Responsiveness Within Regions Implicated in Self-Referential and Emotional Processing to Approaching Animate Threats</i>. Front. Psychiatry; <a href="https://doi.org/10.3389/fpsyt.2020.00345" target="_blank">https://doi.org/10.3389/fpsyt.2020.00345</a>.</li></ol> <h2>Research Newsletter</h2><p>Please sign up to receive occasional research news and events emails from Boys Town National Research Hospital.</p><div align="center"> <a class="button is-primary" href="https://www.boystownhospital.org/research/newsletter">Newsletter Sign-Up</a></div>
DO BETTER: A Framework for Organizations to Implement Translational Research Knowledge for Clinical Practice<img alt="" src="https://assets.boystown.org/hosp_peds_images/BT-Pylon-rollup.jpg" style="BORDER:0px solid;" />https://www.boystownhospital.org/news/implementing-translational-research-knowledge-in-clinical-careDO BETTER: A Framework for Organizations to Implement Translational Research Knowledge for Clinical Practice2020-06-03T05:00:00Z<p>​​The passage of the Family First Prevention Services Act (FFPSA) in 2018 includes new rules for social service organizations to formally follow practices that are supported by clinical research ([1]; U.S. Bipartisan Act, 2018). In recognition of these important changes to the law, researchers at Boys Town National Research Hospital, led by Patrick Tyler, Ph.D., Director of Research Translation, have published a framework to help organizations meet the new requirements [2].</p><p>Simply put, research translation means taking the findings from controlled research studies and applying them to protocols for use in treatment. This broad term can cover any area of medical or behavioral therapy applications. The DO BETTER framework is built on published studies on translational research practices as well as the extensive experience of our team at the <a href="https://www.boystown.org/research/Pages/Translational-Research-Center.aspx" target="_blank">Boys Town Child and Family Translational Research Center</a> in order to produce a clear plan for implementing research into practice [2]. A summary of the framework can be viewed in the <a href="https://assets.boystown.org/hosp_peds_docs/Do-Better-Framework-Boys-Town-Translational-Research-Center.pdf" target="_blank">accompanying PDF</a>.</p><p>As organizations look to implement their own research requirements for the FFPSA, they will want a research model that adds seamles​sly to their current practices. The DO BETTER framework acknowledges the need for research programs that specifically responds to the needs of practitioners and families. Those needs can be identified based on views from practitioners and consumers using surveys, focus groups, and interviews. The organization can then identify the practitioners, clients and researchers who will collaborate to help solve the problem.</p><p>The team approach is critical to the DO BETTER framework. This ensures that the research addresses the issues specific to the treatment programs and that the findings are not blind to the practical limitations of providing care. Involving practitioners and families in the research also increases confidence that the results are relevant to their needs. For the researchers, this collaboration will help improve their future experimental designs, as well as its relevance to society. Additionally, successful collaborations can increase the prominence and visibility of a research program through word of mouth and project successes. </p><p>The overarching goals of the FFPSA are to provide the best care to families by following practices that are supported by good research. The inclusion of a collaborative research program that monitors clinical data can also help practitioners identify issues that may not be overtly obvious and help improve treatment programs. Our goal with DO BETTER is to make that process easier to achieve with a clear set of steps that are outlined in the <a href="https://assets.boystown.org/hosp_peds_docs/Do-Better-Framework-Boys-Town-Translational-Research-Center.pdf" target="_blank">accompanying PDF</a>. A more detailed description is published in the article <a href="https://link.springer.com/article/10.1007/s10566-020-09548-3" target="_blank">Practice to Research and Back in a Social Service Agency: Trying to DO BETTER in the journal Child & Youth Care Forum</a> [2].</p><h2>References</h2><ol><li>Wilson, S., Price, C. S., Kerns, S. E. U., et. al. (2019). <i>Title IV-E Prevention Services Clearinghouse. Handbook of standards and procedures. Version 1.0.</i> Office of Planning Research and Evaluation. Administration for Children and Families, U.S. Department of Health and Human Services.</li><li>Tyler, P. M., Mason, W. A., Vollmer, B., Trout A. L. (2020) Practice to Research and Back in a Social Service Agency: Trying to DO BETTER. <i>Child & Youth Care Forum</i>, https://doi.org/10.1007/s10566-020-09548-3.</li></ol><h2>Research Newsletter</h2><p>Please sign up to receive occasional research news and events emails from Boys Town National Research Hospital.</p><div align="center"> <a class="button is-primary" href="https://www.boystownhospital.org/research/newsletter">Newsletter Sign-Up</a></div>
Research During the COVID-19 Pandemic<img alt="" src="https://assets.boystown.org/hosp_peds_images/Research-Isolation-Stress-Kids-During-Pandemicrollup.jpg" style="BORDER:0px solid;" />https://www.boystownhospital.org/news/research-during-covid-19-pandemicResearch During the COVID-19 Pandemic2020-06-03T05:00:00Z<p>​​​Life-changing research doesn't stop during a pandemic. For more than 40 years, Boys Town National Research Hospital has been conducting research to improve lives. Our mission is to change the way America cares for children and families. Below are some of the ways we are continuing our mission during these unprecedented times.</p><h2>Continuing to Train and Innovate</h2><p>Each year, Boys Town Hospital selects audiology student investigators to participate in a summer research traineeship. This program is designed to give formal research experience through a mix of clinical and research audiology experiences, presentations, and scientific group discussions. This summer we will still host our students, and they will be challenged to find new ways to answer questions about hearing and speech recognition through virtual tools.</p><h2>Research Forging Ahead</h2><p>With the current pause in inviting research volunteers to come to our laboratories to participate in studies, our researchers have moved to online interviews, questionnaires and mobile applications for testing. Some studies are even collecting hair or other biological samples, which can be done with simple instructions through the mail, for needed data.</p><h2>Researching Health Outcomes of the Pandemic</h2><p>Our behavioral health scientists regularly investigate brain development as well as asking how traumatic experiences such as abuse and neglect affect neural, cognitive​, and social development. Unfortunately, this COVID-19 pandemic has presented a societal trauma on a very large scale, including impacts on our youth who have experienced weeks of disruption to their school, daily routines and social lives. </p><p>Additionally, new precautions for wearing masks and social distancing may have an even greater impact on children with hearing and communications difficulties. These kids rely more than others on facial expressions to get the full meaning of speech. Our hearing and language experts are looking at how this new reality is affecting them and way we might be able to help.</p><p>Our researchers are working with our youth care programs to monitor how these large-scale disruptions in daily life, and the accompanying stress, are affecting treatment progress and outcomes. The research team is uniquely positioned to examine the effects of these changes on children and adolescents through our community relationships with families and care providers. Over the coming months, these researchers will be helping the nation understand how the isolation, change in routines, and the stress of the pandemic have affected our youth.​</p><h2>Research Newsletter</h2><p>Please sign up to receive occasional research news and events emails from Boys Town National Research Hospital.</p><div align="center"> <a class="button is-primary" href="https://www.boystownhospital.org/research/newsletter">Newsletter Sign-Up</a></div>​<br>
Residential Care for At-Risk Youth has Long-Term Economic Benefits for Governments and Society<img alt="" src="https://assets.boystown.org/hosp_peds_images/Residential-Care-has-Economic-Benefits-rollup.jpg" style="BORDER:0px solid;" />https://www.boystownhospital.org/news/economic-benefits-helping-at-risk-youthResidential Care for At-Risk Youth has Long-Term Economic Benefits for Governments and Society2020-04-27T05:00:00Z<p>​​Residential care for youth with severe emotional or behavioral issues involves intensive treatment and around-the-clock care. This makes the cost of care high and policy makers often want to know if there are other ways to provide this care or to reduce the amount of services in order to reduce costs. However, young people typically end up in these programs only after multiple other forms of care have been tried and failed, making group residential care programs very important. Therefore, it is vital to show the value of these services and to advocate for continued support.</p><p>Researchers at Boys Town and elsewhere have been looking at ways to place the context of residential care in relationship to the costs of not providing these services. In a recent study, Jonathan C. Huefner and his colleagues adapted a previously developed Return on Investment Tool (ROI tool) for use with Boys Town’s Family Home Program data [1]. The ROI tool relates the cost of care to projected government fiscal and societal impacts, including increased economic contributions after treatment, tax revenue increases from employment gains, and costs associated with criminal recidivism and dependency on safety-net programs like unemployment [2].</p><p>The study looked at 141 individuals who had been treated for less than 6 months (median stay of 3.7 months) and 1031 who had been in treatment for longer than 6 months (median stay of 18.4 months). Outcomes were assessed by a 35-question assessment that was given 24 months after treatment. To compare the 2 groups, the authors normalized the data for the smaller group to the cost of similarly treating 1031 youth. Costs can only be compared for shorter treatment vs. longer treatment because it would be unethical to have a comparison group of young people needing treatment that do not receive it.</p><p>When it comes to cost, one thing that policy makers are often concerned about is whether there is really a need for longer, more costly stays; represented here as stays longer than 6 months. They reasonably want to know if a shorter stay could produce similar results while saving expense. In this study, the authors report that there was a definite benefit for kids who were in treatment for longer than 6 months, with higher educational achievement, better employment outcomes, and​ reduced recidivism. Here is a brief summary of the findings in this paper [1]:</p><ul><li>The estimated cost to care for 1031 kids for 6 months or less was approximately $29 million, whereas the estimated cost for the same number of youth in treatment for more than 6 months was $153 million.</li><li>The net benefit to government is estimated at $44 million through increased revenue and decreased expenditures in the future. However, with the increased cost of care for longer treatment amounts to an $80 million additional cost to the government.</li><li>The societal savings through increased productivity, better employment, and other contributions over a 40-year adult lifetime increased for the more-than-6-month group by $325 million.</li><li>For the group that received more than 6 months of care, the authors calculate that for every $1 spent the societal lifetime return is $3.61.</li></ul><p>A short-term perspective which focuses only on governmental expenditure might conclude that the cost of care is greater than the fiscal returns. This perspective ignores the real human impacts of not taking care of these kids, which most people would not advocate. However, adult lifetime societal savings that are realized by giving kids who need it more care, training and education makes it clear that complete treatment has financial benefits that exceed any arbitrary cutoff. Such improvements (e.g., increased productivity and wages) have a direct impact on the community through spending and investment by these individuals over time. These outcomes should be of concern to policy makers who we need to support these programs.</p><h2>References</h2><ol><li>Huefner J.C., Jay L. Ringle J.L., Thompson R.W., and Wilson F.A., (2018) Economic evaluation of residential length of stay and long-term outcomes. Residential Treatment for Children & Youth, 35(3), 192–208.</li><li>Wilson F.A., Araz O.M., Thompson R.W., Ringle J.L., et. al. (2016) A decision support tool​ to determine cost-to-benefit of a family-centered in-home program for at-risk adolescents. Eval Program Plann, 56, 43–49.</li></ol><h2>Research Newsletter</h2><p>Please sign up to receive occasional research news and events emails from Boys Town National Research Hospital.</p><div align="center"> <a class="button is-primary" href="https://www.boystownhospital.org/research/newsletter">Newsletter Sign-Up</a></div>
Awareness of Developmental Language Disorder is Improved by Using Clear Terminology<img alt="" src="https://assets.boystown.org/hosp_peds_images/Awareness-of-Dev-Language-Disorder-clear-rollup.jpg" style="BORDER:0px solid;" />https://www.boystownhospital.org/news/developmental-language-disorder-terminology-awarenessAwareness of Developmental Language Disorder is Improved by Using Clear Terminology2020-04-10T05:00:00Z<p>​Millions of people in the United States struggle to learn language because of an underlying difference in how their brain develops. Despite the large numbers of people affected, many people are not aware of this because of a confusing array of diagnostic terms and inconsistent criterion for diagnosis. Additionally, better awareness and clear terminology will make it easier to get resources for treatment and new research into causes and therapies.</p><p>Boys Town National Research Hospital is a leader in hearing and communications related research. Our research team, led by <a href="https://www.boystownhospital.org/research/faculty/karla-mcgregor">Karla McGregor, Ph.D.</a> and others are working to raise awareness of Developmental Language Disorder (DLD), as well as developing tools to help clinicians, families, and educators to deal with associated challenges.</p><p>In a recently published paper, Dr. McGregor and her colleagues define DLD, describe the difference between DLD and specific language impairment (SLI), and discuss advantages of for using DLD over other terms, including SLI. They define DLD as ‘a language problem that endures into middle childhood and beyond and that has a significant impact on social or educational function DLD is a spectrum disorder where some individuals have relatively exclusive language deficits and normal non-verbal IQ scores, while others have co-occurring deficits or low-normal-range IQs” [1].</p><div class="is-clearfix"><div class="inline-image is-size-7">​​​​​​​​<img src="https://assets.boystown.org/hosp_peds_images/DLD-infographic.png" alt="What is Developmental Language Disorder infographic" class="inline-image__image" /> <h2 class="is-size-5">What is Developmental Language Disorder?</h2><p>Source: <a href="https://www.dldandme.org/" target="_blank">DLDandMe.org</a></p></div>​ <p>One of the major benefits of using DLD as the diagnostic term is that it includes and emphasizes the social and educational influences of language problems. These are the most challenging problems individuals face with language disorders and will be the reason many will seek help. These functional consequences of DLD can also lead to kids acting out or become depressed and isolated. Unlike a more simplistic approach of using cutoff scores from language or intelligence testing, including functional aspects into the definition improves overall understanding and, hopefully, will open the door to greater availability of resources for affected individuals. The recommendation from the authors of this paper is to emphasize the severity of the impact of DLD on social interactions and academic success over scores when diagnosing DLD [1].</p><p>A key aspect of this paper is to improve awareness of the DLD terminology. With a myriad of terms used to describe developmental language conditions, it is hard for people outside of speech-language pathologists and researchers to understand the scale of the problem. The authors emphasize the use DLD as a unifying term that is widely used and understood, to create an international platform for information, education, advocacy, and resources. Indeed, the authors and their colleagues at Raising Awareness of Developmental La​nguage Disorder (<a href="https://radld.org/" target="_blank">RADLD</a>) and <a href="https://www.dldandme.org/" target="_blank">DLDandMe.org</a> have already made quite a bit of progress to increase awareness and provide resources to those who need it. Check out the full, open-access article in Perspectives of the ASHA Special Interest Groups, at ASHA.org [1].</p><h2>References</h2><ol><li>1. Karla K. McGregor, K. K., Goffman, L., Van Horne, A. O., et. al. (2020) <i> <a href="https://pubs.asha.org/doi/10.1044/2019_PERSP-19-00083">Developmental Language Disorder: Applications for Advocacy, Research, and Clinical Service</a></i>. Perspectives of the ASHA Special Interest Groups; 5(1) 38–46.</li></ol><h2>Research Newsletter</h2><p>Please sign up to r​eceive occasional research news and events emails from Boys Town National Research Hospital.</p><div align="center"> <a class="button is-primary" href="https://www.boystownhospital.org/research/newsletter">Newsletter Sign-Up</a></div></div>
Social Problem-Solving Skills are Protective for Youth Exposed to Trauma<img alt="" src="https://assets.boystown.org/hosp_peds_images/Social-Problem-Solving-Skills-rollup.jpg" style="BORDER:0px solid;" />https://www.boystownhospital.org/news/social-problem-solving-skills-youth-traumaSocial Problem-Solving Skills are Protective for Youth Exposed to Trauma2020-03-31T05:00:00Z<p>​​​​​Childhood trauma changes the way that children’s brains function, and many traumatized kids end up with post-traumatic stress disorder (PTSD). Researching and developing methods ​to ​provide the best care for these kids is the role of the Child and Family Translational Research Center at Boys Town. The research that we do directly informs our staff, and other organizations, who are responsible for caring for kids who have experienced trauma.</p><p>​A major challenge to providing effective therapies is that the type and th​e severity of trauma experienced affect young brains differently [1]. Boys Town has developed a screening instrument to identify possible symptoms youth may have related to past trauma [2] and uses a <a href="https://www.boystownhospital.org/news/trauma-informed-care-critical-for-youth">trauma-informed care model</a> to avoid further traumatization. Boys Town care providers use the questionnaire to determine the suppo​rts and services youth need to help children heal. However, more research is always needed to support existing practices and to help us to continually improve how we take care of at-risk kids.</p><p>In a recent publication, Patrick Tyler, Ph.D., Director of Research Translation, and his colleagues evaluated outcomes for 667 youth, ages 10–18 years old, who received social skills training as part of our trauma informed care model. For this study, the researchers were also focused on kids with more severe trauma and PTSD. The social training was broken down into 3 focus categories: self-advocacy, emotional regulation, and problem solving. The youth in this study were receiving group home services in the Boys Town Family Home Program, which involves direct-care staff residing with them in a family-type setting [3]. The social skills training is also an integral part of their treatment to help them manage their emotions and develop skills for healthy interactions in the home and after they leave. Duration of treatment was a significant factor, with kids who were in treatment longer showing more improvement that those with shorter stays.</p><p>Social skills training for the children was conducted by following established practices at Boys Town. The specific social skills training varied for each child based on the assessment of their needs by their care providers. The researchers were looking for improvements in behavioral incidents, self-injury, conduct, and emotional problems. </p><p>From the 3 categories of social skills t​raining that were examined, the authors noted that all types helped to some degree with behavioral problems. However, problem-solving training had the biggest effect on both behavioral incidents and emotional problems, such as anxiety and depression. This suggests that prioritizing problem-solving skills is an approach that could help a large proportion of traumatized kids. It also offers a narrowed set of skills that can be supp​orted by educators or other caregivers who could receive focused training in this area. Having this support to maintain these skills after a child leaves clinical or residential care may be the best way to help these kids stay healthy.</p><p>You can read more about this study, currently in press, in the journal, <i>Psychological Trauma: Theory, Research, Practice and Policy</i> [3].</p><h2>References</h2><ol><li>Blair K.S., Aloi J., Crum K., et. al. (2019) Association of Different Types of Childhood Maltreatment With Emotional Responding and Response Control Among Youths. 2(5). JAMA Netw Open.</li><li>Tyler, P.M., Mason, W.A., Chmelka, M.B., et. al. (2019) Psycho​metrics of a Brief Trauma Symptom Screen for Youth in residential care Journal of Traumatic Stress. doi: 10.1002/jts.22442.</li><li>Tyler, P.M., Aitken, A.A., Ringle, J.L., et. al. (2020) Evaluating Social Skills Training for Youth with Trauma Symptoms in Residential Programs. (In Press). Psychological Trauma: Theory, Research, Practice and Policy.</li></ol><h2>Research Newsletter</h2><p>Please sign up to receive occasional research news and events emails from Boys Town National Research Hospital.</p><div align="center"> <a class="button is-primary" href="https://www.boystownhospital.org/research/newsletter">Newsletter Sign-Up</a></div>
School Success as an Adult is Influenced by Childhood Traumahttps://www.boystownhospital.org/news/childhood-trauma-influences-later-school-successSchool Success as an Adult is Influenced by Childhood Trauma2020-03-11T05:00:00Z<p>​​Success as an adult is associated with educational achievement. Unfortunately, kids who experience childhood trauma and maltreatment are more likely to struggle academically and later in life. There are many ways that kids experience maltreatment, including neglect, emotional, physical, and sexual abuse. These events affect many aspects of development. Furthermore, different types of trauma can be associated with different outcomes that need to be understood in order to correctly focus resources and therapies.</p><p>In a recent paper Jay Ringle, M.A., at the <a href="https://www.boystownhospital.org/research/translational-research">Boys Town Child and Family Translational Research Center</a>​, and his colleagues tested a developmental cascades model for potential direct and indirect effects of childhood maltreatment on adult educational achievement [1]. The developmental cascades model essentially means that a traumatic event or series of events can alter or disrupt a child’s developmental transitions, thus creating a cascading effect of maladaptation. One result of this can be lower adult academic achievement [2]. For this study, the researchers used longitudinal data on a sample of children and their families assessed 4 times over 30 years, starting in the 1970s [3, 4]. The data were a mix of self-report measures and agency-reported case information.</p><p>Finding direct impacts of any event over a long period of time is difficult, largely due to the number and variety of events that individuals experience. With that in mind, this study only found a direct effect of agency-reported cases of maltreatment — which are likely to be made up of more severe cases than just self-reported cases — and adult educational achievement. Further, the researchers did find several indirect impacts. For example, neglect predicted adolescent engagement academic engagement, which in turn predicted adult educational achievement. Adolescent school discipline reports were also predictive of adult educational achievement.</p><p>With regards to the different categories of abuse, the stud​y found that physical, emotional, and sexual abuse predicted early school-age attention problems that then predicted discipline issues. On the other hand, neglect indirectly impacted adult education achievement through lower ​school engagement in adolescence.</p><p>Perhaps the most important thing to take away from this study is that a case-specific educational approach will more benefi​cial to kids exposed to childhood trauma than a one-size-fits-all approach. This study provides some perspective on different types of childhood maltreatment and how it effects adult educational achievement through different pathways (e.g., attention problems, poor school engagement) The findings also provide a starting point for creating appropriate interventions. For example, positive school-based interventions for kids who have experienced maltreatment are likely to be a more effective approach than punishment. Additionally, developing alternative approaches to get kids who have suffered neglect to engage in school has the potential to make a difference in where they end up.</p><p>Boys Town has been taking care of at-risk kids for more than 100 years. Scientists at Boys Town National Research Hospital also conduct influential research on youth care programs so we can provide the best care possible here and help other schools and youth-care organizations to do the same. The findings from this study are published in Childhood Maltreatment [1]. Find more about our youth care and related research by visiting <a href="https://www.boystown.org/research/Pages/Translastion-Research-Center.aspx" target="_blank">Child and Family Translational Research Center</a>.</p><h2>References</h2><ol><li>Jay L Ringle, J.L., Mason, W.A., Todd I Herrenkohl H.I., et. al. (2020) Prospective Associations of Child Maltreatment Subtypes With Adult Educational Attainment: Tests of Mediating Mechanisms Through School-Related Outcomes. Child Maltreat. EPUB ahead of print.</li><li>Masten, A. S., Roisman, G. I., Long, J. D., et. al. (2005). Developmental cascades: Linking academic achievement and externalizing and internalizing symptoms over 20 years. Dev Psychol, 41(5), 733–746.</li><li>Herrenkohl, R. C., Herrenkohl, E. C., Egolf, B. P., et. al. (1991) The developmental consequences of child abuse: The Lehigh Longit​udinal Study. In R. H. J. Starr & D. A. Wolfe (Eds.), The effects of child abuse and neglect: Issues and research (pp. 57–81). Guilford Press.</li><li>Herrenkohl, R. C., and Herrenkohl, T. I. (2009) Assessing a child’s experience of multiple maltreatment types: Some unfinished business. J. Fam Violence, 24(7), 485–496.</li></ol><h2>Research Newsletter</h2><p>Please sign up to receive occasional research news and events emails from Boys Town National Research Hospital.</p><div align="center"> <a class="button is-primary" href="https://www.boystownhospital.org/research/newsletter">Newsletter Sign-Up</a></div>
Boys Town National Research Hospital Researchers Investigate Hearing and Speech Perception in Down Syndromehttps://www.boystownhospital.org/news/hearing-speech-perception-in-down-syndromeBoys Town National Research Hospital Researchers Investigate Hearing and Speech Perception in Down Syndrome2020-03-03T06:00:00Z<p>​It takes years of consistent, high-quality auditory information to develop the ability to effectively “hear out" one person talking (for example, a teacher) when other people are talking in the background (for example, classmates).  Children with Down syndrome may be at risk for disruptions in this developmental process because of the high prevalence of middle ear infections and hearing loss that occur in this population. Despite these risk factors, very few research studies have looked at how well children with Down syndrome understand speech in noisy environments, such as the classroom.</p><p>Lori Leibold, Ph.D. and Heather Porter, Ph.D., along with their colleagues at the Center for Hearing Research at Boys Town National Research Hospital, are working to identify factors that improve listening-in-noise difficulties so we can increase the likelihood of success for children with Down syndrome. Dr. Porter explains that, “In general, kids have a harder time than adults when listening to speech if other people speaking. This is partly because we develop the ability to tune out background noise through experience. Problems with hearing get in the way of the brain learning to filter out distracting sounds. Therefore, we expect to see that this developmental process is impacted in kids with Down syndrome, and that it will be influenced differently for individuals by their varying sensory, language, and cognitive characteristics." </p><div class="is-clearfix"><div class="inline-image is-size-7"> <img src="https://assets.boystown.org/hosp_peds_images/Computer-Screen.png" alt="computer screen children see when listening to speech-in-noise task" class="inline-image__image" style="max-width:100%;" /> <p>Figure 1. Example of the computer screen children see when listening to the speech-in-noise task.</p></div><p style="margin-bottom:1rem;">The team of researchers at Boys Town National Research Hospital has established Project INCLUDE to learn more about the communication abilities of children with Down Syndrome. Children who participate in this study complete a series of measures that assess hearing, language, and problem-solving abilities. Hearing assessments are completed using developmentally-appropriate, game-like tasks and children have the ability to demonstrate their listening skills using a touchscreen computer application (see Figure 1). The research team has decades of experience working with children with developmental delays, which they use to ensure participants and their families are also welcomed to a friendly and engaging environment. </p></div><p>Families of children with Down syndrome ages 5 to 17 years old are invited to participate in this study.  The study includes up to three visits that last 1–2 hours each. In addition, children receive hearing and language assessments by licensed professionals with expertise working with children with developmental delays. Information from this study will help us to determine influences on the developmental timeline for listening-in-noise in children with Down syndrome and serve as the basis for future funding applications to support work in this area. Compensation for this study is $15 per hour.</p><p>Boys Town National Research Hospital is dedicated to improv​ing care for children and families around the world. This research is important because Down syndrome is a common condition, affecting about 1 in 1000 people in the US, and gaps in our knowledge could have a negative impact on the care and services people receive. As we increase our understanding, we anticipate that we will be able to improve the services children with Down syndrome receive both locally and nationally.</p><p>This study is funded by the National Institutes of Health INCLUDE (INvestigation of Co-occurring conditions across the Lifespan to Understand Down syndromE) Project, launched in June 2018 in support of a Congressional initiative to investigate critical health and quality-of-life needs for individuals with Down syndrome [1]. The results from Project INCLUDE at Boys Town National Research Hospital will contribute to national INCLUDE goals by identifying factors associated with successful speech understanding in less-than-optimal listening environments and result in opportunities for improved communication outcomes for individuals with Down syndrome.</p><h2>References:</h2><ol><li> <a href="https://www.nih.gov/include-project">https://www.nih.gov/include-project</a></li></ol><h2>Research Newsletter</h2><p>Please sign up to receive occasional research news and events emails from Boys Town National Research Hospital.</p><div align="center"> <a class="button is-primary" href="https://www.boystownhospital.org/research/newsletter">Newsletter Sign-Up</a></div>
Remarkable New Sound Research Facility added at Boys Town National Research Hospitalhttps://www.boystownhospital.org/news/anechoic-chamber-sound-research-facilityRemarkable New Sound Research Facility added at Boys Town National Research Hospital2020-01-20T06:00:00Z<p>​​​The first thing you notice when entering the new anechoic chamber at Boys Town National Research Hospital is how big the chamber is. The large white cube stands over 18 feet high and occupies roughly 400 square feet of floor space. The anechoic chamber is the newest addition to our sound research facilities and is also the most advanced facility of its kind in the region.</p><p>The chamber is isolated from outside noise and vibrations by thick walls and sound-deadening insulation. The walls, floor, and ceiling inside the chamber are also completely covered by triangular shaped structures called anechoic wedges that are 19 inches tall. The shape, size and arrangement of the wedges are designed to control all but the lowest frequency​ sound reflections inside the booth. (Figure 1). Finally, a floating, mesh floor suspends occupants above the same wedges in the floor of the structure. These features make the inside of the chamber very quiet with virtually none of the reflected environmental sounds that we hear without thinking about every day. It’s an interesting location to talk to G. Christopher (Chris) Stecker, PhD, the director of the Spatial Hearing Lab, about the new facility.</p><div class="embed-container"> <iframe width="560" height="315" src="https://www.youtube.com/embed/IDAwSz8YT_g" frameborder="0"></iframe> </div>​ <p>Inside, the chamber is configured with a 96-channel speaker system to enable a range of sound simulations and experiments. Dr. Stecker explains that “the array is used for research on hearing and localization of sounds in 3-dimensional spaces. For example, the system can simulate classroom sound environments that helps researchers understand how children develop the ability to focus on one person who is speaking without being confused or distracted by other speakers or noises. This research is relevant for things like refining hearing aid and cochlear implant technology so that they convey the best possible spatial and voice information. Interestingly, the same equipment can also be used to demonstrate for others how a noisy world sounds through a hearing aid or cochlear im​plant."</p><div class="is-clearfix"><div class="inline-image is-size-7">​​​​​​​​<img src="https://assets.boystown.org/hosp_peds_images/anechoic-chamber-wedges.png" alt="anechoic chamber wedges installation details" class="inline-image__image" /> <h2 class="is-size-5">Figure 1.</h2><p>Anechoic wedges, 19 inches measured from base to apex of the triangle, cover the walls floor and ceiling to eliminate all but the lowest frequency sound reflections inside the chamber.</p></div>​ <p>In another type of experiment, tiny microphones can be placed on the ear to measure the influence of head position and ear anatomy on our perception of sound location with assistance from the large speaker array. One use of this capability according to Dr. Stecker is testing by companies developing virtual reality applications. “In order to create convincing virtual environments, it is necessary to know how sound coming from different locations is affected by the ear anatomy so sound cues can be simulated by headphones placed physically on the ear.”</p><p>The described experiments are only some examples of what is possible in the anechoic chamber. We expect that othe​r labs and other research institutions will want to answer a wide range of sound related questions in this space. Support services for the anechoic chamber will also be available through our technology core services. Those interested in conducting research using the anechoic chamber can contact Dr. Chris Stecker in the Spatial Hearing Lab at Boys Town Hospital.</p><p>We are grateful to the National Institutes of Health (NIH), and the Great Plains Institutional Development​ Award for Clinical and Trans​lational Research (IDeA-CTR) for the financial support that helped make the chamber a reality. The Great Plains IDeA-CTR is an NIH-funded program to increase training, collaboration, development of core facilities, and resources for clinical and translational research at in our region. </p><h2>Research Newsletter</h2><p>Please sign up to receive occasional research news and events emails from Boys Town National Research Hospital.</p><div align="center"> <a class="button is-primary" href="https://www.boystownhospital.org/research/newsletter">Newsletter Sign-Up</a></div></div>
Checking Speech Audibility is Important When Assessing Kids with Mild Bilateral Hearing Losshttps://www.boystownhospital.org/news/checking-speech-audibility-importance-when-assessing-hearing-lossChecking Speech Audibility is Important When Assessing Kids with Mild Bilateral Hearing Loss2020-01-19T06:00:00Z<p>​​​​​​​​​​The ability to hear is directly connected with children’s development of the written and spoken language skills that are essential for many aspects of life. However, there is some confusion and disagreement regarding whether children with mild, bilateral hearing loss should receive hearing aids. Compared to young children with moderate or severe hearing loss, children with mild hearing loss may be able to hear some speech sounds without the use of hearing aids. The impact of mild hearing loss on early speech and language development can be subtle and easy to miss by parents and doctors alike, but without intervention these children may still be at risk for later language delays. Therefore, providing better assessment of the impact of hearing aids for children with mild hearing loss would be a great benefit to families and audiologists who are working to help them.</p><p> <a href="https://www.boystownhospital.org/research/faculty/ryan-mccreery">Ryan McCreery, Ph.D., Director of Research at Boys Town National Research Hospital</a>, and his team have been looking at how amplification, language, and cognition support speech perception in children who are hard of hearing in order to improve outcomes. In a recent paper, Dr. McCreery and colleagues specifically examined the use of a standardized Speech Intelligibility Index (SII) score <sup>[1]</sup>, measured without hearing amplification, as a new tool for assessing hearing aid candidacy for children with mild hearing loss<sup>[2]</sup>. Their goal was to develop an evidence-based criterion for when children with mild hearing loss would benefit from hearing aids.</p><p>The SII uses audiological measurements and takes into account individual ear acoustics to predict a child’s access to speech sounds <sup>[1]</sup>. Children with scores less than 80 on the unaided SII should be consid​ered candidates for amplification because of risks for language problems. This score would correspond to pure tone averages of 20 to 30 dB of hearing loss but is more informative than just measuring dB of hearing loss from the audiogram <sup>[2]</sup>.</p>​ <p>Another goal of the study was to determine how much hearing loss poses a risk to language development. Dr. McCreery and his team found that children who were able to hear 80% of speech sounds, or less, without hearing aids were at risk of delays in language and vocabulary development, emphasizing the need for more meaningful testing <sup>[2]</sup>.</p><p>Based on the results from the study, Dr. McCreery and colleagues recommend that clinical audiologists include speech audibility as part of a standard for hearing aid fitting instead of the hearing test. Specifically, the authors found th​at hearing aids could support language development for children with mild hearing loss who hear 80% or less of regular speech sounds. In addition to providing a clear criteria for fitting hearing aids, discussing hearing loss in terms of speech audibility can help families of children with mild hearing loss better understand the benefits of consistent hearing aid use on language development.</p><p>The authors’ complete findings can be found in the journal, <em>Language, Speech, and Hearing Services in Schools</em>.</p><div class="embed-container"> <iframe width="560" height="315" src="https://www.youtube.com/embed/ZR6ZJ-Wxbb0" frameborder="0"></iframe> </div><h3>References</h3><ol><li>American National Standards Institute. (1997). <em>American National Standard: Methods for calculation of the speech intelligibility index</em>. Acoustical Society of America.</li><li>McCreery R.W., Walker E.A., Stiles D.J., Spratford M., et. al. (2020) <em>Audibility-based hearing aid fitting criteria for children with mild bilateral hearing loss</em>. Lang S​peech Hear Serv Sch. 51(1): 55–67. https://doi.org/10.1044/2019_LSHSS-OCHL-19-0021​<br></li></ol><h2>Research Newsletter</h2><p>Please sign up to receive occasional research news and events emails from Boys Town National Research Hospital.</p><div align="center"> <a class="button is-primary" href="https://www.boystownhospital.org/research/newsletter">Newsletter Sign-Up</a></div>
Boys Town Researchers Find that Cannabis Changes how the Brain Responds to Threatshttps://www.boystownhospital.org/news/cannabis-changes-threat-responseBoys Town Researchers Find that Cannabis Changes how the Brain Responds to Threats2019-11-08T06:00:00Z<p>​​​​Cannabis use is becoming increasingly acceptable in the United States with several states legalizing cannabis for medical uses, and some states moving to decriminalization of recreational usage. However, increased access to cannabis is also creating potential harms, especially for adolescents whose brains are still developing.</p><p>James Blair, Ph.D., Susan and George Haddix Endowed Chair in Neurobehavioral Research, and his research team at Boys Town National Research Hospital are interested in how cannabis and alcohol use affects neurodevelopment. They recently published a study where they measured brain activity in 43 male and 44 female adolescents, ages 14–18, who volunteered for the study.​<br></p><p>The researchers specifically looked at how the brain responds to threatening stimuli in young people with different levels of alcohol use disorder (AUD) or cannabis use disorder (CUD) symptoms [1]. The teens saw threatening (angry faces, predatory animals) or neutral images. These appeared to loom towards (or recede from) the adolescents who were lying in a magnetic resonance imaging (MRI) scanner. This scanner detects brain activity through localized changes in blood flow.<br></p><p>Dr. Blair’s team found that more severe CUD, but not AUD, symptoms were related to less responding to looming threats within brain structures such as the rostral frontal cortex and the amygdala. These are brain regions critically involved in emotional processing.<br></p><p>The ability to respond to threats is important for guiding people away from dangerous or risky choices. In other work conducted previously by Dr. Blair’s team, reduced responding to threat on the same task has been related to an increased risk for aggression and antisocial behavior. The link between increased CUD and reduced threat processing may underpin some of the recent findings linking cannabis abuse to aggression. There remains a lot that we don’t know how cannabis and alcohol affect developing brains, and what changes may become long-term changes. For a more detailed review of these findings see the paper Threat Responsiveness as a Function of Cannabis and Alcohol Use Disorder Severity [1].</p><h2>References</h2><ol><li>​Blair R.J.R., White S.F., Tyler P.M., Johnson K., et. al., (2019) <em>Threat Responsiveness as a Function of Cannabis and Alcohol Use Disorder Severity</em>. J Child Adolesc Psychopharmacol. 29(7):526–534.</li><li>Coker-Appiah D.S., White S.F., Clanton R., Yang J., Martin A., Blair R.J. (2013) <em>Looming animate and inanimate threats: The response of the amygdala and periaqueductal gray</em>. Soc Neurosci 8:621–630.<br></li></ol><h2>About Boys Town National Research Hospital</h2><p>Boys Town National Research Hospital offers a broad range of hospital and clinic services, backed by 40 years of life-changing research to provide the latest, most innovative care to our patients. The Hospital is internationally recognized as a leader in hearing research and clinical care and is leading research efforts in language and neuroscience to improve the lives of children and families across America.</p>​<br>
Boys Town National Research Hospital Receives NIH HEAL Initiative Grant to Address the Opioid Epidemichttps://www.boystownhospital.org/news/Grant-to-Research-Opioid-ImpactsBoys Town National Research Hospital Receives NIH HEAL Initiative Grant to Address the Opioid Epidemic2019-10-10T05:00:00Z<p>​​​Boys Town National Research Hospital, Omaha NE,​​ has been awarded a grant from the National Institutes of Health (NIH) in the amount of $552,000 as part of its Helping to End Addiction Long-term Initiative, or the NIH HEAL Initiative. Boys Town Hospital is one of 29 sites that will be taking part in the HEALthy Brain and Child Development Study (HBCD) as part of the NIH HEAL Initiative.  </p><p>The HBCD Study will establish a large cohort of pregnant women from regions of the country that have been significantly affected by the opioid crisis and follow them and their children for at least 10 years. Findings from this cohort will help researchers understand normative childhood brain development as well as the long-term impact of prenatal and postnatal opioid and other drug and environmental exposures. Boys Town Hospital has a long history of working with children and families dealing with sensitive health issues and is uniquely suited to help with this important research. </p><p>Led by James Blair, Ph.D.—Susan and George Haddix Endowed Chair in Neurobehavioral Research and Director, Center for Neurobehavioral Research in Children—Boys Town Hospital researchers will be investigating the impact of pre-natal exposure to opioids on brain, cognition and hearing development using a variety of imaging, behavioral testing and advanced statistics. According to Dr. Blair, “Children exposed to prenatal and postnatal drug abuse face considerable difficulties. To help these children, we need to understand how this exposure affects brain development. The HBCD study is an unprecedented opportunity to achieve this goal.”</p><p>According to Dr. Blair, “Recent work has told us much about how the first few years of life are a period of exponential brain growth and development. However, the effects of early exposure to opioids on normal infant and child development are unknown.”</p><p>The NIH launched the Helping to End Addiction Long-term Initiative, or NIH HEAL Initiative, to improve prevention and treatment strategies for opioid misuse and addiction and enhance pain management. The NIH HEAL Initiative has multiple focus areas and aims to improve treatments for chronic pain, curb the rates of opioid use disorder and overdose, and achieve long-term recovery from opioid addiction.</p><p>“It’s clear that a multi-pronged scientific approach is needed to reduce the risks of opioids, accelerate development of effective non-opioid therapies for pain and provide more flexible and effective options for treating addiction to opioids,” said NIH Director Francis S. Collins, M.D., Ph.D., who launched the initiative in early 2018. “This unprecedented investment in the NIH HEAL Initiative demonstrates the commitment to reversing this devastating crisis.”</p><div><h2>About Boys Town National Research Hospital</h2><p>Boys Town National Research Hospital offers a broad range of hospital and clinic services, backed by 40 years of life-changing research to provide the latest, most innovative care to our patients. The Hospital is internationally recognized as a leader in hearing research and clinical care and is leading research efforts in language and neuroscience to improve the lives of children and families across America.</p>​<br></div>
The Vocal Development Landmarks Interview Helps Clinicians and Families Track Vocal Developmental Milestoneshttps://www.boystownhospital.org/news/vocal-development-landmarks-interviewThe Vocal Development Landmarks Interview Helps Clinicians and Families Track Vocal Developmental Milestones2019-09-18T05:00:00Z<div class="embed-container">​​​ <iframe src="https://www.youtube.com/embed/AckEv3CcXtI" width="560" height="330" frameborder="0"></iframe> </div> ​ <p>Monitoring how babies progress through the early stages of vocal development is important for professionals and families, especially when infants have developmental challenges, such as cerebral palsy, hearing loss, down syndrome, cleft palate, or other special needs. It is essential that children who are at risk for speech and language delays are identified as early as possible so interventions can be tailored to minimize developmental risk. Drs. Mary Pat Moller and Sophie Ambrose at Boys Town National Research Hospital, along with Dr. Anne Thomas of the University of Nebraska-Lincoln, developed the Vocal Development Landmarks Interview (VDLI) for this purpose. </p><p>They recognized that the best way for professionals to monitor an infants' vocal development is to ask the parents about the child's vocal productions. However, they also realized that a better tool was needed to allow professionals to do that. The VDLI is a parent-report instrument for infants and young children who are not developmentally ready to cooperate with more structured testing [1]. It incorporates what has been learned from years of laboratory-based observations about the orderly stages of vocal development that babies go through and involves parents as the best resource for understanding if their child is meeting these vocal milestones. </p><p>The VDLI design uses a series of digital slides with audio files containing authentic infant vocalizations to ensure parents know exactly what vocal behavior the professional is asking them to report on. The vocal behaviors are also arranged in developmental order, beginning with those typically observed by 6 months of age and ending with those typically observed by 21 months of age.</p><p>According to Dr. Ambrose, “The feedback we've gotten is that the tool really helps both parents and clinicians learn about behaviors to watch for and which behaviors to encourage the development of next in early intervention." She also indicated that clinicians reported wanting a tool that was easy to use with families in homes, which led the team to collaborate with the Technology Core at Boys Town National Research Hospital to create the VDLI as an iOS App that allows for maximum accessibility and portability. For more information on the VDLI, watch the included video in this article or access their recent publication cited below. For help with downloading the app and its related resources, you can contact Dr. Ambrose at sophie.ambrose@boystown.org. </p><h1>References</h1><ol><li>Moeller, M. P., Thomas, A. E., Oleson, J., & Ambrose, S. E. (2019). Validation of a parent report tool for monitoring early vocal stages in infants. <em>Journal of Speech, Language, and Hearing Research, 62</em>(7), 2245–​2257. <a href="https://linkprotect.cudasvc.com/url?a=https://doi.org/10.1044/2019_JSLHR-S-18-0485&c=E%2c1%2cTyO9MT8ZeqKqTirqyM4xKxHff156PQsvhkojUIsEvKRTjCOZGYRCZtCYAtis0fB9fSOCsaPzhZ99XRXf3PmhDNSRbXQqOfmSbvP7fua6hmyPH2ofJQ%2c%2c&typo=1">https://doi.org/10.1044/2019_JSLHR-S-18-0485</a>​<br></li></ol>​​​​ <br>
Trauma-Informed Care is Critical for Youth Needing Residential Serviceshttps://www.boystownhospital.org/news/trauma-informed-care-critical-for-youthTrauma-Informed Care is Critical for Youth Needing Residential Services2019-08-26T05:00:00Z<p>​​​​​​​​​Repeated exposure to trauma is extremely common for youth that end up in residential programs. Exposure to trauma changes these kids, <a href="https://www.boystownhospital.org/news/abuse-maltreatment-affect-brain-development"> even altering their brain development [1], </a>in ways that affect their responses to many aspects of their environment, including how they will respond to those people who are attempting to help them. In some cases, this means that attempts to treat kids unintentionally ends up traumatizing them further.</p><p>Boys Town, however, uses a trauma-informed car​e model that takes past trauma exposure into account in order to prevent the treatment from causing additional trauma. Additionally, Boys Town developed a screening instrument to identify possible symptoms youth may have related to past trauma [2]. Boys Town clinicians use this information to determine the supports and services youth need to help them heal. While this approach is widely accepted as the recommended approach for improving care in residential programs, research is also needed to support existing practices and to help us further improve how we take care of at-risk kids.</p><p>To help understand the benefits of our trauma-informed model, researchers at Boys Town, led by Patrick Tyler, Ph.D., recently conducted a study examining records for 1,096 youth from 9 to 18 years old who received Boys Town services. Their goals were to assess how trauma was associated with behavioral incidents, as well as the effects of trauma on psychological health at intake and when youth discharged from our program. [3]</p><p>Among the discoveries from their study, the researchers found that trauma symptoms were the best predictor of emotional problems and self-injury. Additionally, girls had higher rates of self-injurious behaviors than boys, whereas boys had higher rates of conduct problems at intake than girls in this study. Younger children also had higher rates of disruptive behavior compared to older children.</p><p>This study also showed that boys and girls who were grouped into either high or low trauma categories responded favorably to the trauma-informed program. Overall decreases were observed in disruptive and self-injurious incidents while in care, as well as conduct and emotional problems from intake to discharge for all of the groups. However, youth whom clinicians identified as having lower levels of trauma did have greater decreases in emotional problems.</p><p>A primary goal of Dr. Tyler’s team for this study was to determine how well the trauma-informed model has been working for youth that receive Boys Town services. Future studies will build on this by looking at best practices for incorporating trauma screening and assessment into the admission process in order to plan and provide the most effective care for our youth. Research is currently ongoing to identify strategies that can help youth with higher levels of trauma make even greater improvement.</p><h2>References<br></h2><ol><li>Blair K.S., Aloi J., Crum K., et. al. (2019) <em>Association of Different Types of Childhood Maltreatment With Emotional Responding and Response Control Among Youths</em> 2019 <strong>2</strong>(5). JAMA Netw Open.</li><li>Tyler, P.M., Mason, W.A., Chmelka, M.B., et. al. (2019) <em>Psychometrics of a Brief Trauma Symptom Screen for Youth in residential care</em> Journal of Traumatic Stress. doi: 10.1002/jts.22442. </li><li>Tyler P.M., Patwardan I., Ringle J.L., et. al., (2019) <em> <a href="https://assets.boystown.org/hosp_peds_docs/Trauma-Informed_Group_Homes_Tyler_et_al._2019.pdf"> Youth Needs at Intake into Trauma-Informed Group Homes ​and Response to Services: An Examination of Trauma Exposure, Symptoms, and Clinical Impression​</a>.</em> doi: 10.1002/ajcp.12364. Am J Community Psychol</li><ol></ol></ol>
Functional Brain Imaging Shows How Maltreatment Affects Brain Developmenthttps://www.boystownhospital.org/news/abuse-maltreatment-affect-brain-developmentFunctional Brain Imaging Shows How Maltreatment Affects Brain Development2019-06-20T05:00:00Z<p>Boys Town is recognized as a world leader in caring for kids in trouble, many of whom have been subjected to childhood trauma. Boys Town National Research Hospital is also home to research investigating the impacts of maltreatment on developing brains. Karina Blair, Ph.D. and her team at Boys Town Hospital recently published a paper titled, <em>Association of Different Types of Childhood Maltreatment</em><em> </em> <em>With</em><em> Emotional Responding and Response Control Among Youths</em> [1] that examines some of these issues. </p><p style="text-align:left;">Specifically, the authors looked at measures of brain function and behavior for 116 young people from 10–18 years of age who reported and rated their personal experiences with different types of abuse and neglect. The children and adolescents were either enrolled in Boys Town programs or from the surrounding community, and their families gave consent to the study with the option to withdraw at any time. The kids' brain activity was monitored while they performed a number counting task in the presence of distracting emotional images. This allowed Dr. Blair to determine the association of different forms of maltreatment on brain systems critical for task performance as well as emotional responding.  </p><p style="text-align:left;">The main findings of this study were the association of abuse, rather than neglect—at least, within this group of participants—with both difficulties with response control and heightened emotional responding.  Moreover, physical abuse was particularly associated with heightened threat responding. Sexual abuse was associated with a cascade of difficulties that were present even after the influence of other forms of maltreatment was statistically accounted for (Figure 1). </p> <img src="https://assets.boystown.org/hosp_peds_images/brainMRI.png" alt="Brain MRI" /> <p> <strong>Figure 1. The anterior cingulate region of the brain is importantly involved in emotional processing and shows overly increased responding in kids who have suffered sexual abuse. </strong>The colored areas in this image show the regions showing greater responding in kids who have suffered sexual abuse relative to those who have not.  The “hotter" the color, the more overly responding the region. </p><p style="text-align:left;"> </p><p style="text-align:left;">These findings are important because we know these kids need help. They may find themselves in dangerous situations and sometimes legal trouble.  We need to understand exactly what problems they face. Understanding their brain level-difficulties are part of the picture.  Moreover, the findings of this work suggest that maltreatment may have different impacts according to the form of maltreatment.  Indeed, sexual abuse may be associated with particularly severe brain-level difficulties.  Potential findings such as these may become the basis for assessing treatment success at the level of the individual. For a much more detailed description of their findings <a href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2734074" target="_blank"> <span style="text-decoration:underline;">see the article in JAMA Network Open</span></a> [1]. </p> <p>References </p><ol><li>Blair KS1, Aloi J2, Crum K3, Meffert, et. al. (2019) <em>Association of Different Types of Childhood Maltreatment </em> <em>With</em><em> Emotional Responding</em><em> </em> <em>and Response Control Among Youths</em>, 2019 <strong>2</strong>(5). JAMA Netw Open.  </li></ol>
Discussing the Neuroscience of Kids Facing Adult Justice Systemhttps://www.boystownhospital.org/news/discussing-the-neuroscience-of-kids-facing-adult-justice-systemDiscussing the Neuroscience of Kids Facing Adult Justice System2019-06-12T05:00:00Z<p>The adult criminal justice system is often charged with determining the appropriate response to young children who have done bad things. However, these young child offenders are often also victims of abuse, pre-natal drug exposure and neglect. Trauma may change the brain's response to stressful situations and alter the child's ability to control unwanted behaviors. Courts must weigh these circumstances when considering whether the child should be charged as an adult.</p><p>Boys Town researchers are working to understand typical brain development as well as how this may be altered by stress using behavioral assessment tools and functional neuroimaging. In addition, for more than 100 years, Boys Town has been helping at risk youth and their families to change outcomes for the better. This combined experience puts us in an ideal position to provide judges with information relevant to their decisions about what to do with kids who end up in their courtrooms.</p><p>In partnership with the National Courts and Science Institute, Boys Town recently hosted a Neuroscience and the Law Workshop. Led by James Blair, Ph.D., Susan and George Haddix Endowed Chair for Neurobehavioral Research at Boys Town National Research Hospital, the judges were given an overview of current science on brain development and childhood trauma. In addition, judges and Boys Town staff held round table discussions covering case examples and how current knowledge may be applicable to judicial decision making. The judges were given a tour of facilities and technologies they may hear about in cases, and what those technologies can and cannot tell us about developing brains and mental health.</p><p>Advocating for youth, including those who end up in the criminal justice system but might be better served by therapy and intervention, is part of Boys Town's mission to help at risk youth. We appreciate the participation of the judges and hope that this meeting will be a model for future workshops as new discoveries are made.</p><div class="embed-container"> <iframe src="https://www.youtube.com/embed/5sXkqRfThlk?rel=0" width="560" height="315" frameborder="0"></iframe> </div>​
Findings on Safe Vestibular Evoked Myogenic Potential Testing in Children https://www.boystownhospital.org/news/findings-on-safe-vestibular-evoked-myogenic-potential-testing-in-childrenFindings on Safe Vestibular Evoked Myogenic Potential Testing in Children 2019-06-11T05:00:00Z<p>The vestibular evoked myogenic potential (VEMP) test is something you may encounter if you or a family member are experiencing issues with balance or dizziness. The VEMP is a non-invasive test that uses short, intense sound stimuli to produce a muscle reflex in the eye or neck muscles. The muscle reflex is recorded with surface electrodes that attach to the skin over the muscle. The test specifically informs clinicians about the health of vestibular components of the balance system—the utricle and saccule organs of the inner ear (Figure 1).<br></p><p style="text-align:center;"> <img class="ms-rtePosition-4" alt="inner-ear-v2.jpg" src="https://assets.boystown.org/hosp_peds_images/inner-ear-v2.jpg" style="margin:auto;width:340px;height:268px;" />  </p> <strong style="font-size:0.87em;">Figure 1. Diagram of the inner ear. </strong> <span style="font-size:0.87em;">The inner ear in humans contains the auditory and balance systems. The utricle, saccule and semi-circular canals are central components of the balance system and process information about the head's position and movement in space. The cochlea is a central component of the auditory system.</span> <div> <span style="font-size:12.25px;"><br></span><span style="font-size:0.87em;"></span> <p>In children, VEMP responses are correlated with development of standing, walking, and posture control [1, 2]. Children with impaired vestibular function are more likely to achieve these milestones at a later age [3], and can benefit from rehabilitation.</p><p>While the VEMP test is used with children, most of what we know about the test is from research and clinical experience with adults. It is not uncommon for doctors to need to rely information from adults for pediatric procedures but, because children are physically different, this can come with risks. For the VEMP test, there is some risk that the intensity of sound stimuli used for testing in adults is too loud in children and can damage the specialized cells in the ear that are crucial for hearing in children. It's also possible that children will respond better to different frequencies of sound than adults.</p><p>Understanding how the balance system works and develops is the focus of Kristen Janky, Ph.D, in her Vestibular and Balance Laboratory at Boys Town National Research Hospital. In a recent paper, Janky and Amanda Rodriguez explored optimum conditions for completing VEMP testing in children and young adults. They found that young children, ages 4–9, required significantly lower sound levels to elicit normal VEMP responses compared to adolescents or young adults. However, they found that there were no differences in response to the standard 500 Hz and 750 Hz frequencies that are used in testing [4].</p><p> <strong>TABLE 1. Mean (SD) VEMP thresholds at 500 Hz and 750 Hz for adults, adolescents, and children.</strong></p><table class="ms-rteTable-default" width="100%" cellspacing="0"><tbody><tr><td class="ms-rteTable-default" style="width:20%;"> <strong> </strong></td><td class="ms-rteTable-default" style="width:20%;"> <span style="text-decoration:underline;"><strong>500 Hz</strong></span></td><td class="ms-rteTable-default" style="width:20%;">​</td><td class="ms-rteTable-default" style="width:20%;"> <span style="text-decoration:underline;"><strong>750 Hz</strong></span></td><td class="ms-rteTable-default" style="width:20%;">​</td></tr><tr><td class="ms-rteTable-default"> </td><td class="ms-rteTable-default">Mean <br>(dB SPL)</td><td class="ms-rteTable-default">Standard Deviation<br> (dB SPL)</td><td class="ms-rteTable-default">Mean <br>(dB SPL)</td><td class="ms-rteTable-default">Standard Deviation<br> (dB SPL)</td></tr><tr><td class="ms-rteTable-default">Cervical VEMP Threshold<br> Response (dB SPL)</td><td class="ms-rteTable-default"> <strong> </strong></td><td class="ms-rteTable-default"> <strong> </strong></td><td class="ms-rteTable-default"> <strong> </strong></td><td class="ms-rteTable-default"> <strong> </strong></td></tr><tr><td class="ms-rteTable-default">Adults</td><td class="ms-rteTable-default"> <strong>111.5</strong></td><td class="ms-rteTable-default"> <strong>3.25</strong></td><td class="ms-rteTable-default"> <strong>112</strong></td><td class="ms-rteTable-default"> <strong>2.61</strong></td></tr><tr><td class="ms-rteTable-default">Adolescents</td><td class="ms-rteTable-default">107.5</td><td class="ms-rteTable-default">4.85</td><td class="ms-rteTable-default">109.5</td><td class="ms-rteTable-default">3.68</td></tr><tr><td class="ms-rteTable-default">Children</td><td class="ms-rteTable-default"> <strong>106</strong></td><td class="ms-rteTable-default"> <strong>4.63</strong></td><td class="ms-rteTable-default"> <strong>106</strong></td><td class="ms-rteTable-default"> <strong>3.91</strong></td></tr><tr><td class="ms-rteTable-default">Ocular VEMP Threshold Response (dB SPL)</td><td class="ms-rteTable-default"> <strong> </strong></td><td class="ms-rteTable-default"> <strong> </strong></td><td class="ms-rteTable-default"> <strong> </strong></td><td class="ms-rteTable-default"> <strong> </strong></td></tr><tr><td class="ms-rteTable-default">Adults</td><td class="ms-rteTable-default"> <strong>116</strong></td><td class="ms-rteTable-default"> <strong>3.94</strong></td><td class="ms-rteTable-default"> <strong>117</strong></td><td class="ms-rteTable-default"> <strong>3.49</strong></td></tr><tr><td class="ms-rteTable-default">Adolescents</td><td class="ms-rteTable-default">112.5</td><td class="ms-rteTable-default">4.81</td><td class="ms-rteTable-default">114.5</td><td class="ms-rteTable-default">2.83</td></tr><tr><td class="ms-rteTable-default">Children</td><td class="ms-rteTable-default"> <strong>111.1</strong></td><td class="ms-rteTable-default"> <strong>4.10</strong></td><td class="ms-rteTable-default"> <strong>112.2</strong></td><td class="ms-rteTable-default"> <strong>4.17</strong></td></tr></tbody></table><p> <em>Bold values represent significant differences. Children showed lower cervical and ocular VEMP thresholds compared to adults.</em></p><p>This research will help children by providing guidelines for safe VEMP testing in children, and keeping children's ears safe from possible injury. Experienced audiologists will already be careful with the ears of their young patients, but this knowledge will give them a better testing range, and information about what is normal responsiveness. For additional experiments, details and the authors' conclusions check out their paper, <em>Air-Conducted Vestibular Evoked Myogenic Potential Testing in Children, Adolescents, and Young Adults: Thresholds, Frequency Tuning, and Effects of Sound Exposure</em>.</p><p>Thanks to the research volunteers for this study. Our volunteers included 10 children, ages 4–9, 10 adolescents, ages 10–19, and 10 young adults, ages 20–29.</p><h2>References<br></h2><ol><li>Wiener-Vacher, S.R., F. Toupet, and P. Narcy, <em>Canal and otolith vestibulo-ocular reflexes to vertical and off vertical axis rotations in children learning to walk.</em> Acta Otolaryngol, 1996. <strong>116</strong>(5): p. 657-65.</li><li>Wang, S.J., W.S. Hsieh, and Y.H. Young, <em>Development of ocular vestibular-evoked myogenic potentials in small children.</em> Laryngoscope, 2013. <strong>123</strong>(2): p. 512-7.</li><li>Inoue, A., et al., <em>Effect of vestibular dysfunction on the development of gross motor function in children with profound hearing loss.</em> Audiol Neurootol, 2013. <strong>18</strong>(3): p. 143-51.</li><li>Rodriguez, A.I., M.L.A. Thomas, and K.L. Janky, <em>Air-Conducted Vestibular Evoked Myogenic Potential Testing in Children, Adolescents, and Young Adults: Thresholds, Frequency Tuning, and Effects of Sound Exposure.</em> Ear Hear, 2019. <strong>40</strong>(1): p. 192-203.</li></ol></div>
NIH awards $11 Million Grant to Boys Town National Research Hospital to Study Communication and Perception in Childrenhttps://www.boystownhospital.org/news/nih-grant-awarded-communication-researchNIH awards $11 Million Grant to Boys Town National Research Hospital to Study Communication and Perception in Children2019-04-16T05:00:00Z<p>Boys Town National Research Hospital has received an $11 million grant from the National Institute of General Medical Sciences (NIGMS), part of the National Institutes of Health (NIH). </p><p>The five-year Centers of Biomedical Research Excellence (COBRE) grant is set to expand the range of existing, highly successful research programs at the Boys Town National Research Hospital and tackle more complex issues that directly address the problems encountered by children with hearing loss.</p><p>Core research programs covered by the grant will investigate issues related to: </p><ul><li>Speech understanding for young listeners with cochlear implants</li><li>Diagnosis and outcomes for children with otitis media, an inflammatory condition of the inner ear</li><li>Strategies used by children to overcome working memory limitations</li></ul><p>Related projects that will receive funding cover multiple labs and include, examining the impact of hearing loss in real-world environments like classrooms, the contributions of bottom-up and top-down processing in children learning English as a second language, how visual and auditory information work together in speech and language learning, and the consequences for visual processing of vestibular deficits associated with hearing loss.</p><p>Lori Leibold, Ph.D., is the primary investigator on the grant and Director of the Center for Hearing Research. Dr. Leibold notes that, "Our goal is to become the national leader for research on speech, language, hearing, and cognitive development in ​children with communication disorders. We believe we are close to achieving this goal, in large part due to this NIH award that has allowed us to grow our research program and provide the resources these young investigators need to be successful."</p><p>This is the second round of COBRE grant funding for Boys Town Hospital. The first $11.3 million grant was awarded in 2014 and has contributed to Boys Town Hospital recruiting several world-class senior scientists, hosting more than 60 experts from around the country for research talks, sparking many new collaborations. The 2014 grant also established a state-of-the-art Auditory-Visual Core facility that supports research using techniques such as augmented and virtual reality.</p><p>"Scientists and other professionals supported by this grant are the next generation in the 40-year legacy of Boys Town Research," states Director of Research, Ryan McCreery, Ph.D., who also notes that "this additional five years of support from the National Institute of General Medical Sciences (NIGMS) is recognition for the high-impact translational research that our scientists do every day. Their research has the potential to improve the lives of people with hearing and communication problems."</p><p>The new COBRE grant award will have lasting impacts on research in Nebraska and the surrounding region by providing mentoring and resources for the young investigators needed to sustain a thriving research community. The grant also includes a strategic sustainability and development plan for core facilities that expand the technical capabilities of individual labs at Boys Town National Research Hospital and collaborating institutions. The benefits of this grant will be far reaching for Boys Town and for Nebraska, supporting our scientific community and high-skill jobs in Omaha and beyond.​</p>
Chatterjee Group Study Published in Nature Scientific Reportshttps://www.boystownhospital.org/news/understanding-pitch-with-cochlear-implants-studyChatterjee Group Study Published in Nature Scientific Reports2019-02-08T06:00:00Z<p>​Monita Chatterjee, Ph.D., Director of Auditory Prostheses and Perception lab, recently co-authored an article published in Nature Scientific Reports. Dr. Chatterjee worked with collaborators in Canada, Taiwan and San Francisco to test children with cochlear implants on their ability to differentiate pitch inflections.<br></p><p>One downside of cochlear implants is that they don't adequately transmit pitch information, which can be problematic in languages where tone is crucial to comprehension.</p><p>In tone languages such as Mandarin Chinese, the lexical tone (pitch inflections within spoken syllables) can define a word. For example, the same word spoken with a rising or falling pitch might have very different meanings. Dr. Chatterjee's group set out to determine if native Mandarin-speaking children with cochlear implants have a greater sensitivity to changes in pitch compared to English-speaking children with cochlear implants. They hypothesized that immersion in a tone-language environment from birth would help the Mandarin-speaking children to process pitch changes better than English-speaking children in the US.</p><p>"Even for children who are implanted early, the adaptability of their brains to catch the differences in pitch is very limited," Dr. Chatterjee said. "It's a major device limitation."</p><p>Dr. Chatterjee and her collaborators tested 97 children in Taiwan and 97 children in the US on two pitch perception tasks. Each test group had both normal hearing children and children with cochlear implants.</p><p>"Compared to children speaking English in the US, children with normal hearing in Taiwan who speak a Mandarin showed an advantage in both tasks," Dr. Chatterjee said. "Children with cochlear implants who spoke Mandarin showed large deficits in both tasks, which was expected, but even they showed the tone-language advantage in labeling the changes in pitch."</p><p>Results of the study have concluded that the demands of a tonal language have helped Mandarin-speaking children with cochlear implants develop a better ability to determine pitch changes. While their ability is limited and the sound quality is still highly degraded, the results suggest that the natural training provided by one's native language can substantially affect young brains' ability to perceive sounds.</p><p> <a href="https://www.nature.com/articles/s41598-018-36393-1">The full report can be read here.</a></p><p>According to their website, Nature Scientific Reports is a weekly international publication for peer-reviewed research in scientific and technological fields. The research is published based on originality, importance, interdisciplinary interest, timeliness, accessibility, elegance and surprising conclusions.<br></p><p> <br> </p>
Chatterjee Article Awarded as 2018 Technical Area Pickhttps://www.boystownhospital.org/news/musician-advantage-effect-studyChatterjee Article Awarded as 2018 Technical Area Pick2018-11-21T06:00:00Z<p>​The "musician advantage effect" is an auditory phenomenon used to explain how musicians can sometimes achieve better speech recognition in noisy backgrounds than non-musicians. A recent article co-authored by Monita Chatterjee, Ph.D., Director of the Auditory Prostheses and Perception Laboratory at Boys Town National Research Hospital, titled <a href="https://asa.scitation.org/doi/full/10.1121/1.5005496"><em>Similar abilities of musicians and non-musicians to segregate voices by fundamental frequency</em></a><em> </em>was selected as the Technical Area Pick for Psychological and Physiological Acoustics. The article was chosen among all the articles from the same technical field published in the past year in the Journal of the Acoustical Society of America (JASA).</p><p>It is not known what causes the "musician advantage", but one hypothesis is that it arises from better pitch processing by musicians, which might allow them to better track the target talker's voice and separate it out from competing talkers or background noise. The authors conducted a series of studies with musicians and non-musicians to test this hypothesis.</p><p>In these studies, they tested listeners' ability to detect target voices embedded in competing backgrounds. In addition, listeners heard a beeping tone with the same pitch as the target voice, presented before they heard the speech and designed to focus the listener's attention specifically to the target voice. In another case, the pitch of the tone was designed to deliberately mislead the listeners. If musicians benefit from pitch processing, they should show a stronger response to these helpful or confusing tones than non-musicians. The results confirmed the musician advantage, but did not show the predicted effects of manipulating the pitch cues. The authors concluded that the musicians' advantage in hearing speech in background noise does not in fact stem from a better ability to process the target speaker's voice pitch.</p><p>Dr. Chatterjee is the principal investigator and lab director of the <a href="http://hospital.boystown.org/research/HearingResearch/Pages/AuditoryProsthesesAndPerceptionLaboratory.aspx">Auditory Prostheses and Perception Laboratory</a> at Boys Town National Research Hospital. She also co-directs the Technology Core, as part of the <a href="http://hospital.boystown.org/research/COBRE/Pages/default.aspx">Center for Perception and Communication in Children</a>. The primary goal of her research is to understand basic mechanisms underlying auditory and speech perception by individuals with normal hearing, hearing loss, and cochlear implants. Experiments include psychophysical measures of listeners' sensitivity to subtle differences between sounds, measures of listeners' sensitivity to speech intonation and lexical tone recognition, and the processing of degraded speech by the normal and impaired auditory system.<br></p><p><br></p>
Understanding Brain Responses of Alcohol and Cannabis Abuse Disorders in Adolescentshttps://www.boystownhospital.org/news/understanding-brain-responses-of-alcohol-and-cannabis-abuse-disorders-in-adolescentsUnderstanding Brain Responses of Alcohol and Cannabis Abuse Disorders in Adolescents2018-08-15T05:00:00Z<p>​​​Across the country, many adolescents struggle with alcohol and cannabis abuse. While the U.S. Department of Health and Human Services (HHS) notes that alcohol use among teens is decreasing, still 3 out of 5 high school students have reported having a drink within the past 30 days, and 23% of high school seniors have used marijuana within the last month. Brain-imaging work by scientists at <a href="http://hospital.boystown.org/research/CenterNeurobehavResearch/Pages/default.aspx">Boys Town Center for Neurobehavioral Research</a> indicate that abuse of alcohol and cannabis can have lasting negative effects on a child's or teen's brain development.</p><p>Executive attention and response control are critical for impulse control.  They rely on regions at the front of the brain like dorsolateral frontal cortex and dorsomedial frontal cortex.  A recent study at Boys Town National Research Hospital shows a difference in function in these regions among youth with alcohol and cannabis substance abuse disorders. This study published in <em>Neuroimage Clinical</em>, titled, "Adolescents show differential dysfunctions related to Alcohol and Cannabis Use Disorder severity in emotion and executive attention neuro-circuitries." Adolescents reporting more severe substance abuse disorder symptoms, particularly those associated with alcohol abuse, show problems using these brain areas during response control.  This likely leads to further difficulties.  If these regions are not working well, an individual is less likely to control his/her impulses and may be more likely to abuse substances in the future. Behavior also generally becomes more impulsive.</p><p>Joseph Aloi, Ph.D., a research student at the Boys Town Center for Neurobehavioral Research, led the study that investigated the brain's executive attention and response control systems in youth with varying levels of alcohol and cannabis use problems.  The study used an MRI machine to measure youths' brain responses during a type of response control task and then related this information to their levels of alcohol and cannabis problems. </p><p>The findings from the study are important for several reasons.  First, they show that substance abuse problems in adolescents are associated with demonstrable brain level-difficulties, which may require intervention to improve function.  Second, the findings reinforce the importance of considering a person's substance abuse history.  Brain-level difficulties associated with alcohol abuse disorder may require specific intervention strategies.  Third, the data suggests that we might assess substance abuse treatment success, not only by abstinence, but also whether these brain-level difficulties have been reduced.</p><p style="text-align:justify;">This work is a first step in our goal to improve the care of children with substance abuse. By better understanding how substance abuse affects brain function, Boys Town scientists can develop better interventions and treatments to help more children.  To follow the progress of this work, please see our website at boystownhospital.org/research. <br></p><p><br></p>
Research Helps Target Behavioral Interventions for Aggressive Youthhttps://www.boystownhospital.org/news/behavioral-interventions-aggressive-youthResearch Helps Target Behavioral Interventions for Aggressive Youth2018-08-09T05:00:00Z<p>​​​Across the county, many adolescents struggle with disruptive behavior ranging from aggression or rage toward others to outbursts in the classroom. These behaviors appear similar, but a recent brain-imaging study at Boys Town National Research Hospital suggests a youth's prior exposure to abuse or neglect may impact the way that youth emotionally responds to the pain of others. </p><p>"If you could not empathize with another's pain or distress, you would be less concerned by hurting another individual," said <a href="https://www.boystownhospital.org/research/Faculty/Pages/Blair-James.aspx" data-ytta-id="-">James Blair, Ph.D.</a>, Susan and George Haddix Endowed Chair in Neurobehavioral Research at Boys Town National Research Hospital. "Empathy can act as a barrier against aggressive behavior."</p><p>The study, published in <em>Psychological Medicine</em>, is titled "Moderation of prior exposure to trauma on the inverse relationship between callous-unemotional traits and amygdala responses to fearful expressions: an exploratory study."</p><p>Previous research by Blair showed many adolescents with disruptive behavior have problems expressing empathy and guilt, which means they have difficulty emotionally responding to the distress of others. This background led researchers at Boys Town Hospital to explore the relationship of past traumatic experiences, such as abuse and neglect, with emotional responses, such as empathy and guilt.<br></p><p> <a href="https://www.boystownhospital.org/research/Faculty/Pages/Harma-Meffert.aspx" data-ytta-id="-">Harma Meffert, Ph.D.</a>, scientist at the <a href="https://www.boystownhospital.org/research/neurobehavioral" data-ytta-id="-">Boys Town Center for Neurobehavioral Research</a>, led a study that investigated how the amygdala (brain region central to empathy) responds to distress in others in youth with varying levels of prior trauma. The study used an MRI machine to measure youths' brain responses to fearful expressions in others.  The youth also filled out a questionnaire and received a psychological interview on prior traumatic events (abuse and neglect).<br></p><p>The study indicated that not everyone showing the behavioral signs of reduced empathy/guilt also shows the brain signs of reduced empathy/guilt.  In particular, youth that are exposed to significant prior trauma do not show the brain signs of reduced empathy/guilt, despite similar behavioral signs of reduced empathy/guilt.<br> </p><p>The findings revealed results that may help map new behavioral interventions.  </p><ol><li>The data suggests that not all youth with disruptive disorder face the same difficulty – and therefore need different interventions.  </li><li>The data reinforced the importance of considering an individual's trauma history. As other work by this Boys Town research team is beginning to show, trauma has a very negative impact on brain development. </li><li>The data indicates that behavioral symptoms alone may not be sufficient to accurately guide treatment decisions. </li></ol><p style="text-align:justify;">Currently, all youth with problems in expressing empathy and guilt receive the same interventions. Mental health assessments mostly rely on observed behaviors and information the patient and their family share with the clinician. This makes it difficult to tell apart an individual who is aggressive because they are prone to rage and another individual who uses aggression, including anger outbursts, to achieve their goals.  </p><p style="text-align:justify;">The work by Boys Town Center for Neurobehavioral Research in Children is a first step in our goal to improve the care of children with emotional and behavioral problems by developing better assessments in order to find the best interventions for each child individually. <br></p>
Christopher Conway, Ph.D. joins Language Research Team at Boys Town National Research Hospitalhttps://www.boystownhospital.org/news/conway-language-researchChristopher Conway, Ph.D. joins Language Research Team at Boys Town National Research Hospital2018-08-03T05:00:00Z<p>​Boys Town Hospital continues to expand its communication research to include language learning and development for all children. The Hospital's Center for Childhood Deafness, Language and Learning is pleased to announce Christopher Conway, Ph.D., will be joining the team on August 8.<br></p><p>Having spent his career in the academic setting, most recently as an Associate Professor of Psychology at Georgia State University, Dr. Conway will lead the Brain, Learning, and Language Laboratory, focusing on the brain's ability to process speech and language.</p><p>"I'm very excited to be able to focus full-time on research," said Dr. Conway. "Our research will help us understand the processes and mechanisms of language acquisition and will have a real impact on helping children who experience a language delay or have a communication disorder."</p><p>Dr. Conway and his research team will be working on many initial studies including neuromodulation – directly stimulating brain networks to help facilitate children's language learning.</p><p>"There is some research to suggest that such neuromodulation techniques can help stimulate plasticity in the brain, allowing it to be more adaptive and better able to learn complex patterns of information in the environment," said Dr. Conway. "Our lab will have such neuromodulation capabilities and will allow us to start investigating the possible benefits this could have on the brain's ability to learn language and other complex domains."<br></p><p><br></p>
Announcing First Endowed Research Chair at Boys Town National Research Hospitalhttps://www.boystownhospital.org/news/endowed-research-chairAnnouncing First Endowed Research Chair at Boys Town National Research Hospital2018-01-16T06:00:00Z<p>​Boys Town National Research Hospital has received a gift of $2 million to establish the Susan and George Haddix Endowed Chair for the Center of Neurobehavioral Research, to support and expand efforts to improve the lives of children with behavioral and mental health problems.</p><p>This is the first endowed research chair at Boys Town Hospital. It has been created as part of the organization's ongoing commitment to enhance translational pediatric neuroscience research – meaning discoveries found by researchers in the lab are directly applied to improve outcomes in behavioral healthcare. </p><p> "We are truly grateful for Susan and George's deep understanding and compassion toward helping children in need of behavioral and mental health care, and for their generous contribution that will help sustain neuroscience research at Boys Town Hospital for many years to come," said John Arch, Hospital Director and Executive Vice President of Health Care at Boys Town.  "I am pleased to announce Dr. James Blair will be appointed to the Susan and George Haddix Endowed Chair for Neurobehavioral Research."</p><p>Dr. Blair, Director of the Center for Neurobehavioral Research in Children, joined Boys Town Hospital in August 2016, after 12 years at the National Institute of Mental Health. He is internationally recognized for his contributions toward better understanding conduct disorders in children and adolescents by using brain imaging technology to study behavioral traits.</p><p>"I am honored to be appointed to this prestigious position and grateful that the need for this research is being recognized," said Blair. "Our work is just beginning. What we uncover today can be applied to new studies tomorrow, in hopes that one day we will know how to help all children who have behavioral and mental health problems."</p><p>Childhood behavioral and mental health problems, if left untreated, have profound implications for the individuals as well as society. The goal of the Center for Neurobehavioral Research is to understand what is physiologically happening in the brain of a troubled child so that the right interventions can be applied for that individual child. This research moves beyond mere observation of behaviors to developing scientific ways of diagnosing and treating problems like depression, anxiety, aggression and ADHD.</p><p>"I was excited to hear of the neuroscience research at Boys Town Hospital," said Susan Haddix. "To me, the real problem is that we expect a troubled child to function the same as a child without behavioral concerns. This research is going to look deeper into understanding why children are having these problems. Then, one at a time, we will know how to help each child and family, and in doing so, make a real change."</p><p>Susan has been actively working to help troubled children and adolescents in the Omaha community for more than 20 years. She has been a long-time volunteer with Child Saving Institute and currently serves on their Board of Directors. She also has been serving on the Nebraska Foster Care Review Board for 20 years and was recently appointed to serve on their newly formed Probation Review Board. This spring, Susan will join the Boys Town National Board of Trustees, serving on the national youth care committee.</p><p>George Haddix, Ph.D., has been a prominent leader in computer engineering and software, having served as CEO for PKWare Inc., Applied Communications, CSG Systems International and US West.</p><p>The new era of neurobehavioral research couples George's interest in science and technology with Susan's passion to help children and families.</p><p> "We're proud to help this new endeavor at Boys Town Hospital," said Haddix. "This research is ground-breaking and shows great promise that the emotional and behavioral problems that stem from childhood neglect and abuse don't have to be a lifetime diagnosis. We can make a difference and change the future for these vulnerable children."</p><p>As benefactors of the first endowed research chair at Boys Town Hospital, Susan and George Haddix hope to influence others to give. Ongoing support will help Boys Town Hospital continue to lead the charge in neurobehavioral research and improve the lives of children with behavioral and mental health disorders. </p>
Neuroscientist Expands Research To Study PTSDhttps://www.boystownhospital.org/news/neuroscientist-studies-ptsdNeuroscientist Expands Research To Study PTSD2017-10-24T05:00:00Z<p> Posttraumatic Stress Disorder is a disorder that effects an estimated 21 million Americans, including many adolescents. Of those 21 million cases, it is estimated that 30% of patients do not respond to treatment. PTSD can be challenging to treat, as its biology is not fully understood. </p><p>Stuart White, Ph.D., Director of the Decision-Making Program, is hoping to change that. </p><p>Dr. White has received a four-year grant from the National Institute of Mental Health to study the interaction between the neural and hormonal mechanisms implicated in children with PTSD in order to improve treatment methods. Current treatment strategies for pediatric PTSD do not consider the role of testosterone. </p><p>Utilizing the hospital's functional MRI, Dr. White will be analyzing both healthy adolescent patients and those with PTSD from within the Boys Town Residential Program. Both groups of youth will complete tasks in the fMRI designed to assess brain responses to threats in the environment and observe neural processes associated with emotion regulation. Each child will complete a series of tasks, which will either raise or not raise their testosterone level.  </p><p>"We know that PTSD involves changes in hormonal and neural responses, but we don't really understand how these systems work together," said White. "Better understanding the way different biological systems contribute to PTSD will give us more and better ways to help these youth."</p><p>Understanding the biological processes behind PTSD will be useful for cognitive behavioral therapies and different pharmacological treatments. </p><p>"There are a lot of pieces to this puzzle," said White. "This work will be an important step towards making sure that clinicians have all the tools to help youth with ​PTSD that we can give them." ​​</p><div class="embed-container"><iframe width="640" height="360" src="https://www.youtube.com/embed/y6USNpICfsw" frameborder="0"></iframe>​​</div>
Boys Town National Research Hospital Expands Communication Research to Help more Childrenhttps://www.boystownhospital.org/news/language-communication-researchBoys Town National Research Hospital Expands Communication Research to Help more Children2017-08-10T05:00:00Z<p>​For more than 40 years, Boys Town National Research Hospital has been internationally recognized for hearing research, education and clinical care. Starting this August, Boys Town Hospital is expanding its communication research to include language learning and development for all children. The Hospital's Center for Childhood Deafness program has been renamed Center for Childhood Deafness, Language and Learning to reflect the new focus that will help more children and families.<br></p><p>Leading the charge is Karla McGregor, Ph.D., newly appointed senior scientist and director of the Word Learning Lab. McGregor joins Boys Town Hospital this August, after spending 12 years at the University of Iowa as a Professor of Communication Sciences and Disorders.<br></p><p>“We are excited to welcome Dr. Karla McGregor to Boys Town Hospital," said John Arch, Hospital Director and Executive Vice President of Health Care at Boys Town. “Her experience and expertise in speech pathology will help guide the hospital's expansion of translational research in language development."​<br></p><p>McGregor was previously the director of the Word Learning Lab at the University of Iowa. The research of the Word Learning Lab focuses on how individuals learn, remember and use words, and how these functions can be supported for those who have developmental language disorders.<br></p><p>The work began at the University of Iowa and will continue at its original location and at the Center for Childhood Deafness, Language and Learning when McGregor arrives at Boys Town Hospital.<br></p><p>“I want to spend some time listening to the clinicians at the Center for Childhood Deafness, Language and Learning to learn about the work they do and their visions for the future," McGregor said. “It's important to me to connect the clinical and research mission in ways that are meaningful and exciting to both parties."<br></p><p>Center for Childhood Deafness, Language and Learning Director, Mary Pat Moeller, Ph.D, shares McGregor's excitement in seeing the research go beyond deafness and address the needs of hearing children with developmental language disorders.<br></p><p>“I have long recognized that to serve children with hearing loss we must pay considerable attention to the theories and methods of child language researchers like Dr. McGregor," Moeller said. “I see this as a rare and special opportunity to collaborate with a giant in our field."<br></p><p>McGregor finished at the University of Iowa at the end of June and will begin work in the Word Learning Lab in August. Upon arrival, McGregor will be working with Moeller and Cathy Carotta, Ed.D., Associate Director of the Center for Childhood Deafness, Language and Learning, to learn the administrative processes and procedures. McGregor will assume acting director of the Center for Childhood Deafness, Language and Learning in August 2018.<br></p><p>“As we grow our research programs, we are able to better serve our mission and change the way America cares for children, families and communities," said Arch.  <br><br></p><p><a href="http://www.omaha.com/livewellnebraska/health/boys-town-national-research-hospital-to-expand-focus-on-communication/article_030caf38-4abb-53a7-a6f3-53701f73c41a.html">Read the full article</a> <br></p><p><br></p>
Daniel Rasetshwane Awarded Great Plains IDeA-CTR Scholars Granthttps://www.boystownhospital.org/news/daniel-rasetshwane-awarded-grantDaniel Rasetshwane Awarded Great Plains IDeA-CTR Scholars Grant2017-07-21T05:00:00Z<p>​Daniel Rasetshwane, Ph.D., Director of the Auditory Signal Processing <br>Laboratory at Boys Town National Research Hospital, has been awarded the Great Plains Institutional Development Award for Clinical and Translational Research (IDeA-CTR) Scholars Program grant.</p><p>This program is administered through an National Institutes of Health (NIH)/National Institute of General Medical Sciences (NIGMS) grant to the Great Plains IDeA-Clinical Translational Research (CTR) Network. The network is a collaborative effort between nine institutions in Nebraska, South Dakota, North Dakota and Kansas designed to reach medically underserved populations and transform health delivery and outcomes in the Great Plains region.  Institutions in the network include University of Nebraska Medical Center, Boys Town National Research Hospital, University of Kansas Medical Center, North Dakota State University, University of North Dakota, University of South Dakota, University of Nebraska at Kearney, and University of Nebraska-Lincoln.</p><p>One of the primary goals of the program is to develop successful clinical and translational research (CTR) investigators. To achieve this goal, selected Scholars are provided with the protected time and seed grant funding to develop competitive CTR projects for submission to the NIH.  The award provides partial salary support and up to $50,000 annually to support preliminary research efforts for up to four years. This competitive Request for Application ( RFA) received an overwhelming response in which four scholars were chosen.</p><p>Dr. Rasetshwane's project focuses on a physiologically-based and technically rigorous approach to treating hearing loss. Rasetshwane states, “Many people with hearing loss who could benefit from hearing aids choose not to use them because of limited benefit and poor sound quality. We have developed a fitting algorithm that utilizes categorical loudness scaling data and a signal-processing algorithm that restores suppression (referred to as the suppression hearing aid), and evaluation of both algorithms resulted in promising outcomes. Ultimately, we believe that work from our laboratory will lead to improved quality in hearing aids and patient satisfaction with their use."<br><br>To learn more about the Great Plains IDeA-CTR Network and our educational and funding opportunities, visit <a href="https://gpctr.unmc.edu/">https://gpctr.unmc.edu</a> or call our office at 402-552-2260.<br></p><p><br></p>
Research Aims to Improve Speech Perception Testing for Spanish Speaking Childrenhttps://www.boystownhospital.org/news/speech-perception-testing-spanish-speaking-childrenResearch Aims to Improve Speech Perception Testing for Spanish Speaking Children2017-06-27T05:00:00Z<p>​Speech perception testing is a critically important tool for assessing children's auditory skills, determining candidacy for sensory devices, and guiding language intervention. A large number of children in the US are raised in Spanish-speaking households (>15%), but speech perception testing is typically performed in English or omitted altogether, due to a lack of appropriate test materials and a shortage of Spanish-speaking audiologists. Moreover, speech perception testing is typically performed in quiet or in relatively steady state noise despite the prevalence of complex and time varying sounds in children's real-world listening environments. The proposed work will develop an easy-to-administer clinical test of speech perception, allowing audiologists (regardless of their language proficiency) to appropriately evaluate Spanish- and English-speaking children in both noise and two-talker backgrounds.</p><h2><strong>Specific Aims</strong></h2><ul style="list-style-type:circle;"><li> <strong><em>Aim 1: Refine test materials and streamline procedures</em></strong></li><li><strong><em>Aim 2: Establish reliability and validity across listener age and hearing status</em></strong></li><li><strong><em>Aim 3: Evaluate procedures in a clinical setting</em></strong></li></ul><p><strong>IMPACT:</strong> The research team assembled to carry out the proposed work includes expertise in basic hearing science, auditory development, speech perception, clinical research, bilingualism, biostatistics, language assessment, and audiology, ensuring the final produce will be a clinical instrument that is both rigorous and practical. The end result is expected to improve our ability to evaluate and thus treat hearing loss in children. </p><p><strong><em>Speech perception testing is one of the most important clinical tools we have for evaluating children's communication abilities.</em></strong><strong> </strong><strong><em>The current failure to comprehensively evaluate speech perception in bilingual children is a significant public health problem that restricts our ability to differentially diagnose auditory disorders, monitor performance over time, and evaluate the effectiveness of interventions in this population. </em></strong>Assessment and intervention resources for pediatric audiologists have fallen behind the rapidly changing demographics in the US. We are under both ethical and legal obligation to address this service gap: the Individuals With Disabilities Education Act specifies that children be assessed in their native language whenever feasible (<a href="http://hospital.boystown.org/News/Pages/Speech-Perception-Spanish-Speaking-Children.aspx?ControlMode=Edit&DisplayMode=Design#_ENREF_56">US Department of Education, 1997</a>).</p><p><strong><em>There is growing consensus that speech recognition performance in a complex speech masker is a better predictor of children's functional listening skills than performance in steady noise or multi-talker babble. </em></strong>Speech perception tests are typically administered in quiet, in relatively steady-state noise, or in multi-talker babble. Informational masking is widely believed to reflect a failure of higher-order auditory processes such as sound source segregation and selective attention; thus, inclusion of a complex speech masker provides an opportunity to tap into the perceptual and cognitive processes that underlie speech understanding in real-world environments containing complex and time-varying sounds (e.g., Hillock-Dunn et al. 2014). </p><h2><strong>Innovation</strong></h2><p><strong><em>The proposed work will yield a scientifically rigorous and clinically efficient test of children's English and Spanish speech perception. </em></strong><strong><em>The development of this speech perception tool takes into account the fact that most audiologists in the US are not fluent in Spanish.</em></strong>  The proposed clinical tool offers an innovative solution for audiologists with limited Spanish proficiency. Specifically, the audiologist administering the test does not need to speak the test language to obtain a valid score. The development of the present tool avoids these problems by using recorded materials for task instruction and stimulus familiarization, and asking children to respond by pointing to the picture associated with the target word. This general approach has been used with some success in the past to evaluate bilingual children's speech perception in quiet (e.g., Comstock and Martin, 1984); the present work is novel in that it evaluates<em>masked </em>speech perception with English and Spanish stimuli that are rigorously controlled and balanced across languages</p><p><strong><em>The proposed test will allow pediatric audiologists, for the first time, to characterize </em></strong><strong><em>speech-in-noise performance as well as functional hearing</em></strong><strong><em> in a two-talker masker.</em></strong> Completion of this work will yield a speech perception tool used to measure performance in the presence of speech-shaped noise or two-talker speech.</p><p><strong><em>Our approach of adapting masker level and using a closed-set response extends the range of ages and auditory abilities of children than can be tested using the same clinical test. </em></strong>Several features of the proposed speech perception measure facilitate its use with children spanning a wide range of ages and auditory skills. Closed-set word recognition reduces the impact of working memory and linguistic familiarity, which can impact sentence recognition (<a href="http://hospital.boystown.org/News/Pages/Speech-Perception-Spanish-Speaking-Children.aspx?ControlMode=Edit&DisplayMode=Design#_ENREF_32">e.g., memory or linguistic familiarity; Klem et al., 2015</a>). Limiting the set of alternative responses makes the task relatively easy (<a href="http://hospital.boystown.org/News/Pages/Speech-Perception-Spanish-Speaking-Children.aspx?ControlMode=Edit&DisplayMode=Design#_ENREF_43">Miller et al., 1951</a>), such that all but the most severely impaired children can perform the task in quiet, whereas adapting the masker level prevents ceiling effects in the best performers. The forced-choice, picture-pointing response eliminates scoring errors associated with speech production problems or non-native accents (<a href="http://hospital.boystown.org/News/Pages/Speech-Perception-Spanish-Speaking-Children.aspx?ControlMode=Edit&DisplayMode=Design#_ENREF_49">Ross and Lerman, 1970</a>;<a href="http://hospital.boystown.org/News/Pages/Speech-Perception-Spanish-Speaking-Children.aspx?ControlMode=Edit&DisplayMode=Design#_ENREF_48">Rimikis et al., 2013</a>), and this type of task has been used successfully for evaluating monolingual English-speaking children as young as 4 years of age. <br></p><p><br></p>
Center for Neurobehavioral Research Awarded Granthttps://www.boystownhospital.org/news/neurobehavioral-research-awarded-grantCenter for Neurobehavioral Research Awarded Grant2017-05-27T05:00:00Z<h2><strong>​Identification of neural and endocrinological biomarkers in posttraumatic stress disorder</strong></h2><p><a href="http://hospital.boystown.org/research/Faculty/Pages/Stuart-White.aspx">Dr. Stuart White, Ph.D.</a> has been awarded a Research Career Program grant from the NIH's National Institute of Mental Health. Dr. White is the Director of the Decision-Making Research Program at Boys Town National Research Hospital's <a href="http://hospital.boystown.org/research/CenterNeurobehavResearch/Pages/default.aspx">Center for Neurobehavioral Research</a>. The grant, totaling over $450,000 over 4 years, will examine the relationship between hormone levels and neural functioning in youth with posttraumatic stress disorder (PTSD).</p><p>PTSD is associated with disruption in emotional response to threat cues and in emotion regulation, as well as increased levels of testosterone. Increased testosterone is associated with increased emotional response to threat cues in the environment and decreases in emotion regulation. However, the way in which the interactions between testosterone and neural functioning might contribute to PTSD is unclear.</p><p>The grant will fund Dr. White, an expert in neural dysfunction underpinning mental illness, to develop skills in hormone research sufficient to address this question. Upon completion of the grant, Dr. White will be well positioned to expand this approach to understanding other mental health and behavioral problems faced by youth, including youth served by the Boys Town Family Home Program and In-Home Family Services.<br></p><p><br></p>
Telepractice Study for Cochlear Implants Aimed at Extending Access to Carehttps://www.boystownhospital.org/news/telepractice-study-for-cochlear-implantsTelepractice Study for Cochlear Implants Aimed at Extending Access to Care2016-10-03T05:00:00Z<p>​​​​​​​Because cochlear implants are a specialty, implant centers are few and sparsely located. Cochlear implant programming, testing and follow-up require frequent visits and substantial time commitments from patients and their families. Many families must travel long distances to reach their clinic appointment, which can be costly and often results in missed time from school and work. And, if a child is unable or unwilling to engage in the programming process, additional appointments would be necessary. </p><p>Boys Town National Research Hospital researcher, <a href="https://www.boystownhospital.org/research/Faculty/Pages/MichelleHughes.aspx" target="_blank">Michelle Hughes, Ph.D.</a>, Director of the <a href="https://www.boystownhospital.org/research/hearing-speech-perception/auditory-prostheses-perception" target="_blank">Cochlear Implant Research Laboratory</a>, is studying the effectiveness of remote cochlear implant service delivery.</p><p>“Our research on remote cochlear implant service delivery will hopefully provide an avenue for increased access to clinical services and better outcomes for all cochlear implant recipients, especially for children who are still developing listening skills,” said Dr. Hughes. </p><p>Dr. Hughes and her team are currently conducting three studies that make up the research project, <i>Telepractice for Cochlear Implants</i>. The studies focus on how to effectively deliver a range of cochlear implant services through remote technology for individuals in varying geographical locations. </p><p>The first study focuses on validating the use of telepractice for pediatric-specific hearing testing procedures that are used to program the cochlear implant. Remote programming of cochlear implant sound processors for adults has been validated in earlier studies, but test methods for young children are much more challenging. Young children do not understand the concepts of soft and loud, nor do they have the language to tell the audiologist about what they hear through the implant. </p><p>Because of this barrier, audiologists use behavioral conditioning methods in a clinic setting that either engage the child with games or reinforce certain behaviors that indicate when they hear a sound. This method requires two clinicians – one who is manipulating the cochlear implant programming software and one who is engaging the child and watching for responses. Recreating the behavioral conditioning for a remote setting adds to the complexity of the task because both clinicians must coordinate communication and timing efforts. Lapses or delays during remote testing may alter results.</p><p>Two other studies in this project are examining ways to test speech understanding with the implant in a remote setting and evaluating outcomes of aural rehabilitation conducted in person versus remotely via videoconferencing. </p><p>“While we still have more work to do, our recent research shows promising results that we believe will greatly expand access to specialized cochlear implant services,” said Dr. Hughes.</p><p>Dr. Hughes’s research team includes Sangsook Choi, Ph.D., Sara Robinson, M.A., CCC-SLP, and Alexis Mills. The Telepractice for Cochlear Implant research project is part of a $212,500 per-year five-year grant funded by the National Institute on Deafness and other Communication Disorders (NIDCD) at the National Institutes of Health (NIH). </p><div class="embed-container"> <iframe width="560" height="315" src="https://www.youtube.com/embed/Q7zIPkgka5g" frameborder="0"></iframe>​ </div>​​ ​
Kathryn Beauchaine Becomes an American Speech-Language-Hearing Association Fellowhttps://www.boystownhospital.org/news/kathryn-beauchaine-asha-fellowKathryn Beauchaine Becomes an American Speech-Language-Hearing Association Fellow2016-09-30T05:00:00Z<p>​Kathryn L. Beauchaine, B.S., M.A., CCC-A, Clinical Coordinator in Audiology at Boys Town National Research Hospital, was elected as a Fellow of the American Speech-Language-Hearing Association (ASHA).<br></p><p>The recognition is one of the highest forms of acknowledgement ASHA bestows, honoring an individual's professional and scientific accomplishments. Every year, only 10 to 12 professionals are chosen by colleagues, marking a lifetime achievement in the field of audiology.</p><p>Beauchaine's contributions include research and publications contributing to the educational knowledge for state Speech-Language-Hearing Associations and national organizations. She has given more than 65 professional presentations and through her collaborations with other professionals in the scientific field, she has co-authored 59 published articles and has appeared in Tier 1 journals, nationally.</p><p>Allan O. Diefendorf, Ph.D., FASHA, and Professor Emeritus at the Indiana University School of Medicine, recently explained why Beauchaine was deserving of this distinguished achievement.</p><p>“Kathy and I are contemporaries and because of our mutual clinical and research interests, we have enjoyed working together over the past 15 years," said Dr. Diefendorf. “Through my collaborations and time with her at events, I've seen her continued national leadership shine. She has a reputation for delivering what her audiences have come to expect from a seasoned authority with experience and knowledge. Based not only on scholarly pursuits, but through thoughtful studies and laboratory research, she has shown how much she truly cares about the advancements toward the field of audiology."</p><p>Beauchaine first started at Boys Town Hospital as a student in the spring of 1979. After an internship with the Mayo Clinic, she returned as an employee and has been an integral part of the audiology team for 37 years. She dedicates her time to working on the daily operations of the audiology clinics, provides quality patient care and participates in hearing research projects. She has served on committees and working groups including ASHA, Nebraska Early Hearing Detection and Intervention (EHDI), Nebraska Department of Health and Human Services and the Centers for Disease Control and Prevention.</p><p>“I love being a part of the Boys Town mission and incorporating my love of audiology and research to the change that helps communities across the world," said Beauchaine. “I am honored to join the dedicated Fellows of ASHA and will continue collaboration with my wonderful colleagues and friends!"</p><p>Her work with pediatric audiology has impacted and accelerated service provision to many infants, young children and families. Congratulations to Kathy Beauchaine on her Fellowship Award!<br></p><p><br></p>
Michael Gorga, Ph.D. Earns High Honor for His Impact on Audiology Researchhttps://www.boystownhospital.org/news/michael-gorga-honored-for-audiology-researchMichael Gorga, Ph.D. Earns High Honor for His Impact on Audiology Research2016-09-22T05:00:00Z<p>​On March 3, 2016, Michael Gorga, Ph.D., Director of the Human Sensory Physiology Laboratory at Boys Town National Research Hospital, gave the Carhart Memorial Lecture at the annual meeting of the American Auditory Society.  T his lecture, named after the "father of audiology," Raymond Carhart, is considered the most prestigious lecture in audiology.</p><p>During his lecture, Michael presented a sampling of 35 years of high-impact translational research from his laboratory.  Work from his group has had major influences on the implementation of universal newborn hearing screening and the identification and quantification of hearing loss in infants, young children and patients with developmental disabilities who are unable to provide voluntary responses to sound. In addition, Michael has contributed to research that has increased our understanding of auditory function in both individuals with normal hearing and those with hearing loss. </p><p>Michael began working at Boys Town Hospital i n 1981, spending much of his early career focused on directing clinical services.  This direct clinical experience led to his observations of the inadequacies of assessment tools and the need for translational research to improve the services provided to patients. To address this important clinical issue, Michael sought and received funding from the National Institutes of Health (NIH-NIDCD), which has been continuous for the past 20 years. </p><p>With support from the NIH and Boys Town Hospital, Michael has been able to lead a creative and productive research program.  He has produced over 130 publications in archival, refereed and scientific journals, which is the second-highest level of published research in the history of Boys Town Hospital.  Michael frequently acknowledges the contributions of his colleagues at Boys Town Hospital have made to his success.  He considers himself fortunate to have had so many smart colleagues throughout his career.  This group includes co-investigators, postdoctoral fellows and graduate students.  Michael readily admits that without the help of these individuals and the environment at Boys Town Hospital, any success he has had would have been greatly diminished. </p><p>As Michael's career winds down, he looks back fondly on his work experiences and is thankful for the opportunities he has had to contribute to the body of knowledge related to the identification and diagnosis of hearing loss.  He considers his invitation to give the Carhart Memorial Lecture a wonderful recognition and a fitting capstone to a career well-spent.   Those who have worked with him can't help but agree.</p><p> "Michael deserves this award not only because he has done good work, but because he has mentored a lot of scientists, including me," said Ryan McCreery, Ph.D., Director of the Center for Audiology. "If you just look at the people who have worked with him - students and postdocs – they have gone on to be very successful in their own right. He has that academic family tree that shows he not only did a lot of great work himself, but he enabled other people to do really amazing work as well."</p><p>Michael Gorga epitomizes translational science. Boys Town National Research Hospital thanks Michael for his contributions to the mission and the impact he had on the field of audiology and congratulates him for his accomplishments locally, nationally and internationally, as recognized by this prestigious award. <br></p><p><br></p>
Brain Imaging Research Aims to Improve Outcomes for Children with Behavioral and Mental Health Problemshttps://www.boystownhospital.org/news/brain-imaging-research-behavioral-and-mental-healthBrain Imaging Research Aims to Improve Outcomes for Children with Behavioral and Mental Health Problems2016-09-06T05:00:00Z<p>A new era of childhood behavioral health is underway at Boys Town. Boys Town National Research Hospital and Boys Town Youth Care Services are collaborating in neuroscience research in the hopes of understanding what is physically and biologically happening in the brain of a troubled child.</p><p>Many of the children who come to Boys Town have serious mental health problems such as mood disorder​s, problems with impulse control, self-harm and aggression. The goal of this research is to improve behavioral assessment, distinguish individual types of cognitive difficulties and identify novel, evidence-based interventions to increase positive outcomes for all children with behavioral and mental health problems.</p><p>Boys Town has assembled some of the brightest minds in cognitive neuroscience including James Blair, Ph.D., as Director of the Center for Neurobehavioral Research in Children. Dr. Blair joins Boys Town after 12 years at the National Institute of Mental Health, where he served as Chief of the Unit on Affective Cognitive Neuroscience. Dr. Blair is internationally known for his significant insights into conduct disorders in children and adolescents and his talent in using brain imaging technology to study behavior traits.</p><p>“Dr. Blair's expertise in conduct disorder research fits directly into our strategic goals and our mission to help more children and families," said John Arch, Executive Vice President of Healthcare and Director of Boys Town National Research Hospital. “The future of behavioral health care will be guided by a greater understanding of brain activity and biology. This pairing will lead to better, more effective treatments for all children with behavioral and mental health problems."</p><p>Dr. Blair brings a team of highly-regarded neuroscientists from his previous research laboratory: Stuart White, Ph.D.; Karina Blair, Ph.D. and Harma Meffert, Ph.D. The team is conducting research studies focused on mood and anxiety disorders, disruptive disorders, substance abuse and web and computer-based therapeutics.</p><p>“Boys Town offers a unique environment with access to cutting-edge neuroscientific techniques and a population of youth facing the sorts of difficulties that have been largely neglected by researchers," said Dr. Blair. “Given that Boys Town is spread across the country, our discoveries can be translated to a broad base of clinicians faster and more efficiently, getting the best intervention methods to more children who need help."</p><p>To enable the work of Dr. Blair and his team, Boys Town Hospital has purchased the latest functional magnetic resonance (fMRI) technology that offers a safe, noninvasive way to better understand the functioning of the brain. The fMRI uses magnets, not radiation, to take real-time pictures to determine well a child's brain is functioning. Photos are taken before and after interventions to help researchers determine the best evidence-based solution for a child.</p><p>“Two children may show very similar defiant or problematic behaviors, but for very different reasons," said Dr. Blair. “Our research will help develop assessment tools that will uncover the cause of children's difficulties so we can more precisely target the intervention to really help the individual child."</p><p>Boys Town is on the leading edge of this work that will change the way America will care for children with beh​avioral and mental health disorders.<br></p><p style="text-align:center;"> <a href="https://www.youtube.com/watch?v=cWncEc3np4c"> <strong>Watch Video Overview: Center for Neurobehavioral Research</strong></a></p><p style="text-align:center;"> <a href="/services/hospital-care/imaging"> <strong>Boys Town National Research Hospital 3T MRI and Patient Caring ​Suite</strong></a></p><p>To schedule an interview with James Blair, Ph.D., or to request photos or b-roll of the research, contact:</p><p>Colin Crawford<br>Video Producer and Media Coordinator<br> 531-355-6624<br><a href="mailto:Colin.Crawford@boystown.org">Colin.Crawford@boystown.org</a></p>
Advancing Hearing Research with Virtual Reality Technologyhttps://www.boystownhospital.org/news/advancing-hearing-research-virtual-reality-technologyAdvancing Hearing Research with Virtual Reality Technology2016-06-15T05:00:00Z<p>​It’s cool, modern and a lot of fun to instantly transpose your sight and mind to believing you are in another location. That’s the technology behind virtual reality. So what does visual stimulation have to do with hearing research? </p><p>The researchers at Boys Town National Research Hospital are leveraging virtual reality technology to create the illusion that research subjects are in specific environments, such as classrooms or cafeterias, when really they are in a controlled environment. </p><p>“Virtual reality allows my lab to match the visual space with the audio space for participants,” explains Dawna Lewis, Ph.D., Director of the Listening and Learning Laboratory at Boys Town National Research Hospital. “For example, desks, chairs, books on the bookshelves and blackboards across the room are all visible and match the environment we want to represent. The participants may also see reflections of light, like a sun ray coming from the window or a light dancing on the surface of a desk. It feels very realistic.” </p><p>Dr. Lewis is studying how to improve communication access for children with mild hearing loss, in complex listening environments. With a simulated classroom environment, including audio-visual cues and background noise, she is able to conduct a controlled experiment and track the difficulties that children with hearing loss are having with hearing and understanding speech at school and in other noisy environments. </p><p>This research is important because about five percent or 3 million school-age children in the U.S. have some degree of hearing loss. Previous research shows that children with hearing loss often do not perform as well as their normal hearing peers in academic settings. </p><p>In previous ​studies, a classroom was simulated by surrounding participants with five different television screens and having the subjects turn to each screen when an auditory-visual cue was given. </p><p>“This is a big step from our previous study,” said Timothy Vallier, M.M., research systems analyst and virtual reality software developer. “By taking away the distraction of the room looking different from how it sounds, we may see a higher performance from the subjects in this virtual environment.”</p><p>The virtual reality research will help identify why children with mild hearing loss perform the way they do in noisy environments and hopefully lead to further understanding of the accommodations that will benefit learning for these children across their educational lifespan. </p><p>“Virtual reality opens current and future experimental possibilities and has the potential to influence audiological and educational strategies,” explains Dr. Lewis. “We hope we can use the technology to help children and families within our community as well as worldwide.”</p><p>Utilizing this kind of technology has fellow Boys Town scientists excited for what the future holds – new research, new findings and more ways to help children, families and communities. </p><div class="embed-container"> <iframe width="560" height="315" src="https://www.youtube.com/embed/AcOhffPsd-0?rel=0" frameborder="0" id="widget2"></iframe> </div>​​
Dawna Lewis, Ph.D., Studies Effects in Children with Mild Bilateral and Unilateral Hearing Loss in Complex Listening Environmentshttps://www.boystownhospital.org/news/hearing-loss-in-complex-listening-environmentsDawna Lewis, Ph.D., Studies Effects in Children with Mild Bilateral and Unilateral Hearing Loss in Complex Listening Environments2016-06-06T05:00:00Z<p>​​</p><p style="margin-top:0.357em;margin-bottom:0.929em;color:#333333;font-family:tahoma, arial, sans-serif;font-size:14px;">New studies at Boys Town National Research Hospital are using simulation environments to examine auditory skills in elementary age children with mild bilateral or unilateral hearing loss and how these skills relate to understanding speech in everyday situations such as classrooms, gymnasiums and cafeterias.</p><p style="margin-top:0.357em;margin-bottom:0.929em;color:#333333;font-family:tahoma, arial, sans-serif;font-size:14px;">“In complex listening environments, children with mild hearing loss may have difficulty concentrating due to factors including multiple talkers, new information being taught and multiple sources of background noises,” said <a href="http://hospital.boystown.org/research/Faculty/Pages/DawnaLewis.aspx" target="_blank" style="color:#4db3d0;text-decoration-line:underline;">Dawna Lewis</a>, Ph.D., Principal Investigator and Director of the <a href="http://hospital.boystown.org/research/HearingResearch/Pages/ListeningandLearningLab.aspx" target="_blank" style="color:#4db3d0;text-decoration-line:underline;">Listening and Learning Laboratory</a>. “Research conducted in the 1980s and 1990s found these children were failing at a rate 10 times higher than their peers with normal hearing. The purpose of the work being done in my lab is to examine which factors may be affecting listening for an estimated three million children with these types of hearing loss.”</p><p style="margin-top:0.357em;margin-bottom:0.929em;color:#333333;font-family:tahoma, arial, sans-serif;font-size:14px;">The Listening and Learning Laboratory is equipped with technology that allows simulation of acoustic environments that are similar to those that children experience in a real-world school setting. For example, gymnasiums, cafeterias and classrooms have hard surfaces that create reverberation as well as have multiple talkers from many directions and at varying voice levels. Dr. Lewis and her staff are able to simulate the acoustics of the settings they want to test while maintaining experimental control.</p><p style="margin-top:0.357em;margin-bottom:0.929em;color:#333333;font-family:tahoma, arial, sans-serif;font-size:14px;">“Children should have the best environment for learning,” said Dr. Lewis. “Elementary classrooms are typically the noisiest. While classrooms in middle and high school years may have lower levels of background noise, the material being learned becomes more complex. By focusing on elementary age children in our current studies, we hope to be able to find strategies and technology that will help them process new information they are learning across all grade levels.”</p><p style="margin-top:0.357em;margin-bottom:0.929em;color:#333333;font-family:tahoma, arial, sans-serif;font-size:14px;">The study is one of five labs covered by an $11.3 million, five-year Centers of Biomedical Research Excellence (COBRE) grant, awarded to the hospital by the National Institutes of Health to develop a Center for Perception and Communication in children.</p><p style="margin-top:0.357em;margin-bottom:0.929em;color:#333333;font-family:tahoma, arial, sans-serif;font-size:14px;">Tessa McDermott, B.S. and Andrew Dergan, B.S. currently work as research assistants in the lab. Tim Vallier, M.M., a systems analyst, provides support through the Technical Core. Sara Robinson, M.A. and Sarah Al-Salim, Au.D., provide speech-language and audiological support through the Clinical Measurement Core. Boys Town Hospital collaborators include Judy Kopun, M.A., Lori Leibold, Ph.D., Ryan McCreery, Ph.D., Mary Pat Moeller, Ph.D., and Nicholas Smith, Ph.D. Outside collaborators include Kendra Schmid, Ph.D., University of Nebraska Medical Center and Bruce Tomblin, Ph.D., University of Iowa.​​​<br></p><p><br></p>
New Research Studies to Help Children with Mild Hearing Loss in Complex Listening Environmentshttps://www.boystownhospital.org/news/mild-hearing-loss-complex-listening-environmentsNew Research Studies to Help Children with Mild Hearing Loss in Complex Listening Environments2016-05-17T05:00:00Z<p>New studies at Boys Town National Research Hospital are using simulation environments to examine auditory skills in elementary age children with mild bilateral or unilateral hearing loss and how these skills relate to understanding speech in everyday situations such as classrooms, gymnasiums and cafeterias.</p><p>“In complex listening environments, children with mild hearing loss may have difficulty concentrating due to factors including multiple talkers, new information being taught and multiple sources of background noises," said <a href="http://hospital.boystown.org/research/Faculty/Pages/DawnaLewis.aspx">Dawna Lewis, Ph.D.</a>, Principal Investigator and Director of the <a href="http://hospital.boystown.org/research/HearingResearch/Pages/ListeningandLearningLab.aspx">Listening and Learning Laboratory</a>. “Research conducted in the 1980s and 1990s found these children were failing at a rate 10 times higher than their peers with normal hearing. The purpose of the work being done in my lab is to examine which factors may be affecting listening for an estimated three million children with these types of hearing loss."</p><p>The Listening and Learning Laboratory is equipped with technology that allows simulation of acoustic environments that are similar to those that children experience in a real-world school setting. For example, gymnasiums, cafeterias and classrooms have hard surfaces that create reverberation as well as have multiple talkers from many directions and at varying voice levels. Dr. Lewis and her staff are able to simulate the acoustics of the settings they want to test while maintaining experimental control.</p><p>“Children should have the best environment for learning," said Dr. Lewis. “Elementary classrooms are typically the noisiest. While classrooms in middle and high school years may have lower levels of background noise, the material being learned becomes more complex. By focusing on elementary age children in our current studies, we hope to be able to find strategies and technology that will help them process new information they are learning across all grade levels."</p><p>The study is one of five labs covered by an $11.3 million, five-year Centers of Biomedical Research Excellence (COBRE) grant, awarded to the hospital by the National Institutes of Health to develop a Center for Perception and Communication in children.</p><p style="text-align:center;"> <a href="http://hospital.boystown.org/knowledgeCenter/Videos/Pages/Understanding-Speech-in-Complex-Listening-Environments.aspx" target="_blank">Watch Video Overview: Understanding Speech in Complex Listening Environments</a></p><p>To schedule an interview with Dawna Lewis, Ph.D., or to ​request B-roll of the research, contact:</p><p>Colin Crawford<br>Video Producer and Media Coordinator <br> 531-355-6624<br><a href="mailto:Colin.Crawford@boystown.org">Colin.Crawford@boystown.org</a> </p>
Boys Town National Research Hospital Study to be Honored at American Auditory Society Annual Meetinghttps://www.boystownhospital.org/news/study-honored-at-american-auditory-societyBoys Town National Research Hospital Study to be Honored at American Auditory Society Annual Meeting2016-03-25T05:00:00Z<p>​​For decades, Boys Town National Research Hospital has been working to change the way America cares for kids. We know the progress we have made – we see it in the lives of our patients and the work of our colleagues every day. Now another organization is recognizing the work that is being done by our researchers.</p><p>The first weekend of March in Scottsdale, AZ., representatives from Boys Town Hospital attended the American Auditory Society ​(AAS) Annual Meeting, where they were honored for their work with children who are hard of hearing in a study conducted over a five year period.</p><p>In 2008, Boys Town Hospital researchers in audiology and child language development began working with researchers at The University of Iowa and the University of North Carolina at Chapel Hill. The team designed and facilitated a multi-site longitudinal study to examine the outcomes of children, ages 0-6, with hearing aids and the factors that affect these outcomes.</p><p>In 2015, the results for this study, Outcomes of Children with Hearing Loss (OCHL), was released, and the research began receiving international attention. The co-principal investigators are Mary Pat Moeller, Ph.D. of Boys Town Hospital and J. Bruce Tomblin, Ph.D., emeritus professor at the University of Iowa. A nine-article supplement volume in the professional journal <em>Ear and Hearing</em> was entirely devoted to OCHL and, the journal editors awarded this OCHL supplement volume a special recognition award to be presented to Moeller and Tomblin and the research team at the AAS meeting.</p><p>Additional Boys Town Hospital personnel who contributed to OCHL are Sophie Ambrose, Ph.D.; Ryan McCreery, Ph.D.; Merry Spratford and Lauren Unflat-Berry.</p><p>McCreery, Spratford and Pat Stelmachowicz, Ph.D., attended the AAS meeting and had the opportunity to be recognized on stage with Moeller when the award was announced. In addition, McCreery gave a podium presentation on sentence recognition in noise and reverberation for children with hearing aids. Both he and Spratford presented several poster sessions from Boys Town Hospital research including “Vocabulary Facilitates Speech Perception in Children with Hearing Aids,” “Relationships of Cognitive Abilities to Spectro-Temporal Ripple Detection,” “Does Sentence Predictability Influence Word Identification in School-Age Children?” and “Teacher & Student Perceptions of Student Classroom Listening Ability.”</p><p>Boys Town Hospital is proud of the work being done in the research labs here in Omaha. Their hard work will lead to improved services for children and adults around the country.</p><div class="embed-container"> <iframe width="560" height="315" src="https://www.youtube.com/embed/eXIF97g8CC0?rel=0" frameborder="0"></iframe> </div>​<br>
Learning to Hear: Understanding Speech in Noise from Infancy to Adolescencehttps://www.boystownhospital.org/news/understanding-speech-in-noiseLearning to Hear: Understanding Speech in Noise from Infancy to Adolescence2016-01-18T06:00:00Z<p><a href="http://hospital.boystown.org/research/Faculty/Pages/Lori-Leibold.aspx">Lori Leibold, Ph.D.</a>, Director of the Center for Hearing Research and <a href="http://hospital.boystown.org/research/HearingResearch/Pages/Human-Auditory-Development-Lab.aspx">Human Auditory Development Laboratory</a> at Boys Town National Research Hospital will be presenting <em>Learning to Hear: Understanding Speech in Noise from Infancy to Adolescence</em> on Sunday, Feb. 14, 2016 from 8:00 a.m. to 9:30 a.m. in the Marshall Ballroom South (Marriott Wardman Park) at the American Association for the Advancement of Science's (AAAS) 2016 Annual Meeting in Washington, D.C.</p><p>Dr. Leibold's presentation will focus on research showing that children have more difficulty than adults when listening to speech in the presence of competing background sounds, particularly when the background sounds are also speech. One surprising finding from Dr. Leibold's program of research is that the ability to hear and understand speech in the presence of other people talking remains immature into the adolescent years. The lecture will focus on studying how extensive listening experience and neural maturation are required for children to master the perceptual skills required to hear and understand speech in noisy environments.</p><p>This study impacts all children with hearing loss because children spend the majority of their days in environments that include multiple people talking at the same time. While these environments are challenging for children who are typically developing, emerging new findings indicate that hearing loss exacerbates the difficulties all children have in noisy environments.</p><p>Dr. Leibold will be one of three speakers during the presentation, <em>I Can't Hear Myself Think! Noise and the Developing Brain from Infancy to Adulthood</em>. Other speakers include Amir Lahav, Assistant Professor in the Department of Pediatrics at Harvard Medical School and Rochelle Newman, Professor and Chair in the Department of Hearing and Speech Sciences, and Associate Director of the new Maryland Language Science Center at the University of Maryland. For more information, ​visit <a href="https://aaas.confex.com/aaas/2016/webprogram/Session12139.html">AAAS.org</a>.</p>
Cochlear Implants and Voice Emotion Recognition: A conversation with Dr. Monita Chatterjeehttps://www.boystownhospital.org/news/cochlear-implants-and-voice-emotion-recognitionCochlear Implants and Voice Emotion Recognition: A conversation with Dr. Monita Chatterjee2015-10-30T05:00:00Z<p>Cochlear implants have helped many individuals with hearing loss understand speech and other sounds since the U.S. Food and Drug Administration (FDA) first approved cochlear implant devices for adults in 1985 and for children in 1990. Monita Chatterjee, Ph.D., Director of the Auditory Prostheses and Perception Laboratory at Boys Town National Research Hospital was recently interviewed for a weekly podcast by Science, one of the premiere scientific journals in the United States.</p><p>“Although the technology is constantly evolving, individuals wearing cochlear implants still have difficulty perceiving changes in pitch or frequency of a speaker's voice, which makes it hard to recognize conveyed emotions or the speaker's mood," said Dr. Chatterjee.</p><p>One aspect of her lab's NIH-funded research focuses on the study of how well children with cochlear implants can convey and detect voice emotion with their devices.</p><p>“With children who have hearing loss and are listening through a cochlear implant, we wonder if their social development relates to their ability to recognize or communicate voice emotion," said Dr. Chatterjee. “There is some published work suggesting that cochlear-implanted children have self-perceived quality of life is related to their voice emotion identification performance. Research is limited and no definite answers are available yet."</p><p>In a recent study published in Hearing Research, Dr. Chatterjee's team at Boys Town Hospital and her collaborators at Johns Hopkins University compared voice emotion recognition by individuals with cochlear implants and normal hearing listeners. Using simple emotion-neutral sentences spoken in five different emotions – happy, sad, angry, scared and neutral – they asked listeners to identify the emotion associated with each utterance.</p><p>The cochlear implanted children showed large variations in performance but on average performed about as well as adults with cochlear implants. The key difference between these two groups were the cochlear-implanted adults who had hearing at birth and had learned spoken language normally through acoustic hearing, and the children with cochlear implants who had very little or no exposure to sounds at birth and had learned spoken language through the implant itself. The two groups showed similar performance underscores showing the benefit received by the children from their devices. Both groups of implant users, however, performed significantly worse than normal hearing children and adults.</p><p>In the same study, children and adults with normal hearing listened to the same sentences but processed digitally through a noise vocoder, which simulated information transmitted by a cochlear implant. Normal hearing listeners' performance declined as sounds were progressively degraded, with the children showing much poorer emotion recognition than adults in the degraded condition.</p><p>Results showed normal hearing children who were younger, struggled significantly more with the simulated cochlear implanted speech than older children, even though they all did very well with the natural speech sounds. The children had never heard vocoded speech before and had no prior experience with distorted speech. On the other hand, the children with cochlear implants had long periods of experience with their devices and clearly benefited from it.</p><p>These tests show how important it is for the brain to be accustomed to the input sound, especially for younger children. Brains of young children are still developing and the auditory and language systems continue to develop well into the adolescent years. Dr. Chatterjee and her team speculate that their work has implications for peer-to-peer and other social communication, especially at a younger age, which may play an important role in quality of life and social development.</p><p>“Hearing with cochlear implants or listening to degraded sounds takes a lot of cognitive effort, and there's more and more interest in the area as we realize the reason cochlear implants work, is that the brain is amazing and does a lot of reconstruction and repair from incoming degraded signals," said Dr. Chatterjee. “The results we found show a huge variation in the performance by these children and adults with cochlear implants – some children with cochlear implants did quite poorly although others did really well in voice emotion recognition, and it really shows how far we have yet to go in cochlear implant research."</p><p>While the success of cochlear implants and the availability of the device (children as young as 12 months of age can receive cochlear implants) is a miracle in itself for the medical world, the mission now is to improve the technology in order to optimize hearing and speech communication for patients. In ongoing analyses of children's speech, Dr. Chatterjee's team is finding that children with cochlear implants make smaller acoustic contrasts between “happy" and “sad" emotions than their normal hearing peers. Dr. Chatterjee and her team recently presented their research at the 169th meeting of the Acoustical Society of America in Pittsburgh, PA.</p><p>“There's been a lot of discussion in the medical world and it seems like the ability to transmit high-quality voice pitch information to the listener will be part of the next big leap in cochlear implant research," said Dr. Chatterjee. “Understanding more about how the brain processes voice pitch information transmitted by cochlear implants is a key step and we hope by sharing our knowledge and continuing to learn more from our own and other labs' research, we can contribute to the global effort in this area."</p><p>The Cochlear Implant Center at Boys Town National Research Hospital has provided cochlear implants to more than 500 children and adults with moderate to profound hearing loss and has more than 600 patients from across the country.</p><p>Listen to Dr. Chatterjee's full podcast interview on <a href="http://www.sciencemag.org/content/348/6240/1274.2.full" target="_blank"><span style="text-decoration:underline;">Sciencemag.org</span></a>, published on June 12, 2015.</p>
National Study finds Providing Well-Fit Hearing Aids in Infancy Helps Many Hard of Hearing Children Develop Optimal Speech and Language Skillshttps://www.boystownhospital.org/news/hearing-aids-help-develop-speech-skillsNational Study finds Providing Well-Fit Hearing Aids in Infancy Helps Many Hard of Hearing Children Develop Optimal Speech and Language Skills2015-10-30T05:00:00Z<p>​On October 27, 2015, findings from a national study called Outcomes of Children with Hearing Loss were published in a special supplement volume of the journal, <a href="http://journals.lww.com/ear-hearing/toc/2015/11001" data-ytta-id="-"><em>Ear and Hearing</em></a>. Results include the discovery that many hard of hearing children who receive optimal, early services are able to “catch up or significantly close the gaps with their hearing peers," according to Bruce Tomblin, Ph.D., an emeritus professor in the University of Iowa's Department of Communication Sciences and Disorders.</p><p>“Hearing well is crucial to developing speech and language skills, building social connections and succeeding in life," says Mary Pat Moeller, Ph.D., director of the Center for Childhood Deafness and the language development laboratory at Boys Town National Research Hospital.</p><p>Moeller and Tomblin have been co-principal investigators on this longitudinal research collaboration with the University of Iowa, Boys Town National Research Hospital and the University of North Carolina at Chapel Hill since 2008.</p><p>Other main takeaways from the study include: hearing aid provision in early infancy results in better early language outcomes, but children who were fit later showed the ability to resolve early language delays after hearing aids were used for an extended period; consistent daily hearing aid use provides some protection against language delay and supports auditory development; the richness of parents' or caregiver's talk with the child positively influences children's language abilities.</p><p>Moeller says that this study empowers parents, health care providers, and educators with the empirical support to put protections in place that may help children with hearing loss succeed in all facets of their lives.</p><p>“Protection arises from properly fit hearing aids that are used consistently and from providing a rich language environment around the child," Moeller says, “as well as making sure the families who need additional support and knowledge receive it."</p><p>Researchers at Boys Town National Research Hospital conducted the early research that led to the development of universal newborn hearing screening, which is now a nationally mandated screening for all babies born in the U.S. Universal newborn hearing screening programs have led to identification of hearing loss during infancy, but research on the impact of early intervention on the development of children who are hard of hearing has not been conducted on a large scale.</p><p>“The work in the supplement issue was designed to respond to a major gap in research on hard of hearing children. The largest study ever done in the U.S. was in the 1980s and it only had 40 hard of hearing children," said Moeller. “Previous studies did not specifically explore the impact of interventions (like hearing aids) on children's speech and language growth over time."</p><p>Over five years, the Outcomes of Children with Hearing Loss study collected data from 317 children who are hard of hearing and 117 children with normal hearing, from 17 states. With a few exceptions, children in the study had permanent, bilateral hearing losses, ​and all but a few children were fitted with hearing aids.</p><p>This is the first study of its kind in the United States to identify a large group of young children who are hard of hearing and follow their language development for several years.</p><p>The study was funded by the National Institutes of Health–National Institute on Deafness and Other Communicative Disorders (NIDCD-DC009560).</p><h2> <a href="https://www.boystownhospital.org/knowledge-center/new-study-of-mild-to-moderate-hearing-loss" data-ytta-id="-">Outcomes of Children with Hearing Loss Video</a></h2><p> <strong>To schedule an interview with Mary Pat Moeller, Ph.D., contact: </strong><br>Brooke Wittrock<br>Marketing and Communication, Boys Town National Research Hospital<br>531-355-6640 or 531-355-4645<br><a href="mailto:Brooke.Wittrock@boystown.org" data-ytta-id="-">Brooke.Wittrock@boystown.org</a></p><p> <strong>To schedule an interview with Bruce Tomblin, Ph.D., contact: </strong><br>Lois J. Gray<br>Office of Strategic Communication, University of Iowa<br>319-384-0077 or 319-430-3740 <br><a href="mailto:lois-gray@uiowa.edu" data-ytta-id="-">lois-gray@uiowa.edu</a></p>