# Binaural cue sensitivity in children and adults with combined electric and acoustic stimulation

> **NIH NIH R01** · VANDERBILT UNIVERSITY MEDICAL CENTER · 2024 · $675,898

## Abstract

PROJECT SUMMARY
Cochlear implantation with minimally traumatic surgical techniques and atraumatic electrode arrays has led to
an increasing prevalence of adult and pediatric cochlear implant (CI) recipients with the potential for combined
Electric and binaural Acoustic Stimulation (EAS). Many studies have demonstrated that adult EAS users
consistently exhibit significant benefits for speech understanding in noise and spatial hearing tasks as
compared to a CI paired only with a contralateral HA. We have also demonstrated that sensitivity to interaural
time difference (ITD) and interaural level difference (ILD) cues is correlated with EAS benefit for postlingually
deafened adult listeners. Despite this active phase of discovery, there is still a striking paucity of research on
EAS outcomes in pediatric CI users, the expected trajectory of benefit following EAS fitting, as well as
underlying mechanisms driving EAS benefit (or lack thereof) in all populations. There is a disconnect between
EAS availability and EAS utilization in all CI recipients and current audiological management of EAS
candidates is not data driven. This is problematic given the protracted maturation of the binaural system and
the fact that we do not understand what additional effects sensorineural hearing loss and combined EAS may
have on the developing binaural system. The proposed research activities will describe the time course of
binaural development using behavioral and objective responses to interaural differences in timing (phase) and
level as well as allow for a natural factor investigation of a clinical intervention, the EAS fitting, on said
development. Within the context of a clinical trial, we will compare acute and chronic EAS outcomes for
speech recognition and spatial hearing as related to binaural cue sensitivity, cue weighting, and underlying
neural synchrony necessary for ITD resolution. We have proposed a single-group assignment for both adult
and pediatric EAS users and will also include chronological- and hearing-age-matched listeners with normal
hearing (NH). A within-subjects, accelerated longitudinal design for both EAS and NH listeners will provide
insight into the developmental trajectory of the binaural system for children NH and will provide a benchmark
for interpreting effects of sensorineural hearing loss, asymmetry in audibility resulting from cochlear
implantation, and EAS use on said trajectory. Our proposed research activities will help close the gap between
what is technologically possible with EAS technology and what is clinically implemented by otologists and
audiologists investigating development of binaural sensitivity and spatial hearing abilities. The resultant data
will comprise the first comprehensive description of behavioral and electrophysiologic measures of binaural
hearing in adults and children both with NH and EAS and will uncover information about our EAS clinical
populations holding high potential for clinical application in de...

## Key facts

- **NIH application ID:** 10732267
- **Project number:** 5R01DC020194-02
- **Recipient organization:** VANDERBILT UNIVERSITY MEDICAL CENTER
- **Principal Investigator:** Rene H Gifford
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $675,898
- **Award type:** 5
- **Project period:** 2022-12-01 → 2027-11-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10732267

## Citation

> US National Institutes of Health, RePORTER application 10732267, Binaural cue sensitivity in children and adults with combined electric and acoustic stimulation (5R01DC020194-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10732267. Licensed CC0.

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