# Cognitive Outcomes in Children with Hearing Loss and the Effects of Audibility: The COCHLEA Multimodal Imaging Study

> **NIH NIH P20** · UNIVERSITY OF NEBRASKA MEDICAL CENTER · 2020 · $196,554

## Abstract

Summary/Abstract: Research Project (B)
According to the Centers for Disease Control and Prevention, about 1 in 400 children are born with some degree
of hearing loss. It is well-established that children with even modest degrees of hearing loss (CHL) suffer from a
breadth of language and communication delays throughout development compared to matched children with
normal hearing (CNH). These deficits generally correlate with hearing aid (HA) audibility and usage measures,
which is especially pertinent as there is significant variability in HA usage and fit within the CHL population.
Further, children with severe-to-profound hearing loss also exhibit impairments in other cognitive domains such
as working memory, attention, and executive function, and these deficits reliably correlate with measures of
language function in these children. Nonetheless, the degree to which these impairments in other cognitive
domains are also present in the less severe CHL population is unknown. More broadly, it is unclear whether
cognitive deficits exist above and beyond the impact of language in those with milder hearing loss, and it is very
difficult to dissociate the contributions of language to other cognitive functions (e.g., attention) using behavioral
tests alone. This proposal seeks to fill these knowledge gaps, and provide pivotal new data clarifying the impact
of hearing loss on cognitive function, development, and brain activity in children. Our groundbreaking preliminary
work is the first to show that CHL exhibit altered neuronal dynamics during high-order verbal and nonverbal
cognitive processing compared to CNH, and suggests that neuroimaging is a powerful avenue by which to
differentiate the impact of hearing loss on language function versus other cognitive domains. In the proposed
study, we will further identify the effects of hearing loss on verbal and nonverbal higher-order cognition. We will
enroll a large developmental cohort of CHL and demographically-matched CNH to undergo multimodal imaging
with magnetoencephalography (MEG) during a battery of cognitive tests, as well as structural MRI. In Aim 1, we
will probe the behavioral and neural markers of verbal cognitive function and development in CHL and CNH. In
Aim 2, we will quantify behavior and neurophysiology during performance of nonverbal cognitive tasks in the
same groups. In Aim 3, we will clarify the impact of age at intervention, HA fit (e.g., aided audibility), and HA use
on these parameters in CHL. We hypothesize that CHL will exhibit altered behavioral performance and dynamic
neural patterns during these tasks. Specifically, we postulate that neural aberrations will be found in frontal and
parietal language regions during verbal cognitive tasks, but that dorsal attention and frontal executive function
will also be aberrant during nonverbal cognitive tasks, indicative of a general cognitive deficit over-and-above
language function. Finally, we posit that quality of HA fit, amount of HA u...

## Key facts

- **NIH application ID:** 9856129
- **Project number:** 1P20GM130447-01A1
- **Recipient organization:** UNIVERSITY OF NEBRASKA MEDICAL CENTER
- **Principal Investigator:** Elizabeth Heinrichs-Graham
- **Activity code:** P20 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $196,554
- **Award type:** 1
- **Project period:** — → —

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9856129

## Citation

> US National Institutes of Health, RePORTER application 9856129, Cognitive Outcomes in Children with Hearing Loss and the Effects of Audibility: The COCHLEA Multimodal Imaging Study (1P20GM130447-01A1). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9856129. Licensed CC0.

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