Neural dynamics underlying speech processing in children with unilateral hearing loss

The National Institute on Deafness and Other Communication Disorders awarded Father Flanagan's Boys' Home $134,495 on July 10, 2026, under the Research Related to Deafness and Communication Disorders program (CFDA 93.173).

The award funds a K01 Career Development Award project investigating neural dynamics underlying speech processing in children with unilateral hearing loss. The research characterizes behavioral speech perception in the normal-hearing ear of affected children and examines neural dynamics of speech perception using magnetoencephalography, testing the hypothesis that consistent, quality input from both ears during development is critical to ensure robust neural representations of phonemes. The work aims to advance evidence-based rehabilitation approaches for the over 3 million school-age children in the United States with unilateral hearing loss and to address the unmet healthcare need created by current failure-based intervention models.

Work is performed in Omaha, Nebraska, with a period of performance from July 10, 2026, through June 30, 2029. Father Flanagan's Boys' Home, a tax-exempt nonprofit headquartered in Boys Town, Nebraska, operates pediatric neuroscience research infrastructure including magnetoencephalography and structural MRI imaging at Boys Town National Research Hospital and delivers the project as part of its portfolio of longitudinal developmental language and hearing research supported by NIH institutes.

Abstract

Unilateral hearing loss (UHL) affects over 3 million school-age children in the united states. Children with UHL (cuhl) are at significant risk for delayed or disordered auditory, cognitive, speech, and language development, resulting in poor academic performance and quality of life. Currently, there is a distinct lack of empirical evidence to guide rehabilitation for cuhl, leading to a costly, failure-based model of intervention with limited efficacy. This underscores a critical, unmet healthcare need. Prior work has largely attributed the developmental difficulties of cuhl to poorer speech perception resulting from spatial (i.e., binaural) hearing deficits. Emerging evidence suggests this is an incomplete account of the speech perception challenges of cuhl. Even when cuhl have speech presented to their unaffected, normal-hearing ear or utilize a hearing aid, speech perception challenges persist. The research described in this K01 proposal tests the hypothesis that cuhl show experience-dependent alterations in the neural representation of phonological information even when stimuli are presented to their normal-hearing ear. The core premise is that consistent, quality input from both ears is critical in development to ensure robust neural representations of phonemes. To test our innovative premise, we leverage world-class resources and cutting-edge multimodal neuroimaging technology to-for the first time-characterize behavioral speech perception in the normal-hearing ear of cuhl (aim 1) and examine the neural dynamics of speech perception in the normal-hearing ear of cuhl using magnetoencephalography (aim 2). The goal of this K01 career development award is to directly advance the PI's short-term career development goal of combining cutting-edge neurophysiological and behavioral methodology to comprehensively characterize speech perception in cuhl. Our specific objective in this K01 is to address the current gaps in the PI's knowledge and skills in applied cognitive neuroscience, factors related to individual differences in academic, auditory, and language outcomes in hard-of-hearing children, and advanced statistical modeling. The expected outcome of the proposed career development award is advancement of the PI's long-term career goal of becoming a productive, independent investigator whose program of research advances evidence-informed approaches to the management of pediatric unilateral hearing loss. Completion of this novel proposal will also shift the current spatial-hearing centric approach of studying cuhl to a more comprehensive, holistic focus that could provide crucial insights into acoustics, speech, and language abilities involved in spoken language processing. This research falls under nidcd research priority area 2: understanding diseases and disorders, changes in perception with disease.