An fNIRS study to examine executive function in children: Version 1
Research type
Research Study
Full title
Towards the development of an objective measure of executive function in children with a cochlear implant using functional near-infrared spectroscopy (fNIRS).
IRAS ID
257177
Contact name
Douglas E H Hartley
Contact email
Sponsor organisation
Research & Innovation, Nottingham University Hospitals NHS Trust
Duration of Study in the UK
2 years, 1 months, 31 days
Research summary
Research Summary
A cochlear implant (CI) can provide a sensation of hearing to someone who is deaf. This is achieved by electrically stimulating the nerves that carry sound from the ear to the brain. Most children who receive a CI learn to successfully understand speech. However, speech and language abilities in children with a CI vary widely and we still don’t understand why. Children, just like adults, are known to have different patterns of behaviour. It may be that these patterns of behaviour explain the differences in speech and language abilities. We want to know whether the ability of children to perform certain behavioural tasks, such as memory tests, is related to their understanding of speech and learning of words.
This research uses functional near-infrared spectroscopy (fNIRS), a technique for measuring brain activity. It is safe for use in all children, including those with a CI, and doesn’t harm a child’s head. We will use fNIRS to measure brain responses whilst a child is performing behavioural tasks such as searching for a hidden toy. These brain responses or patterns of activity may tell us more about a child’s ability to understand words and learn language. They may even allow us to predict at an earlier stage, which children are at risk of doing poorly in terms of speech and language skills. In the future, this will hopefully allow us to intervene, address and treat poor speech and language development at an earlier stage of a child’s life.
Our research will involve both normally-hearing children and severe-to-profoundly deaf children who are candidates for CI insertion. We will carry out fNIRS alongside behavioural testing either 3 or 4 times over the space of a year or so to assess how brain responses change and develop as a child grows and/or has CIs inserted.
Summary of Results
Cochlear implants are surgically inserted hearing devices that aim to help children with a severe-to-profound hearing loss. While cochlear implants (CIs) allow many infants to develop appropriate language skills, the ability of individual children to understand speech varies widely. Established evidence suggests that certain processes within the brain, such as executive function processes, contribute to variable language performance in children with CIs. Executive function (EF) skills are the mental processes that enable us to plan, focus attention, remember instructions, and juggle multiple tasks successfully.
The experiments in this study aimed to investigate the association between EF and language performance in normal-hearing (NH) children and children with CIs.
Firstly, parents were asked to rate their child's behaviour in terms of EF skills and assess their language performance via specific questionnaires. Parent-reported EF skills were strongly associated with language performance in both NH children and paediatric CI users of preschool age. This relationship was significantly stronger in children with CIs compared with NH children.
This research also used functional near-infrared spectroscopy (fNIRS), a technique for measuring brain activity. We measured how active a particular part of a child’s brain was while they performed certain EF tasks, and how this activity related to their language skills. A strong pattern between the strength of brain activation overlying certain regions in the front part of the left side of the brain and language performance was observed in NH children.
The COVID-19 pandemic had a negative effect on the amount of children that could join in on and participate in this study, especially children with CIs. Therefore, we could not fully explore how brain activation during EF tasks relates to language performance in children with CIs. However, the current results not only highlight the importance of EF skills in language development, but they also support the current theory that such EF processes are potentially more important in deaf children. Furthermore, these findings demonstrate the potential of fNIRS as a brain-imaging tool that is uniquely well-suited for children with CIs. Future advances in this technology could help explain why language performance varies amongst children and to deliver treatments that may improve EF and language skills at an earlier stage of a child's life.
REC name
HSC REC A
REC reference
19/NI/0121
Date of REC Opinion
18 Jun 2019
REC opinion
Further Information Favourable Opinion