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Improving Children's Auditory Rehabilitation

Final Report Summary - ICARE (Improving Children's Auditory Rehabilitation)

improving Children’s Auditory Rehabilitation or iCARE ( focusses on optimizing spoken communication in children with hearing impairment by developing novel methods, training skills and procedures. Hearing impairment (HI) is highly prevalent with 1.2 per 1000 infants born with bilateral hearing loss. HI at birth severely affects the development of spoken language, learning, psychosocial development and academic achievement if not appropriately handled. The EU promotes the active inclusion and full participation of disabled people in society. However, full active inclusion in an oral society can only be achieved through cooperation and involvement across disciplines (language, psychology, audiology, engineering, special education,...). It is therefore of fundamental importance to approach the inclusion of children with HI in an holistic and interdisciplinary manner, and to train future experts to adopt such principles in their research and practice.

iCARE involved 17 European partner institutions (7 academic full-partners, 2 industrial full-partners, and 8 associated academic partners), coordinated by prof dr Astrid van Wieringen ( iCARE recruited 11 early stage researchers (ESRs) and 5 experienced researchers (ERs) divided over 4 main research WPs: communication accessibility (WP1), improving acoustics (WP2), auditory remediation (WP3), and integration and e-learning (WP 4). The fellows came from very different disciplines and represented a good gender balance (70% female). More details can be found on the website

iCARE was a fantastic project, which has certainly pushed the field forward thanks to the dedicated and enthusiastic input of all partners and fellows. Both research and training were highly successful. All milestones and deliverables were met and have led to new collaborations, which go beyond the project. All members of the consortium have presented state-of-the art findings at national and internal conferences (140 abstracts) and have participated in approximately 90 outreach activities. ESRs are currently pursuing their 4th year, which will be completed with (more) peer-reviewed papers (11 already published) and doctorates. A summary of main research achievements is given below.

WP1 (5 ESRs, 2 ERs) has demonstrated how datalogging of a cochlear implant (CI) can be used as a meaningful tool for the clinical rehabilitation of children with HI. Moreover, the research of this WP has provided a procedure to measure spatial hearing in virtual and real rooms in children with normal hearing (NH) children and children with auditory processing difficulties. Because of iCARE an innovative project was possible for children with unilateral hearing impairment who received a CI in the deaf ear. A protocol was developed to monitor the spoken language and neurocognitive development of children with SSD with and without a CI. In addition, a prototype of a mobile-based game was developed to help children with CIs train their auditory skills. A more technical deliverable concerned the development of a prototype, which combines geometric and appearance-based computer vision and machine learning methods to automatically detect visual cues in face-to-face dyadic interaction videos. Also, the neural processing of sounds in children with mild to moderate hearing loss was researched by means of electroencephalography.

WP2 (3 ESRs, 1 ER) has produced auditory training for children with hearing loss in virtual acoustic environments. Moreover, the research of iCARE has allowed for the development of a mobile acoustic laboratory to measure localization abilities of normal-hearing children and patients at locations outside the hospital. It has also resulted in the development and evaluation of a real-time virtual acoustics system with simulated room acoustics for hearing aid users. A binaural real-time auralization framework was implemented and assessed objectively allowing for the simulation and playback of both simulated hearing aid signals and an external sound field, including room acoustic simulations. In addition, strategies were developed to measure and assess the interaction of environmental, perceptual and cognitive factors during speech processing in bilingual children and non-invasive (EEG) and (psychophysical methods were developed to research cross-modal (audiovisual) plasticity.

WP3 (2 ESRs, 1 ER) has resulted in the design, development, and validation of WASP, an innovative behavioural paradigm to assess listening effort in children with HI, with normative data from different age groups. Moreover, children with normal hearing and CIs were trained with the Swedish version of Klauer’s inductive reasoning program (Tankespelet). Finally, research from this WP shows that neural correlates of lexical expectations may be able to predict the participant's perception of the upcoming speech input.

WP4: (1ESR, 1 ER) has focused on the development and implementation of learning materials for the iCARE fellows. Core interdisciplinary competencies were researched from the literature and an interdisciplinary competency framework was proposed. Learning modules were developed according the 4C/ID model, with simple to more complex learning tasks addressing complex problems of children with HI. Moreover, webinars were presented by the consortium and the fellows, in addition to the local and network-wide training.

Benefits and socio-economic impacts
iCARE has been instrumental with regard to the development of a holistic approach when addressing the needs of children with HI and their inclusion in oral society. The balanced distribution of leading expertise in hearing, education, information technology, acoustics, and the international and intersectoral involvement have guaranteed a well-rounded training and and has led to novel developments. All full and associated partners have been very active throughout the project, thereby ensuring that fellows understand the heart of the issue. The different types of training courses and secondments of iCARE have allowed fellows to become thoroughly acquainted with the different concepts and fields of research, as well as with soft skills including planning, reporting, paper writing, management, market awareness, entrepeneurship, etc. Fellows have learned to communicate their scientific work to experts and lay men and still form a tight community. These skills are of utmost importance with regard to career prospects and employability. In sum, the network has allowed for new synergies that would otherwise not be possible and will lead to enduring partnerships, which will continue after the project. Please visit for more information.

Indisputably, the main benefit of Marie Curie funding is to create opportunities for researcher collaborations, to encourage sharing of ideas in an inter-disciplinary context, to bring into play industrial partners with application capacity in order to test the novel ideas and make use of the research findings for the benefit of society. In this project, such benefits have been acquired and exploited, and lots of new scientific ground has been gained in understanding the factors that can guide successful inclusion of children with HI in class, social play and society and developing a foundation for novel products and technological advances.

Keywords: hearing impairment, children, innovation