Neural Speech Tracking in Infants: Associations with Hearing, Environment, and Language - PROJECT SUMMARY While most infants acquire language with ease, congenital hearing loss commonly causes deficits in speech- language development. Additionally, about 40% of infants with hearing loss have a physical or developmental disability that prevents reliable behavioral responses. Therefore, there is a critical need for an objective measure (i.e., neural biomarker) of speech processing to improve the clinical management of infants and children with hearing loss. Neural speech tracking (NST) is a novel electrophysiological (EEG) technique that quantifies hierarchical encoding of speech from low-level acoustic features (fundamental frequency, spectrogram, speech envelope, acoustic onset) to high-level content (phonetic, prosodic, and semantic). However, little is known about the developmental trajectory of NST while infants are acquiring language and the impact of hearing and environmental factors. To address these gaps, we will conduct a prospective longitudinal study of NST in full- term infants at 1, 6, and 12 months of age. Testing will include assessment of hearing and the environment (social risk, shared reading, home and language environment) as they relate to language outcomes. The specific aims of the study are to evaluate hearing, environmental factors, and language outcomes (Aim 1), examine the developmental trajectory of NST and spontaneous EEG (Aim 2), and examine relationships among hearing, environment, NST and spontaneous activity, and language outcomes (Aim 3). The central hypothesis is that NST will be modulated by age, hearing, and environmental factors and that NST will be correlated with later language outcomes. The expected outcomes are that hearing and environmental factors will have a measurable impact on NST and that NST will prove to be a neural biomarker of language acquisition. The proposed research will advance the field of hearing research by providing a strong foundational knowledge of the developmental trajectory of NST and the impact of hearing and environment as the infant brain assembles functional networks that support speech processing. To improve clinical management of infants and children with hearing loss – a key mission of the NIDCD – a neural biomarker of how speech is encoded in the brain is essential. The K23 award will provide structured training and experience in three core areas: 1) Impact of the Environment on Language Acquisition, 2) Advanced Neurophysiological Techniques, and 3) Scientific Dissemination, Grantsmanship, and Biostatistics. The proposed study will take place at Cincinnati Children's Hospital under primary mentorship of Dr. Hunter along with an accomplished team of experts in early language development and assessment, socioenvironmental risk, NST and spontaneous EEG, auditory neurodevelopment, computational neuroscience, and biostatistics. The training will build upon Dr. Blankenship’s clinical and research experience and ensure that she achieves her long-term career goal to become an independent clinician-scientist using translational methods to improve the diagnosis and treatment of infants and children with hearing loss.