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Priority Areas in Voice, Speech, and Language Research
The NIDCD Voice, Speech, and Language Program contains areas of research that overlap with mission areas of other NIH ICOs. In particular:
- Language: NIDCD research focuses on language acquisition in the presence of dysfunctions, diseases, and disorders that alter the traditional developmental course such as hearing loss, ASD, SLI, and aphasia. Research on the normal acquisition of language and on normal language decline from normal aging is within the mission of other NIH ICOs.
- Literacy: As with language, the normal acquisition of literacy skills and individual outcomes in educational settings are within the mission of other NIH ICOs. The NIDCD supports research into literacy for people who are deaf and hard of hearing, the acquisition of written language for people with pre-existing language disorders, improving reading and writing deficits often associated with stroke, and educational interventions to support improved individual outcomes.
- Swallowing: Speech and swallowing functions have shared anatomy, leading the NIDCD to fund some research on swallowing and disordered swallowing (dysphagia). Dysphagia often occurs after head and neck cancer or certain neurological conditions. Many NIH ICOs may have an interest in research on swallowing and dysphagia.
Priority Area 1: Understanding Normal Function
- Modeling: Improve and validate physical, computational, and theoretical modeling of human communication, including vibratory properties of the larynx, neural and speech motor control, and speech language processing.
- Laryngeal System: Examine impact on vocal health from changes to laryngeal muscle function and structure, such as muscle fiber and mucosal changes at the cellular and molecular level. Determine effects from development, the environment, aging, and voice use (voice training and vocal dose—amount, intensity, and distribution).
- Motor Speech Production: Determine the similarities and differences in development and functioning of neural and musculoskeletal systems for human voice and speech production vs. non-speech oral motor control to identify the sensorimotor principles underlying typical speech development and adult speech motor control, and to understand overlapping sensorimotor mechanisms of the larynx.
- Developmental and Neural Plasticity: Identify the developmental course of sensory and motor plasticity and the underlying neural mechanisms associated with voice and speech motor learning in children and adults (e.g., sensorimotor adaptation).
- Sign Language Research: Investigate the acquisition, processing, and neural underpinnings of languages within the visual-manual modality.
- Literacy and Deafness: Identify central and peripheral factors associated with the successful comprehension and use of written language for people who use sign language as their primary way of communication.
Priority Area 2: Understanding Diseases and Disorders
- Natural History and Epidemiology: Identify genetic, neural, sensorimotor, cognitive, linguistic, behavioral, demographic, and environmental factors associated with the progression, developmental course, and long-term outcomes of voice, speech, and language impairments. Determine the relative contribution of those factors to the development of and the recovery from impairment.
- Pathophysiology: Identify the pathophysiologic and cognitive mechanisms underlying both common and rare voice, speech, and language impairments.
- Genetics: Identify genetic and epigenetic factors that contribute to voice, speech, and language impairments, including studies that identify prenatal factors that can modify genetic and epigenetic expression in offspring.
- Developmental and Neural Plasticity: Examine changes in brain structure and functioning in response to behavioral, pathologic, or environmental insult as a basis for voice, speech, and language impairments with an emphasis on developmental timing.
- Co-Occurring Conditions: Examine factors (e.g., social context, inflammatory response, co-morbid conditions) that interact or coexist with primary voice, speech, and language impairments. Examine diagnostic and treatment strategies for voice, speech, and language impairments that may coexist in individuals with deafness, and in individuals with communication disorders. Examine cross-system deficits and their influence on communication health and responsiveness to treatment.
Priority Area 3: Improving Diagnosis, Treatment, and Prevention
- Detection, Diagnosis and Hypothesis-Driven Interventions: Develop biomarkers (e.g., genetic, imaging, behavioral) of objective diagnosis, prognosis, treatment monitoring for developmental and acquired voice, speech, and language impairments. Develop models of intervention informed by cognitive, linguistic, biological, or neurophysiological processes, accounting for cultural and linguistic variation and including predictors of response to treatment. Develop and refine techniques, technology, and instrumentation for improved diagnosis to aid in treatment and prevention.
- Efficacy: Using outcomes-based clinical studies and randomized clinical trials, determine the efficacy of proposed interventions for the prevention and treatment of voice, speech, and language impairments, which can include accounting for cultural and linguistic variation.
- Prevention: Develop and expand programs that prevent the onset or limit the severity of developmental and acquired voice, speech, and language impairments for people with genetic, occupational, environmental, or other risks.
- Understudied Populations: Identify the cause and pathophysiology for understudied populations, such as school-aged children, minimally verbal children with ASD, health disparity groups, and multicultural groups, or understudied conditions, such as stuttering and apraxia of speech in children and adults. Develop methods of assessing and new effective interventions or approaches tailored for understudied populations or conditions.
- Rare Disorders: Develop biomarkers for improved diagnosis, prediction of risk, and treatment response for patients with rare voice, speech and language disorders (e.g., spasmodic dysphonia, paradoxical vocal fold motion).
- Bioengineering, including Assistive Technologies: Harness recent advances in bioengineering to inform the development and evaluate efficacy of wearable monitoring devices, imaging procedures, tissue engineering, bioreactors, and novel augmentative and alternative communication approaches. Enhance brain-computer interface technologies for communication.
- Literacy Skills: Develop methods that promote the acquisition of literacy skills during childhood and improve the reading and writing abilities of people who are deaf and native American Sign Language users.
Priority Area 4: Improving Outcomes for Human Communication
- Novel Delivery: Translate and evaluate efficacy of conventional interventions into new delivery models (e.g., group, family, telehealth, cell-based therapies, and emerging technology platforms).
- Screening: Develop effective and efficient clinical screening tools for use in health and community settings such as schools, primary care physician offices, and senior centers. Develop novel screening tools to document treatment outcomes, to determine communication status, and to improve clinical outcomes in real-world settings. Determine efficacy of screening for improving clinical outcomes.
- Comparative Effectiveness Research and Evidence-Based Medicine: Through clinical trials and epidemiological comparative effectiveness research, identify best treatments for a given communication disorder for a defined set of individuals.
- Patient-Oriented Research: Conduct research to help define the impact of voice, speech, and language communication problems and the desirable/reasonable expectation for quality of life outcome from the individual’s perspective.
- Community-Based Research:
- Promote community-based research and data collection to identify factors that influence outcomes for people with voice, speech, or language impairments, and to inform the development of public policy recommendations.
- Examine community-level health promotion strategies to prevent the occurrence of voice, speech, and language impairments, reduce risk, and improve adherence with treatment.
- Bridging the Gap between Research and Practice: Determine effective dissemination and implementation strategies that enhance the adoption of voice, speech, and language clinical discoveries into routine community practice.
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