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NIDCD Strategic Plan: FY 2000-2002

Effective communication is essential for the function of modern society. While science and technology have greatly improved our capacity for communication, many aspects of contemporary life remain profoundly difficult for those with communication disorders. It is estimated that one of every six Americans, people of both genders and of all ages and races, experiences some form of communication disorder (e.g., hearing impairment, dizziness, balance problems, smell and taste disorders, and voice, speech or language disturbances). Such disorders often compromise social, emotional, educational and vocational aspects of an individual's life. The cost of these disorders in terms of quality of life and unfulfilled potential is substantial. As the population ages and survival rates improve for medically-fragile infants and individuals who have sustained injury, the number of individuals with communication disorders will continue to increase.

The mission of the National Institute on Deafness and Other Communication Disorders (NIDCD) is to conduct and support basic and clinical research and research training in the normal and disordered processes of hearing, balance, smell, taste, voice, speech, and language. Basic and clinical research focused on understanding the normal processes and disorders of human communication are motivated both by intrinsic scientific interest and importance to the health of the Nation.

In January and February, 1999, the NIDCD convened a group of 18 distinguished scientists and members of the public, to provide recommendations for a Strategic Plan for the NIDCD for Fiscal Years 2000-2002. The Strategic Planning Group was asked to identify areas of research that fell within the mission of the NIDCD. The Strategic Planning Group considered the research currently supported by the Institute, as well as NIH-wide scientific initiatives. In addition, oral presentations and written statements from public organizations with an interest in research supported by NIDCD, were provided to assure that the public's perspective would be assimilated into the recommendations for a Strategic Plan. The final draft of the plan was discussed in detail at the National Deafness and Other Communication Disorders (NDCD) Advisory Council meeting on May 27, 1999.

Research Areas That Offer Extraordinary Scientific Opportunity

  1. Determine the Molecular and Epidemiological Bases of Normal and Disordered Communication

    --Utilize molecular biologic and genetic approaches to study normal and disordered human communication, including gene identification, associated mutations and gene expression changes.

    --Apply emerging technologies in genetics and molecular biology to the clinical setting and encourage multidisciplinary approaches to the detection, diagnosis, and treatment of communication disorders.

    --Investigate complex, multifactorial disorders of human communication that arise from polygenic sources. Identify and analyze factors that influence variability and susceptibility to disease and response to treatment.

    --Develop animal models to identify specific disease gene loci, to identify and isolate specific cell populations, and to investigate cellular processes.

    --Develop in vitro systems to facilitate the study of function at the molecular level (e.g. expression systems for chemosensory receptors, organ and cell culture systems).

    --Apply genomic and informatic technologies to understand the molecular bases of disordered communication. Examples include the development of comprehensive expressed sequence databases from sensory organs (olfactory neuroepithelium, cochlear and vestibular hair cells, taste receptor cells, etc.); these scientific databases will be used to identify many of the genes selectively expressed in these organs.

  2. Study the Development, Deterioration, Regeneration, and Plasticity of Processes Mediating Communication

    --Characterize age-related changes in structural, and functional plasticity.

    --Develop and apply novel techniques, e.g., functional imaging to assess structural and functional plasticity.

    --Determine cellular and molecular mechanisms underlying sensory cell regeneration (cochlear and vestibular hair cells, olfactory and gustatory cells), which may lead to the development of new therapeutic interventions.

    --Elucidate mechanisms underlying development, maturation, aging and recovery of function needed for communication, including cell proliferation, differentiation, pattern formation and cell death and survival.

  3. Study Perceptual and Cognitive Processing in Normal and Disordered Communication

    --Investigate the molecular mechanisms of neurotransmission at key synapses between sensory receptor cells in the inner ear, taste buds, and olfactory epithelium and their neuronal targets, as well as those in the central nervous system, that relay and integrate information.

    --Apply physiologic approaches, such as functional neuroimaging, in animal models to dissect the pathways, and define the location and sequence of neuronal activity essential for peripheral and central processing of sensory input. Define abnormalities of neural pathways and spatiotemporal neuronal activity patterns associated with disordered communication.

    --Develop quantitative methods to analyze sensory, sensori-motor, and cognitive processing in humans, in particular, those processes not readily studied in animal models.

    --Investigate the perceptual and cognitive consequences of disordered communication and determine how these processes change with treatment.

  4. Develop and Improve Devices, Pharmacologic Agents, and Strategies for Habilitation and Rehabilitation of Human Communication Disorders

    --Capitalize on emerging technologies to design and improve devices that enhance communication.

    --Use clinical trials and other clinical studies to evaluate the efficacy of newly developed devices, drugs, and other therapies for individuals with communication disorders.

    --Develop and refine diagnostic criteria and capabilities to facilitate early diagnosis of hearing, speech, or language disorders.

    --Use clinical trials and other clinical studies to develop and assess medical and behavioral interventions for infants and children who have a hearing, speech, or language disorder.

    --Develop cost-effective techniques for the assessment of speech/language development and disorders in the broad range of languages currently used by residents of the United States, taking into account all cultural and ethnic groups.

    --Use molecular genetic, electrophysiological, imaging, and other approaches to precisely define the phenotypes of communication disorders as a basis for optimizing clinical diagnosis and intervention.

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