The NIH Almanac

Mission

The National Institute on Deafness and Other Communication Disorders (NIDCD) conducts and supports research and research training on disorders of hearing and other communication processes, including diseases affecting hearing, balance, smell, taste, voice, speech, and language through:

• Research performed in its own laboratories and clinics
• A program of research grants, individual and institutional research training awards, career development awards, center grants, conference grants, and contracts to public and private research institutions and organizations
• Cooperation and collaboration with professional, academic, commercial, voluntary, and philanthropic organizations concerned with research and training that is related to deafness and other communication disorders, disease prevention and health promotion, and the special biomedical and behavioral problems associated with people having communication impairments or disorders
• The support of efforts to create devices that substitute for lost and impaired sensory and communication functions
• Ongoing collection and dissemination of information to health professionals, patients, industry, and the public on research findings in these areas.

Important Events in NIDCD History

October 28, 1988—Public Law 100-553 authorized the formation of the National Institute on Deafness and Other Communication Disorders.

June 26, 1989—The NIDCD Advisory Board held its first meeting.

September 18, 1989—The Advisory Council of NIDCD convened for the first time.

February 11, 1990—James B. Snow, Jr., M.D., was appointed as the first Director of NIDCD.

September 21, 1990—The NIDCD established the Office of Administrative Branch, Financial Management Branch, Personnel Management Branch, and Program and Health Reports Branch.

December 5, 1990—The Division of Intramural Research established labs and branches within the division.

December 6, 1990—The Information Systems Branch was created.

March 1, 1991—The NIDCD Information Clearinghouse was established.

April 4, 1991—The Board of Scientific Counselors of NIDCD held its first meeting.

November 19, 1991—The Deafness and Other Communication Disorders Interagency Coordinating Committee met for the first time.

December 29, 1991—David J. Lim, M.D., was appointed as Scientific Director.

May 8, 1992—NIDCD/American Academy of Otolaryngology—Head and Neck Surgery sponsored a live interactive satellite conference, "Warning! The Impact of Pollution on the Upper Alimentary and Respiratory Tracts," to inform scientists, physicians, and the public about health problems associated with pollution and identify areas of needed research.

August 21, 1992—NIDCD/Department of Veterans Affairs directors signed a Memorandum of Understanding that established a collaboration to expand and intensify hearing aid research and development.

October 23, 1992—NIDCD/National Aeronautics and Space Administration (NASA) established a formal scientific collaboration to enhance basic knowledge and understanding of vestibular function in both clinical and normal states and provide investigators access to NASA's unique ground-based research facilities and to space flight.

March 1-3, 1993—Consensus Development Conference, "Early Identification of Hearing Impairment in Infants and Young Children," evaluated current research and provided recommendations regarding hearing assessment from birth through 5 years of age.

October 25, 1993—NIDCD commemorated its fifth anniversary, "A Celebration of Research in Human Communication."

January 18, 1994—The Division of Communication Sciences and Disorders established the Hearing and Balance/Vestibular Sciences Branch and the Voice, Speech, Language, Smell, and Taste Branch.

May 1994—The NIDCD Advisory Board held its final meeting.

August 5, 1994—The Division of Communication Sciences and Disorders was changed to the Division of Human Communication.

February 14, 1995—"The Partnership Program" began, designed to maximize opportunities for underrepresented students to participate in fundamental and clinical research in the NIDCD research areas, with 4 academic centers: Morehouse School of Medicine; University of Puerto Rico School of Medicine; University of Alaska System, Fairbanks; and Gallaudet University.

March 1, 1995—James F. Battey, Jr., M.D., Ph.D., was appointed as Director of the Division of Intramural Research.

May 15-17, 1995—Consensus Development Conference, "Cochlear Implants in Adults and Children," summarized current knowledge about the range of benefits and limitations of cochlear implantation.

September 11-13, 1995—First biennial conference, "Advancing Human Communication: An Interdisciplinary Forum on Hearing Aid Research and Development," was held.

September 4-5, 1997—Collaboration between NIDCD and the Maternal and Child Health Bureau and the Centers for Disease Control and Prevention resulted in the first NIDCD Working Group on Early Identification of Hearing Impairment. The panel agreed that early identification of and appropriate intervention for children with hearing impairment leads to improvements in speech and language development in affected children, thereby improving the likelihood of positive social, emotional, cognitive, and academic development. The Working Group recommends a system of universal hearing screening within newborn nurseries be instituted.

September 13, 1997—James B. Snow, Jr., M.D., retired as the first Director of NIDCD. James F. Battey, Jr., M.D., Ph.D., became Acting Director of NIDCD.

September 22-24, 1997—The second biennial hearing aid research and development conference took place.

February 10, 1998—James F. Battey, Jr., M.D., Ph.D., was appointed as the new Director of NIDCD.

March 13, 1998—The NIDCD Working Group on Early Identification of Hearing Impairment's second workshop identified research opportunities offered by neonatal hearing screening programs, specifically in diagnostic strategies for characterizing hearing impairment and in the intervention strategies for remediating hearing impairment.

August 13-14, 1998—The Working Group on Single and Multiple Project Grants held its first meeting.

December 20, 1998—Robert J. Wenthold, Ph.D., was appointed as Scientific Director.

January - February 1999—The NIDCD convened a group of distinguished scientists and members of the public to provide recommendations for a Strategic Plan.

May 25, 1999—The NIDCD Working Group on Communicating Informed Consent to Individuals Who Are Deaf or Hard-of-Hearing met to clarify issues of informed consent, develop guidelines for use by scientists, and propose new, needed materials for improving communication about informed consent.

September 19, 2000—The third workshop of the NIDCD Working Group on Early Identification of Hearing Impairment identified critical research needs in the area of early identification of hearing impairment. The workshop was designed to provide advice to the NIDCD for identifying research to be supported through the Federal government grant and contract processes.

December 11, 2000—NIDCD signed a Memorandum of Understanding with the Center for Comparative and Evolutionary Biology of Hearing, University of Maryland, College Park, to establish a program for training graduate students in the hearing sciences.

March 22-23, 2001—The Division of Intramural Research, NIDCD, held its first retreat at St. Michael's, Md.

May 24, 2001—Dr. Battey unveiled the Institute's new logo at the Advisory Council meeting.

September 2002—Dr. Battey was appointed as Chair of the NIH Stem Cell Task Force by NIH Director Dr. Elias Zerhouni. In March 2007, Dr. Battey began serving as Vice Chair.

October 21, 2002—NIDCD hosted the first NIH lecture on health literacy, "Babel Babble: What Is the Doctor Saying? What Is the Patient Understanding?" for health communication professionals who develop health materials and communication strategies for a range of diverse audiences.

June 12, 2003—Dr. Battey opened the First NIH Symposium on Human Embryonic Stem Cells, Bethesda, Md.

December 2003—NIDCD's WISE EARS!® national campaign to prevent noise-induced hearing loss turned 5 years old. The campaign is a coordinated effort among NIDCD, the National Institute on Occupational Safety and Health (NIOSH), and a coalition of organizations who care about hearing.

October 2004—NIDCD-funded investigator Dr. Linda Buck won the 2004 Nobel Prize in Physiology or Medicine.

October 19-20, 2006—NIDCD co-sponsored a workshop, titled "Noise-Induced Hearing Loss in Children at Work and Play," in Covington, Ky. The workshop convened researchers, hearing health professionals, teachers, and advocacy groups and focused on the prevention of noise-induced hearing loss.

Biographical Sketch of NIDCD Director James F. Battey, Jr., M.D., Ph.D.

Dr. Battey became the new NIDCD director on February 10, 1998. He served as acting director since the retirement of the Institute's first director in September 1997. He is responsible for the planning, implementation, and evaluation of Institute programs to conduct and support biomedical and behavioral research, research training, and public health information in human communication.

He received his education at the California Institute of Technology, where he earned his B.S. with honors in physics. He earned his M.D. and Ph.D. in biophysics at Stanford University, where he had residency training in pediatrics. His postdoctoral fellowship at Harvard Medical School was under the direction of the eminent scientist Dr. Philip Leder. While working with Dr. Leder, Dr. Battey was part of a team that cloned the genes encoding the IgE immunoglobulin constant region domains. In addition, he isolated and characterized the human c-myc gene, a key growth regulatory nuclear proto-oncogene that contributes to cancer formation when inappropriately expressed.

Dr. Battey has been with NIH since 1983, first on the staff of the National Cancer Institute (NCI), where he rose from senior staff fellow to senior investigator. In his work at the NCI-Navy Medical Oncology Branch, he collaborated in the isolation and characterization of human N-myc and L-myc, two additional members of the human myc gene family, important in human neoplasms. He became interested in neuropeptides and their receptors at this time because of their dual function as growth factors and regulatory peptides. His group isolated cDNA and genomic clones for mammalian bombesin-like peptides, key regulators of secretion, growth and neuronal firing.

In 1988 he moved to the National Institute of Neurological Disorders and Stroke as chief of the molecular neuroscience section in the Laboratory of Neurochemistry. In 1992 he returned to the NCI to head the molecular structure section of the Laboratory of Biological Chemistry, where his laboratory cloned and characterized the genes for 3 subtypes of mammalian receptors for bombesin-like peptides. His team at NCI's Laboratory of Biological Chemistry was among the first to clone the gene encoding cdk5, a member of the cyclin-dependent kinase family, where important proteins are involved in cell cycle control. Dr. Battey was appointed as director of the Intramural Research Program for NIDCD in 1995 by Dr. Snow, the first NIDCD director. The PHS has honored him with its PHS Commendation Medal in 1990 and the Outstanding Service Medal in 1994. He is author or co-author of over 130 research articles and is co-author with Leonard Davis and Michael Kuehl of Basic Methods in Molecular Biology.

NIDCD Directors

Name	In Office from	To
Jay Moskowitz (Acting)	October 31, 1988	February 1990
James B. Snow, Jr.	February 1990	September 13, 1997
James F. Battey, Jr.	September 14, 1997	Present

Research Programs

NIDCD supports and conducts research and research training in the normal and disordered processes of hearing, balance, smell, taste, voice, speech, and language through a program of grants and contracts in basic, clinical, and translational research. They are conducted in public and private institutions across the country and around the world and within the laboratories and clinics at the National Institutes of Health in Bethesda, Md.

The Division of Intramural Research conducts basic and clinical research in human communication disorders, which is within the mission of the Institute. Research objectives include: studies of electromechanical processes responsible for fine tuning in the cochlea; identification, characterization, and cloning of genes responsible for hereditary hearing impairment; electromotility of the outer hair cell; molecular bases of mechanosensory transduction mechanisms in the organ of Corti; molecular bases for G-protein signaling with emphasis on sensory signaling processes in the chemical senses; development of vaccines for otitis media; molecular mechanisms underlying the development and function of the mammalian taste system; mechanisms responsible for the development of the inner ear; molecular mechanisms underlying auditory system function with emphasis on neurotransmission and neuromodulation; identification of genes associated with neoplasms affecting human communication; identification of the genetic component of stuttering; neuroimaging of brain function in physiologic and pathophysiologic states; pathophysiology and etiology of voice and speech disorders; and epidemiological and biometric research studies of communication disorders.

The Division of Extramural Activities provides leadership and advice in developing, implementing, and coordinating extramural programs and policies. It represents the Institute on NIH committees on extramural program policies and oversees compliance with such policies within the NIDCD. The Division provides grant management and processing services for all of the Institute's grants and conducts initial scientific merit review of a large array of grant mechanisms and R&D contract proposals. In addition, the Division coordinates the Institute's committee management activities, research integrity activities, and Certificates of Confidentiality, and manages the meetings of the National Deafness and Other Communication Disorders Advisory Council. The Division has 2 components: Grants Management Branch and Scientific Review Branch.

• Grants Management Branch (GMB)—focal point for all business-related activities associated with the negotiation, award, and administration of grants and cooperative agreements within the NIDCD. GMB plays a critical role of bridging among the various NIH offices (review, program, financial management, and policy), institutional offices of sponsored programs, and principal investigators.
• Scientific Review Branch (SRB)—coordinates the initial scientific peer review of applications for the following mechanisms of support: research project grants, clinical center and core center grants, research training and career development grants, multi-site clinical trials, conference grants, and cooperative agreements, as well as all proposals for research and development contracts. SRB also coordinates receipt and referral issues with the Center for Scientific Review, represents NIDCD on NIH's overall committee for review policies, and manages all aspects of NIDCD's peer review process.

The Division of Scientific Programs of NIDCD is responsible for coordinating a broad range of activities and functions to assure sound and efficient management of NIDCD's extramural activities that include a program of research grants, career development awards, individual and institutional research training awards, center grants, and contracts to public and private research institutions and organizations. The Division also plans and directs a program of grant and contract support for research and research training in the normal processes and diseases and disorders of hearing, balance, smell, taste, voice, speech, and language to insure maximum utilization of available resources in attainment of the Institute's objectives; assesses needs for research and research training in program areas; establishes program priorities and recommends funding levels for programs to be supported by grants; and sets priorities and funding levels for research to be supported by contracts.

Hearing

The fields of cellular and molecular biology have furthered hearing research. A multitude of genes for syndromic and nonsyndromic forms of hearing impairment including autosomal dominant and recessive, X-linked and mitochondrial modes of transmission have been located in specific regions of the human genome. In addition, clinically relevant genes essential for normal auditory development and/or function are being identified and cloned at a rapid pace.

Other cochlear-specific genes have been isolated from enriched membranous labyrinth cDNA libraries. New technology, including the development of detailed maps of expressed sequence tags (EST) coupled with the use of inner ear specific cDNA libraries, exon trapping, and cDNA library enrichment procedures, have facilitated gene cloning. Once relevant genes have been cloned, the molecular biology of hearing and the role of particular proteins in the development and/or maintenance of the inner ear can be determined. Mouse models of hereditary hearing impairment have been instrumental in mapping and cloning many deafness genes. Because of the utility of the mouse for such studies, additional mouse models of deafness are being created through mutagenesis and screening programs as well as targeted mutation of deafness genes found in man. In addition, mouse models are being used to study the function of the proteins encoded by deafness genes and to test therapeutic approaches. These advances offer researchers many opportunities to study the characteristics of deafness, hereditary factors involved in hearing loss, and genes that are critical for the development and maintenance of the human ear. Great strides are being made in the study of properties of auditory sensory cells and of characteristics of the inner ear's response to sound.

Hearing conversation in the midst of a crowded, noisy room is very difficult with current hearing aids. NIDCD-supported researchers are working to revolutionize the technology of directional microphones. The technology is based on the ears of a parasitic fly, Ormia ochracea. Despite the small size of the insect's ears and the short distance between them, Ormia's ears are able to rapidly pinpoint the location from which the sound of a potential host—a cricket—is coming, even in a noisy environment. The intriguing mechanism that enables Ormia to accomplish this feat has provided a model for scientists and engineers to use in developing miniature directional microphones for hearing aids that can better focus on speech in a single conversation, even when surrounded by other voices.

Scientific advances have also been translated into cochlear implants. Research has verified that despite the variability in the performance of children who have received cochlear implants, most demonstrate marked improvements in speech perception and production. Cochlear implants also positively influence children's receptive and expressive language skills. The longer children use their implants, the greater their language ability. To achieve the most benefit from their implants, however, children generally need extensive oral-auditory training following implantation and also benefit from periodic audiological assessments. Cochlear implants have benefited children who are congenitally deaf as well as those who are postlingually deaf. Scientists supported by the NIDCD have demonstrated that cochlear implants can restore the structure of synapses—the connecting space between neurons—along the auditory nerve in deaf cats. Because untreated congenital (at birth) deafness is believed to cause permanent changes in the auditory system, this finding may explain why cochlear implants work best in young children before irreversible abnormalities occur. The vast majority of adult implant recipients derive substantial benefit in conjunction with speechreading, and most can communicate effectively by telephone.

Neural prosthesis development efforts are continuing to seek improved device design elements and novel algorithms for operation. These activities are primarily based on animal studies that allow new concepts for selective stimulation of neural tissue to be tested quantitatively and any risks for safe operation identified through both neurophysiologic and histologic studies. Microstimulation delivered through electrodes that penetrate the neural tissue and infrared optical stimulation are 2 examples of novel device elements currently under development. Other research projects are assessing novel signal processing and stimulation algorithms which could be provided to the current generation cochlear implant recipients, if they are proven to extend user performance limits.

It is estimated that more than 50 million Americans experience tinnitus to some degree. Of these, about 12 million have tinnitus severe enough to seek medical attention. Many learn to ignore the sounds and experience no major effects. However, about 2 million patients are so seriously debilitated that they cannot function normally, finding it difficult to hear, work, or sleep. For many years, it was believed that structures in the inner ear produced tinnitus, but more recent evidence suggests that for many people, tinnitus is generated in the central nervous system. Though research is providing more evidence for the causes and treatments of tinnitus, there is no real understanding of the biological bases of tinnitus, nor are there any treatments that help most sufferers. New research directions promise to produce new treatments.

Valuable progress has been made in understanding the structure and function of efferent feedback pathways to the inner and middle ear. There is now evidence that this system may aid in the detection of signals in noisy environments and serve to protect the ear from acoustic injury.

Our knowledge of the mechanisms of neural plasticity (the ability of the brain to change or adapt) has increased tremendously over the past decade. In contrast, our knowledge of the mechanisms that regulate and instruct plasticity remains primitive. The calibration of the auditory system's map of space by the visual system is a well-characterized example of supervised learning. In an animal model, the site in the auditory pathway where visual signals exert their effects, and the structural and functional changes they cause, have been determined. However, the properties of the instructive signals themselves, and the mechanisms by which they exert their effects, remain unknown. Research is ongoing to understand these mysteries, which will allow us to better understand learning and learning problems.

In the aging auditory system, discoveries have been made demonstrating changes in the regulation of fluid composition and autoregulation of cochlear blood flow which may underlie some of the biologic effects of aging on auditory function. The role of the stria vascularis in maintaining cochlear homoestasis has now been shown to be a component in the loss in hearing accompanying aging. Improved behavioral and electrophysiological techniques for measuring auditory function are providing more accurate assessments of the peripheral and central components of age-related hearing impairment.

Recent development of animal models for bacterial and viral infections hold promise for new diagnostic and therapeutic approaches to sensorineural hearing loss caused by infections. Antiviral drugs may find rapid application in the treatment for these conditions with the advent of suitable animal models in which to test efficacy. In addition, models will allow a greater understanding of why and to what degree infants and children are susceptible to ototoxic drugs used in the treatment of infections.

Otitis media continues to be a significant focus of research because of its prevalence and cost to society. Important risk factors have been identified. Studies of the eustachian tubes have provided new information on tubal mechanics, surfactant-like (fluid) substances and middle ear pressure regulation. The role of bacterial biofilms in chronic otitis media is a new and promising area of investigation. State-of-the-art molecular, genetic and genomic techniques are being used to identify genes that may predispose an individual to chronic otitis media. These techniques are also being used to define the specific molecular changes that allow viral and bacterial infection of the middle ear as well as the host/pathogen interactions that facilitate the disease process. The EarPopper (developed with support from the Small-Business Innovation Research Program) is a safe, simple, non-surgical, non-drug related prescription device for treating such common conditions as otitis media with effusion, aerotitis/barotitis (caused by rapid elevation changes), and eustachian tube dysfunction in children and adults.

Balance

NIDCD supports research on balance and the vestibular system. Balance disorders affect a large proportion of the population, particularly the elderly. The vestibular system, with its receptor organs located in the inner ear, plays an important role in the control of balance while the body is immobile and in motion, the maintenance of one's orientation in space, and visual fixation of objects during head movement. Vestibular disorders can therefore yield symptoms of imbalance, vertigo (the illusion of motion), disorientation, instability, falling, and visual blurring (particularly during motion). Deficits in vestibular function result from diverse disease processes, including infection, trauma, toxicity, impaired blood supply, autoimmune disease, impaired metabolic function, and tumors.

The cellular motion detectors of the vestibular system are mechanosensory hair cells, activated by movements of fluids and masses in the inner ear. New technologies are being used with NIDCD support to visualize and understand the micromechanical motions and the biophysical mechanisms that lead to the neural signals carried from the inner ear to the brain.

Investigators supported by the NIDCD also use molecular biology and biochemistry to characterize the cellular biochemical pathways and genes essential to normal development and function in the vestibular system. The genetic bases of several human-inherited cerebellar syndromes of imbalance and incoordination are currently being investigated.

NIDCD-supported studies suggest that, in addition to its role in the stabilization of gaze and balance, the vestibular system plays an important role in regulating respiratory muscles as well as autonomic functions, including blood pressure. These studies hold potential clinical relevance for the understanding of certain kinds of breathing problems, and management of orthostatic hypotension (lowered blood pressure related to a change in body posture).

The Institute supports research to develop and refine tests of balance and vestibular function. Computer-controlled systems have been developed and validated for clinical use to measure eye movement and body postural responses activated by stimulating specific parts of the vestibular sense organ and nerve. Also, tests of functional disability and physical rehabilitative strategies currently being applied in clinical and research settings will have important implications for refining the rehabilitation of patients with balance and vestibular disorders.

A vestibular neural prosthesis similar to the cochlear implant is under development by a team of NIDCD-funded investigators. Animal studies with this device will allow preliminary assessment of the restoration of function possible through electrical stimulation of the vestibular nerve. Research is progressing to refine the vestibular prosthesis and to determine its viability for application to vestibular-deficient humans.

Smell and Taste

NIDCD investigators study the chemical senses of olfaction (smell) and gustation (taste) to enhance our understanding of how individuals sense their environment and make discriminating food choices. Smell and taste perception play important roles in preferences and aversions for aromas, specific foods, and flavors. Sweet-tasting substances are generally consumed and contribute to caloric intake and proper nutrition; bitter-tasting substances are typically avoided because bitterness is often associated with toxic compounds that cause illness. The NIDCD is supporting research on the development of bitter-taste blockers and artificial sweeteners in an effort to identify compounds that can mask the bitter taste of essential medications and reduce the caloric impact of sugars, especially in children.

Both the olfactory and gustatory systems offer special approaches for the understanding of the fundamental mechanisms of neural plasticity. NIDCD scientists have found that smell and taste receptor cells are continually replaced and have the further capacity to replace themselves rapidly in response to injury. With every hard sneeze and with every burnt tongue from a hot cup of coffee, olfactory and taste receptor cells are destroyed and then replaced. In addition, chronic rhinosinusitis and nasal polyps can affect olfactory function, and a variety of prescription medications can harm taste receptors. Smell and taste receptor cells are the only known mammalian sensory cells with this native regenerative capability, and the olfactory system is now used as a model system in the study of the biology of multipotent stem cells. Unfortunately, the plasticity of the olfactory system declines with age, with important consequences to the health of the increasingly aged population. The perceived quality of foods moves toward blandness in the elderly and this affects food intake, diet and overall nutrition, and health status. Prevention of this age-related decline in olfactory sensitivity is being studied by NIDCD investigators.

Advances in molecular and cellular biology, biophysics and biochemistry of the olfactory and gustatory systems are paving the way for improved diagnosis, prevention and treatment of chemosensory disorders. The vertebrate olfactory receptor neuron has become an important model system in molecular and cellular biology. The olfactory receptor gene family has been described in several mammalian species, including humans, and may contain as many as 1,000 members. NIDCD scientists are presently characterizing genetic mechanisms of olfaction, which will provide the opportunity to study the molecular pharmacology of the process of smell. More recently, a family of about 80 taste receptor genes has been identified by NIDCD investigators. Interestingly, both olfactory and sweet and bitter taste receptors are structurally related and activate similar second messenger signal transduction cascades, which ultimately generate neural activity in the central nervous system. The characterization of these receptor genes was greatly facilitated by the genetic database provided by the NIH's human and mouse genome projects.

The molecular biological studies of olfactory and taste receptor cells have provided essential information about the sensitivities of the chemical senses at the first level of neural integration. The coding of odorants and tastants by the central nervous system begins at the level of the receptor cell. In addition, in both the olfactory and gustatory systems, odor and taste quality coding is further refined by a synthetic computational process of the central nervous system. NIDCD-funded projects are examining the nature of the central coding. In the olfactory system, odor coding appears very complex because of the numerous types of structurally diverse odors that must be detected and because of the complicated neuroanatomical organization of the olfactory system. We are just beginning to understand the nature of the olfactory code. On the other hand, in the taste system, significant progress has been made in our understanding of how the four taste qualities of sweet, salty, sour, and bitter are coded centrally. Recent work suggests a fifth taste quality, umami, which is familiar to many as the taste of monosodium glutamate (MSG). The nature of the gustatory code and the high degree of central processing makes the gustatory system very resistant to damage. Consequently, the taste system is less often affected by injury and aging in comparison to the olfactory system.

NIDCD-supported research has shown that an individual's preference and sensitivity to certain odors and taste compounds has a genetic basis. Simply stated: different people like different foods. Since genetic factors play a role in one's food choices and overall diet, any level of smell and taste dysfunction will have an adverse impact on nutrition. Altered nutritional status can lead to emotional, cardiovascular and gastrointestinal complications. The NIDCD supports research to study the health risks associated with compromised smell and taste function.

Voice, Speech, and Language

Studies in the voice and speech program focus on determining the nature, causes, treatment, and prevention of a variety of disorders of motor speech production throughout the lifespan. Research is being conducted on disorders such as stuttering, speech-sound acquisition disorders, childhood apraxia of speech, voice disorders, and swallowing disorders. When oral speech communication may not be a realistic option for individuals with severe dysarthria, alternative and augmentative communication (AAC) devices and strategies are used. Substantial progress has been made in the development of augmentative communication devices to facilitate the expressive communication of persons with severe communication disabilities. An investigation of performance by young users of augmentative communicative devices is in progress. Other funded research evaluates whether a low-cost, laser-activated keyboard for accessing personal computers is feasible. By providing access to computers, including a brain-computer interface (BCI) communication prothesis, individuals with disabilities can immediately use personal computer software programs and speech synthesizers for augmentative communication.

NIDCD-funded investigators are studying the use and development of aerosol hydration to prevent voice injury and optimize vocal performance. Others are comparing behavioral treatments for voice disorders in school teachers. Basic research is laying the groundwork for translational research towards creating a more successful treatment of laryngeal paralysis and other peripheral nerve injuries. Others are studying the limbic and motor system interaction in laryngeal function using an animal model to better understand mechanisms of voice disorders and speech disorders and their recovery.

Spasmodic dysphonia is a unique voice disorder with significant physical and emotional burden. A phase 1 randomized prospective clinical trial comparing Botox injection, a combination treatment of behavioral intervention and Botox injections, and sham therapy and Botox is being conducted.

Investigators are actively working to provide locked-in individuals with a direct means of producing speech to allow rapid communication between the individual and caregivers. The individual's control of computers will be enabled through development of a direct brain-to-speech generator that uses a person's neural signals.

Language research continues to expand our knowledge of the role played by each brain hemisphere in communication and language, early specialization of the brain, and the recovery process following brain damage. This research will further our understanding of the neural bases of language and language disorders. Research on acquisition, characterization, and utilization of American Sign Language is expanding knowledge of the language used by many people who are deaf.

Language researchers supported by NIDCD are also exploring the genetic bases of child speech and language disorders, as well as characterizing the linguistic and cognitive deficits in children and adults with language disorders. Researchers are developing effective diagnostic and intervention strategies for children who are autistic, or have specific language impairment, as well as adults with aphasia.