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Miles K, Best V, Buchholz JM. Feasibility of an Adaptive Version of the Everyday Conversational Sentences in Noise Test. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2024; 67:680-687. [PMID: 38324271 PMCID: PMC11000810 DOI: 10.1044/2023_jslhr-23-00507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 11/08/2023] [Accepted: 11/18/2023] [Indexed: 02/08/2024]
Abstract
PURPOSE To investigate potential reasons for the mismatch between laboratory/clinic-based sentence-in-noise performance and real-world listening abilities, we recently developed a corpus of natural, spontaneously spoken speech with three vocal effort levels (Everyday Conversational Sentences in Noise [ECO-SiN]). Here, we examined the feasibility of using the ECO-SiN corpus for adaptive speech-in-noise testing, which might be a desirable format in certain situations (e.g., during a clinical visit). METHOD Ten young, normal-hearing adults, along with 20 older adults with hearing loss participated in the study. Speech reception thresholds (SRTs) were obtained using ECO-SiN sentences, which were systematically compared to the SRTs obtained using traditional Bamford-Kowal-Bench-like sentences. RESULTS Results demonstrated the properties of the test compared favorably with those of a standard test based on scripted and clearly spoken sentences. Moreover, whereas normal-hearing listeners received a benefit from an increase in vocal effort, the participants with hearing loss showed a disbenefit that increased with increasing hearing loss. CONCLUSION The adaptive version of the ECO-SiN test is feasible for research and clinical testing. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.25146338.
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Affiliation(s)
- Kelly Miles
- ECHO Laboratory, Macquarie University, Sydney, New South Wales, Australia
| | - Virginia Best
- Department of Speech, Language & Hearing Sciences, Boston University, MA
| | - Jörg M. Buchholz
- ECHO Laboratory, Macquarie University, Sydney, New South Wales, Australia
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Helfer KS, van Emmerik R, Freyman RL, Banks JJ. An Exploratory Study of Walking, Listening, and Remembering in Younger and Middle-Aged Adults. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023; 66:4052-4065. [PMID: 37672796 PMCID: PMC10713016 DOI: 10.1044/2023_jslhr-23-00198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 06/22/2023] [Accepted: 06/26/2023] [Indexed: 09/08/2023]
Abstract
PURPOSE The purpose of this study was to assess how needing to listen and remember information while walking affects speech perception, memory task performance, and gait in younger and middle-aged adults. METHOD Four gait parameters (stride duration, step variability, whole-body center of mass acceleration, and mediolateral head acceleration) were measured when younger and middle-aged participants stood or walked on a treadmill while they simultaneously completed a speech-on-speech perception task and a preload memory task, singly and in combination. RESULTS Speech perception was significantly poorer for middle-aged than for younger participants. Performance on the speech perception measure did not differ significantly between walking and standing for either group of participants, but the additional cognitive load of the memory task reduced performance on the speech perception task. Memory task performance was significantly poorer when combined with the speech perception task than when measured in isolation for both participant groups, but no further declines were noted when participants were also walking. Mediolateral head acceleration, which has been linked to loss of balance, was significantly greater during multitask trials, as compared to when participants were only walking without being required to listen or remember. Post hoc analysis showed that dual- and multitask influences on mediolateral head acceleration were more prominent for middle-aged than for younger participants. Stride duration was longer in the multitask condition than when participants were only walking. CONCLUSIONS Results of this exploratory study indicate that gait may be impacted when individuals (both younger and middle-aged) are listening and remembering while walking. Data also substantiate prior findings of early age-related declines in the perception of speech in the presence of understandable speech maskers.
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Affiliation(s)
- Karen S. Helfer
- Department of Speech, Language, and Hearing Sciences, University of Massachusetts Amherst
| | | | - Richard L. Freyman
- Department of Speech, Language, and Hearing Sciences, University of Massachusetts Amherst
| | - Jacob J. Banks
- Department of Kinesiology, University of Massachusetts Amherst
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Hey M, Mewes A, Hocke T. Speech comprehension in noise-considerations for ecologically valid assessment of communication skills ability with cochlear implants. HNO 2023; 71:26-34. [PMID: 36480047 PMCID: PMC10409840 DOI: 10.1007/s00106-022-01232-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/10/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND Nowadays, cochlear implant (CI) patients mostly show good to very good speech comprehension in quiet, but there are known problems with communication in everyday noisy situations. There is thus a need for ecologically valid measurements of speech comprehension in real-life listening situations for hearing-impaired patients. The additional methodological effort must be balanced with clinical human and spatial resources. This study investigates possible simplifications of a complex measurement setup. METHODS The study included 20 adults from long-term follow-up after CI fitting with postlingual onset of hearing impairment. The complexity of the investigated listening situations was influenced by changing the spatiality of the noise sources and the temporal characteristics of the noise. To compare different measurement setups, speech reception thresholds (SRT) were measured unilaterally with different CI processors and settings. Ten normal-hearing subjects served as reference. RESULTS In a complex listening situation with four loudspeakers, differences in SRT from CI subjects to the control group of up to 8 dB were found. For CI subjects, this SRT correlated with the situation with frontal speech signal and fluctuating interference signal from the side with R2 = 0.69. For conditions with stationary interfering signals, R2 values <0.2 were found. CONCLUSION There is no universal solution for all audiometric questions with respect to the spatiality and temporal characteristics of noise sources. In the investigated context, simplification of the complex spatial audiometric setting while using fluctuating competing signals was possible.
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Affiliation(s)
- Matthias Hey
- Department of Otorhinolaryngology, Head and Neck Surgery, Audiology, UKSH, Campus Kiel, Arnold-Heller-Straße 14, 24105, Kiel, Germany.
| | - Alexander Mewes
- Department of Otorhinolaryngology, Head and Neck Surgery, Audiology, UKSH, Campus Kiel, Arnold-Heller-Straße 14, 24105, Kiel, Germany
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Hey M, Mewes A, Hocke T. [Speech comprehension in noise-considerations for ecologically valid assessment of communication skills ability with cochlear implants. German version]. HNO 2022; 70:861-869. [PMID: 36301326 PMCID: PMC9691490 DOI: 10.1007/s00106-022-01234-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/01/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND Nowadays, cochlear implant (CI) patients mostly show good to very good speech comprehension in quiet, but there are known problems with communication in everyday noisy situations. There is thus a need for ecologically valid measurements of speech comprehension in real-life listening situations for hearing-impaired patients. The additional methodological effort must be balanced with clinical human and spatial resources. This study investigates possible simplifications of a complex measurement setup. METHODS The study included 20 adults from long-term follow-up after CI fitting with postlingual onset of hearing impairment. The complexity of the investigated listening situations was influenced by changing the spatiality of the noise sources and the temporal characteristics of the noise. To compare different measurement setups, speech reception thresholds (SRT) were measured unilaterally with different CI processors and settings. Ten normal-hearing subjects served as reference. RESULTS In a complex listening situation with four loudspeakers, differences in SRT from CI subjects to the control group of up to 8 dB were found. For CI subjects, this SRT correlated with the situation with frontal speech signal and fluctuating interference signal from the side with R2 = 0.69. For conditions with stationary interfering signals, R2 values <0.2 were found. CONCLUSION There is no universal solution for all audiometric questions with respect to the spatiality and temporal characteristics of noise sources. In the investigated context, simplification of the complex spatial audiometric setting while using fluctuating competing signals was possible.
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Affiliation(s)
- Matthias Hey
- Klinik für Hals-Nasen-Ohren-Heilkunde, Kopf- und Halschirurgie; Audiologie, UKSH, Campus Kiel, Arnold-Heller-Straße 14, 24105, Kiel, Deutschland.
| | - Alexander Mewes
- Klinik für Hals-Nasen-Ohren-Heilkunde, Kopf- und Halschirurgie; Audiologie, UKSH, Campus Kiel, Arnold-Heller-Straße 14, 24105, Kiel, Deutschland
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Miles K, Beechey T, Best V, Buchholz J. Measuring Speech Intelligibility and Hearing-Aid Benefit Using Everyday Conversational Sentences in Real-World Environments. Front Neurosci 2022; 16:789565. [PMID: 35368279 PMCID: PMC8970270 DOI: 10.3389/fnins.2022.789565] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 02/17/2022] [Indexed: 11/13/2022] Open
Abstract
Laboratory and clinical-based assessments of speech intelligibility must evolve to better predict real-world speech intelligibility. One way of approaching this goal is to develop speech intelligibility tasks that are more representative of everyday speech communication outside the laboratory. Here, we evaluate speech intelligibility using both a standard sentence recall task based on clear, read speech (BKB sentences), and a sentence recall task consisting of spontaneously produced speech excised from conversations which took place in realistic background noises (ECO-SiN sentences). The sentences were embedded at natural speaking levels in six realistic background noises that differed in their overall level, which resulted in a range of fixed signal-to-noise ratios. Ten young, normal hearing participants took part in the study, along with 20 older participants with a range of levels of hearing loss who were tested with and without hearing-aid amplification. We found that scores were driven by hearing loss and the characteristics of the background noise, as expected, but also strongly by the speech materials. Scores obtained with the more realistic sentences were generally lower than those obtained with the standard sentences, which reduced ceiling effects for the majority of environments/listeners (but introduced floor effects in some cases). Because ceiling and floor effects limit the potential for observing changes in performance, benefits of amplification were highly dependent on the speech materials for a given background noise and participant group. Overall, the more realistic speech task offered a better dynamic range for capturing individual performance and hearing-aid benefit across the range of real-world environments we examined.
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Affiliation(s)
- Kelly Miles
- ECHO Laboratory, Department of Linguistics, Macquarie University, Sydney, NSW, Australia
| | - Timothy Beechey
- Hearing Sciences – Scottish Section, School of Medicine, University of Nottingham, Glasgow, United Kingdom
| | - Virginia Best
- Department of Speech, Language and Hearing Sciences, Boston University, Boston, MA, United States
| | - Jörg Buchholz
- ECHO Laboratory, Department of Linguistics, Macquarie University, Sydney, NSW, Australia
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Smeds K, Larsson J, Dahlquist M, Wolters F, Herrlin P. Live Evaluation of Auditory Preference, a Laboratory Test for Evaluating Auditory Preference. J Am Acad Audiol 2021; 32:487-500. [PMID: 34965595 DOI: 10.1055/s-0041-1735213] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Many laboratory tests are performed under unrealistic conditions. Tasks, such as repeating words or sentences, are performed in simple loudspeaker setups. Currently, many research groups focus on realistic audiovisual laboratory setups. Fewer groups focus on the tasks performed during testing. PURPOSE A semicontrolled laboratory test method focusing on the tasks performed, the Live Evaluation of Auditory Preference (LEAP) was evaluated. LEAP is developed to evaluate hearing-instrument performance in test scenarios that represent everyday listening situations. RESEARCH DESIGN LEAP was evaluated in a feasibility study. The method comprises conversations between a test participant and one or two test leaders, enabling evaluation of the test participant's own voice. The method allows for visual cues (when relevant) and introduce social pressure to participate in the conversation. In addition, other everyday listening tasks, such as watching television (TV) and listening to radio, are included. In this study, LEAP was used to assess preference for two hearing aid settings using paired comparisons. STUDY SAMPLE Nineteen experienced hearing aid users (13 females and 6 males; mean age 74 years), participated in the study. DATA COLLECTION AND ANALYSIS LEAP was performed at three visits to the laboratory. In addition, participants conducted a field trial where the two hearing aid programs were compared using Ecological Momentary Assessments (EMA). During LEAP testing, six mandatory test cases were used, representing commonly occurring everyday listening situations. Individual test cases were also included, selected from individually experienced listening situations during the field trial. Within- and between-session reliability of the LEAP test was investigated. Validity was investigated by comparing the LEAP and the EMA results. RESULTS For the current signal-processing evaluation, the test was judged to have acceptable reliability and validity. The inclusion of individually selected test cases increased the representativeness of the LEAP test, but it did not substantially alter the results in the current study. CONCLUSION LEAP in its current implementation seems suitable for investigating signal-processing preference in the laboratory in a way that is indicative of everyday preference. The LEAP method represents one step forward in bringing the real world into the laboratory.
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Abstract
OBJECTIVES The motivation for this research is to determine whether a listening-while-balancing task would be sensitive to quantifying listening effort in middle age. The premise behind this exploratory work is that a decrease in postural control would be demonstrated in challenging acoustic conditions, more so in middle-aged than in younger adults. DESIGN A dual-task paradigm was employed with speech understanding as one task and postural control as the other. For the speech perception task, participants listened to and repeated back sentences in the presence of other sentences or steady-state noise. Targets and maskers were presented in both spatially-coincident and spatially-separated conditions. The postural control task required participants to stand on a force platform either in normal stance (with feet approximately shoulder-width apart) or in tandem stance (with one foot behind the other). Participants also rated their subjective listening effort at the end of each block of trials. RESULTS Postural control was poorer for both groups of participants when the listening task was completed at a more adverse (vs. less adverse) signal-to-noise ratio. When participants were standing normally, postural control in dual-task conditions was negatively associated with degree of high-frequency hearing loss, with individuals who had higher pure-tone thresholds exhibiting poorer balance. Correlation analyses also indicated that reduced speech recognition ability was associated with poorer postural control in both single- and dual-task conditions. Middle-aged participants exhibited larger dual-task costs when the masker was speech, as compared to when it was noise. Individuals who reported expending greater effort on the listening task exhibited larger dual-task costs when in normal stance. CONCLUSIONS Listening under challenging acoustic conditions can have a negative impact on postural control, more so in middle-aged than in younger adults. One explanation for this finding is that the increased effort required to successfully listen in adverse environments leaves fewer resources for maintaining balance, particularly as people age. These results provide preliminary support for using this type of ecologically-valid dual-task paradigm to quantify the costs associated with understanding speech in adverse acoustic environments.
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Keidser G, Naylor G, Brungart DS, Caduff A, Campos J, Carlile S, Carpenter MG, Grimm G, Hohmann V, Holube I, Launer S, Lunner T, Mehra R, Rapport F, Slaney M, Smeds K. The Quest for Ecological Validity in Hearing Science: What It Is, Why It Matters, and How to Advance It. Ear Hear 2021; 41 Suppl 1:5S-19S. [PMID: 33105255 PMCID: PMC7676618 DOI: 10.1097/aud.0000000000000944] [Citation(s) in RCA: 62] [Impact Index Per Article: 20.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 07/10/2020] [Indexed: 12/03/2022]
Abstract
Ecological validity is a relatively new concept in hearing science. It has been cited as relevant with increasing frequency in publications over the past 20 years, but without any formal conceptual basis or clear motive. The sixth Eriksholm Workshop was convened to develop a deeper understanding of the concept for the purpose of applying it in hearing research in a consistent and productive manner. Inspired by relevant debate within the field of psychology, and taking into account the World Health Organization's International Classification of Functioning, Disability, and Health framework, the attendees at the workshop reached a consensus on the following definition: "In hearing science, ecological validity refers to the degree to which research findings reflect real-life hearing-related function, activity, or participation." Four broad purposes for striving for greater ecological validity in hearing research were determined: A (Understanding) better understanding the role of hearing in everyday life; B (Development) supporting the development of improved procedures and interventions; C (Assessment) facilitating improved methods for assessing and predicting ability to accomplish real-world tasks; and D (Integration and Individualization) enabling more integrated and individualized care. Discussions considered the effects of variables and phenomena commonly present in hearing-related research on the level of ecological validity of outcomes, supported by examples from a few selected outcome domains and for different types of studies. Illustrated with examples, potential strategies were offered for promoting a high level of ecological validity in a study and for how to evaluate the level of ecological validity of a study. Areas in particular that could benefit from more research to advance ecological validity in hearing science include: (1) understanding the processes of hearing and communication in everyday listening situations, and specifically the factors that make listening difficult in everyday situations; (2) developing new test paradigms that include more than one person (e.g., to encompass the interactive nature of everyday communication) and that are integrative of other factors that interact with hearing in real-life function; (3) integrating new and emerging technologies (e.g., virtual reality) with established test methods; and (4) identifying the key variables and phenomena affecting the level of ecological validity to develop verifiable ways to increase ecological validity and derive a set of benchmarks to strive for.
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Affiliation(s)
- Gitte Keidser
- Eriksholm Research Centre, Oticon A/S, Snekkersten, Denmark
- Department of Behavioural Sciences and Learning, Linnaeus Centre HEAD, Linköping University, Linköping, Sweden
| | - Graham Naylor
- Hearing Sciences—Scottish Section, School of Medicine, University of Nottingham, Glasgow, United Kingdom
| | | | - Andreas Caduff
- Applied Physics Department and the Center for Electromagnetic Research and Characterization, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Jennifer Campos
- KITE—Toronto Rehabilitation Institute, University Health Network, Toronto, Canada
| | - Simon Carlile
- School of Medical Sciences, University of Sydney, Sydney, Australia
- X-The Moonshot Factory, Mountain View, California, USA
| | - Mark G. Carpenter
- School of Kinesiology, University of British Columbia, Vancouver, Canada
| | - Giso Grimm
- Auditory Signal Processing and Cluster of Excellence “Hearing4all”, Department of Medical Physics and Acoustics, University of Oldenburg, Oldenburg, Germany
| | - Volker Hohmann
- Auditory Signal Processing and Cluster of Excellence “Hearing4all”, Department of Medical Physics and Acoustics, University of Oldenburg, Oldenburg, Germany
| | - Inga Holube
- Institute of Hearing Technology and Audiology, Jade University of Applied Sciences, and Cluster of Excellence “Hearing4all”, Oldenburg, Germany
| | - Stefan Launer
- Department of Science and Technology, Sonova AG, Staefa, Switzerland
| | - Thomas Lunner
- Eriksholm Research Centre, Oticon A/S, Snekkersten, Denmark
| | - Ravish Mehra
- Facebook Reality Labs Research, Redmond, Washington, DC, USA
| | - Frances Rapport
- Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
| | - Malcolm Slaney
- Machine Hearing Group, Google Research, Mountain View, California, USA
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Lundberg EMH, Chon SH, Kates JM, Anderson MC, Arehart KH. The Type of Noise Influences Quality Ratings for Noisy Speech in Hearing Aid Users. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2020; 63:4300-4313. [PMID: 33253602 PMCID: PMC8608155 DOI: 10.1044/2020_jslhr-20-00156] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 07/04/2020] [Accepted: 09/08/2020] [Indexed: 06/12/2023]
Abstract
Purpose The overall goal of the current study was to determine whether noise type plays a role in perceptual quality ratings. We compared quality ratings using various noise types and signal-to-noise ratio (SNR) ranges using hearing aid simulations to consider the effects of hearing aid processing features. Method Ten older adults with bilateral mild to moderately severe sensorineural hearing loss rated the sound quality of sentences processed through a hearing aid simulation and presented in the presence of five different noise types (six-talker babble, three-talker conversation, street traffic, kitchen, and fast-food restaurant) at four SNRs (3, 8, 12, and 20 dB). Results Everyday noise types differentially affected sound quality ratings even when presented at the same SNR: Kitchen and three-talker noises were rated significantly higher than restaurant, traffic, and multitalker babble, which were not different from each other. The effects of noise type were most pronounced at poorer SNRs. Conclusions The findings of this study showed that noise types differentially affected sound quality ratings. The differences we observed were consistent with the acoustic characteristics of the noise types. Noise types having lower envelope fluctuations yielded lower quality ratings than noise types characterized by sporadic high-intensity events at the same SNR.
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Affiliation(s)
- Emily M. H. Lundberg
- Department of Speech, Language, and Hearing Science, University of Colorado Boulder
| | - Song Hui Chon
- Department of Audio Engineering Technology, Belmont University, Nashville, TN
| | - James M. Kates
- Department of Speech, Language, and Hearing Science, University of Colorado Boulder
| | - Melinda C. Anderson
- Department of Otolaryngology, School of Medicine, University of Colorado, Aurora
| | - Kathryn H. Arehart
- Department of Speech, Language, and Hearing Science, University of Colorado Boulder
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Conversational Interaction Is the Brain in Action: Implications for the Evaluation of Hearing and Hearing Interventions. Ear Hear 2020; 41 Suppl 1:56S-67S. [DOI: 10.1097/aud.0000000000000939] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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The Cost of Intrinsic and Extrinsic Cognitive Demands on Auditory Functioning in Older Adults With Normal Hearing or Using Hearing Aids. Ear Hear 2020; 42:615-628. [PMID: 33027198 DOI: 10.1097/aud.0000000000000963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES We investigated the impact of both intrinsic and extrinsic cognitive demands on auditory and secondary task performance in older adults with normal hearing (NH) and adults using hearing aids (HAs) in an ecologically relevant listening environment. DESIGN Fifteen adults with NH and 15 adults using HAs (60 to 72 years of age) were recruited to perform the "Audiovisual True-to-Life Assessment of Auditory Rehabilitation"-paradigm (AVATAR), which combines an auditory-visual speech-in-noise task with three secondary tasks on either auditory localization or visual short-term memory in a preload multitask paradigm. Intrinsic demands were altered by presenting speech either at equivalent speech accuracy levels of 50% correct (SPIN50%) or equivalent speech-to-noise ratios of +5dB SNR (SPIN+5dB). We manipulated the amount of extrinsic cognitive demands by including one (dual condition) or three secondary tasks (quadruple condition). Performance decrements on the secondary tasks were considered to reflect an increase in resource allocation to speech understanding and thus an increase in listening effort. In addition, we administered a cognitive test battery as well as a questionnaire on self-reported hearing difficulties and subjective measures of effort and motivation. RESULTS Speech understanding and secondary task performance on the visual short-term memory task were lower in the SPIN50% condition compared to SPIN+5dB. Whereas speech understanding at SPIN50% was equally high in the dual and quadruple conditions, the quadruple condition resulted in lower secondary task performance on the visual short-term memory task, higher levels of self-reported effort, and lower motivation compared to the dual-task condition. The same was true for experimental conditions at SPIN+5dB. Additionally, adults with NH outperformed adults using HAs on speech understanding, auditory localization, and self-reported hearing abilities, but no group differences were observed on secondary task costs or cognitive measures. CONCLUSIONS This study showed that, irrespective of the hearing status of the listener, speech performance was not affected by the amount of extrinsic cognitive demands, but was worse and required more effort under conditions with a more negative SNR. Also, increasing the extrinsic cognitive demands resulted in lower performance on one of the secondary tasks, suggesting that more complex listening environments require more effort. Although adults with NH outperformed HA users on speech understanding and auditory localization, the two groups did not differ with respect to secondary task costs.
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Abstract
OBJECTIVES We examined the effect of age on speech understanding and multitask costs in the ecologically relevant "Audiovisual True-to-Life Assessment of Auditory Rehabilitation"-paradigm (AVATAR). DESIGN Twenty-nine normal-hearing middle-aged adults completed AVATAR, which combines an auditory-visual speech-in-noise task with three secondary tasks on auditory localization or visual short-term memory in different dual-, triple-, and quadruple-task combinations. Performance decrements on the secondary tasks were considered to reflect the cognitive resources allocated during listening. Self-reported hearing difficulties were administered via a questionnaire. Results were compared with scores of 35 young normal-hearing adults. RESULTS Middle-aged adults performed consistently worse than young adults on speech understanding and, in the triple- and quadruple-task combinations only, on secondary task performance. Furthermore, middle-agers reported higher levels of daily listening concentration and more difficulties with speech understanding. CONCLUSIONS This study demonstrated the adverse effect of age on speech-in-noise understanding and the amount of allocated cognitive resources during challenging listening situations realized in AVATAR.
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