The Swedish Hayling task, and its relation to working memory, verbal ability, and speech-recognition-in-noise

A structural equation mediation model captures the predictions amongst the parameters of the ease of language understanding model

Objective

The aim of the present study was to assess the validity of the Ease of Language Understanding (ELU) model through a statistical assessment of the relationships among its main parameters: processing speed, phonology, working memory (WM), and dB Speech Noise Ratio (SNR) for a given Speech Recognition Threshold (SRT) in a sample of hearing aid users from the n200 database.

Methods

Hearing aid users were assessed on several hearing and cognitive tests. Latent Structural Equation Models (SEMs) were applied to investigate the relationship between the main parameters of the ELU model while controlling for age and PTA. Several competing models were assessed.

Results

Analyses indicated that a mediating SEM was the best fit for the data. The results showed that (i) phonology independently predicted speech recognition threshold in both easy and adverse listening conditions and (ii) WM was not predictive of dB SNR for a given SRT in the easier listening conditions (iii) processing speed was predictive of dB SNR for a given SRT mediated via WM in the more adverse conditions.

Conclusion

The results were in line with the predictions of the ELU model: (i) phonology contributed to dB SNR for a given SRT in all listening conditions, (ii) WM is only invoked when listening conditions are adverse, (iii) better WM capacity aids the understanding of what has been said in adverse listening conditions, and finally (iv) the results highlight the importance and optimization of processing speed in conditions when listening conditions are adverse and WM is activated.

Informational Masking and Listening Effort in Speech Recognition in Noise: The Role of Working Memory Capacity and Inhibitory Control in Older Adults With and Without Hearing Impairment

PURPOSE

The study aimed to assess the relationship between (a) speech recognition in noise, mask type, working memory capacity (WMC), and inhibitory control and (b) self-rated listening effort, speech material, and mask type, in older adults with and without hearing impairment. It was of special interest to assess the relationship between WMC, inhibitory control, and speech recognition in noise when informational maskers masked target speech.

METHOD

A mixed design was used. A group (N = 24) of older (M_age = 69.7 years) individuals with hearing impairment and a group of age normal-hearing adults (M_age = 59.3 years, SD = 6.5) participated in the study. The participants were presented with auditory tests in a sound-attenuated room and with cognitive tests in a quiet office. The participants were asked to rate listening effort after being presented with energetic and informational background maskers in two different speech materials used in this study (i.e., Hearing In Noise Test and Hagerman test). Linear mixed-effects models were set up to assess the effect of the two different speech materials, energetic and informational maskers, hearing ability, WMC, inhibitory control, and self-rated listening effort.

RESULTS

Results showed that WMC and inhibitory control were of importance for speech recognition in noise, even when controlling for pure-tone average 4 hearing thresholds and age, when the maskers were informational. Concerning listening effort, on the other hand, the results suggest that hearing ability, but not cognitive abilities, is important for self-rated listening effort in speech recognition in noise.

CONCLUSIONS

Speech-in-noise recognition is more dependent on WMC for older adults in informational maskers than in energetic maskers. Hearing ability is a stronger predictor than cognition for self-rated listening effort.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.21357648.

Is Having Hearing Loss Fundamentally Different? Multigroup Structural Equation Modeling of the Effect of Cognitive Functioning on Speech Identification

OBJECTIVES

Previous research suggests that there is a robust relationship between cognitive functioning and speech-in-noise performance for older adults with age-related hearing loss. For normal-hearing adults, on the other hand, the research is not entirely clear. Therefore, the current study aimed to examine the relationship between cognitive functioning, aging, and speech-in-noise, in a group of older normal-hearing persons and older persons with hearing loss who wear hearing aids.

DESIGN

We analyzed data from 199 older normal-hearing individuals (mean age = 61.2) and 200 older individuals with hearing loss (mean age = 60.9) using multigroup structural equation modeling. Four cognitively related tasks were used to create a cognitive functioning construct: the reading span task, a visuospatial working memory task, the semantic word-pairs task, and Raven's progressive matrices. Speech-in-noise, on the other hand, was measured using Hagerman sentences. The Hagerman sentences were presented via an experimental hearing aid to both normal hearing and hearing-impaired groups. Furthermore, the sentences were presented with one of the two background noise conditions: the Hagerman original speech-shaped noise or four-talker babble. Each noise condition was also presented with three different hearing processing settings: linear processing, fast compression, and noise reduction.

RESULTS

Cognitive functioning was significantly related to speech-in-noise identification. Moreover, aging had a significant effect on both speech-in-noise and cognitive functioning. With regression weights constrained to be equal for the two groups, the final model had the best fit to the data. Importantly, the results showed that the relationship between cognitive functioning and speech-in-noise was not different for the two groups. Furthermore, the same pattern was evident for aging: the effects of aging on cognitive functioning and aging on speech-in-noise were not different between groups.

CONCLUSION

Our findings revealed similar cognitive functioning and aging effects on speech-in-noise performance in older normal-hearing and aided hearing-impaired listeners. In conclusion, the findings support the Ease of Language Understanding model as cognitive processes play a critical role in speech-in-noise independent from the hearing status of elderly individuals.

The cognitive hearing science perspective on perceiving, understanding, and remembering language: The ELU model

The review gives an introductory description of the successive development of data patterns based on comparisons between hearing-impaired and normal hearing participants' speech understanding skills, later prompting the formulation of the Ease of Language Understanding (ELU) model. The model builds on the interaction between an input buffer (RAMBPHO, Rapid Automatic Multimodal Binding of PHOnology) and three memory systems: working memory (WM), semantic long-term memory (SLTM), and episodic long-term memory (ELTM). RAMBPHO input may either match or mismatch multimodal SLTM representations. Given a match, lexical access is accomplished rapidly and implicitly within approximately 100-400 ms. Given a mismatch, the prediction is that WM is engaged explicitly to repair the meaning of the input - in interaction with SLTM and ELTM - taking seconds rather than milliseconds. The multimodal and multilevel nature of representations held in WM and LTM are at the center of the review, being integral parts of the prediction and postdiction components of language understanding. Finally, some hypotheses based on a selective use-disuse of memory systems mechanism are described in relation to mild cognitive impairment and dementia. Alternative speech perception and WM models are evaluated, and recent developments and generalisations, ELU model tests, and boundaries are discussed.

The Contribution of Age, Working Memory Capacity, and Inhibitory Control on Speech Recognition in Noise in Young and Older Adult Listeners

Purpose The study aimed to investigate the relationship between speech recognition in noise, age, hearing ability, self-rated listening effort, inhibitory control (measured with the Swedish Hayling task), and working memory capacity (WMC; measured with the Reading Span test). Two different speech materials were used: the Hagerman test with low semantic context and Hearing in Noise Test sentences with high semantic context, masked with either energetic or informational maskers. Method A mixed design was used. Twenty-four young normally hearing (M _age = 25.6 years) and 24 older, for their age, normally hearing individuals (M _age = 60.6 years) participated in the study. Speech recognition in noise in both speech materials and self-rated effort in all four background maskers were correlated with inhibitory control and WMC. A linear mixed-effects model was set up to assess differences between the two different speech materials, the four different maskers used in the study, and if age and hearing ability affected performance in the speech materials or the various background noises. Results Results showed that high WMC was related to lower scores of self-rated listening effort for informational maskers, as well as better performance in speech recognition in noise when informational maskers were used. The linear mixed-effects model revealed differences in performance between the low-context and the high-context speech materials, and the various maskers used. Lastly, inhibitory control had some impact on performance in the low-context speech material when masked with an informational masker. Conclusion Different background noises, especially informational maskers, affect speech recognition and self-rated listening effort differently depending on age, hearing ability, and individual variation in WMC and inhibitory control.

Cognitive Flexibility and Inhibition in Individuals with Age-Related Hearing Loss

Growing evidence suggests alterations in cognitive control processes in individuals with varying degrees of age-related hearing loss (ARHL); however, alterations in those with unaided mild ARHL are understudied. The current study examined two cognitive control processes, cognitive flexibility, and inhibition, in 21 older adults with unaided mild ARHL and 18 age- and education-matched normal hearing (NH) controls. All participants underwent comprehensive audiological and cognitive evaluations including Trail Making Test-B, Verbal Fluency, Stroop, and two Go/NoGo tasks. Group differences in cognitive flexibility and inhibition as well as associations between peripheral and central hearing ability and measures of cognitive flexibility and inhibition were investigated. Findings revealed that the ARHL group took significantly longer to complete the Stroop task and had higher error rates on NoGo trials on both Go/NoGo tasks relative to the NH controls. Additionally, poorer peripheral and central hearing were associated with poorer cognitive flexibility and inhibitory control. Our findings suggest slower and more inefficient inhibitory control in the mild ARHL group relative to the NH group and add to decades of research on the association between hearing and cognition.

Response suppression, strategy application, and working memory in the prediction of academic performance and classroom misbehavior: A neuropsychological approach

BACKGROUND

Neurological illness can produce a disorganization of behavior, including verbal disinhibition, despite apparent preserved intelligence. Neuropsychological tests of such behavioral control mechanisms may predict real-world performance of healthy people, such as success or misbehavior in educational contexts.

METHOD

In two separate studies, we examined how the Hayling Test of verbal response suppression predicts grades and classroom misbehavior.

RESULTS

Verbal suppression errors and spontaneous strategy use were significant predictors of undergraduate grades. Using a modified version of the Hayling Test designed to reduce strategic responding with high school students (mean age 16), higher grades were predicted by shorter response suppression latencies and better working memory scores, and classroom misbehavior was predicted by lower working memory scores.

CONCLUSION

Verbal response suppression and spontaneous strategy use, both closely linked to disorganized behavior in neuropsychological patients, predict academic achievement but seem unrelated to classroom misbehavior, which is associated with weakness in working memory.

Differences in Working Memory Capacity Affect Online Spoken Word Recognition: Evidence From Eye Movements

Individual differences in working memory capacity have been gaining recognition as playing an important role in speech comprehension, especially in noisy environments. Using the visual world eye-tracking paradigm, a recent study by Hadar and coworkers found that online spoken word recognition was slowed when listeners were required to retain in memory a list of four spoken digits (high load) compared with only one (low load). In the current study, we recognized that the influence of a digit preload might be greater for individuals who have a more limited memory span. We compared participants with higher and lower memory spans on the time course for spoken word recognition by testing eye-fixations on a named object, relative to fixations on an object whose name shared phonology with the named object. Results show that when a low load was imposed, differences in memory span had no effect on the time course of preferential fixations. However, with a high load, listeners with lower span were delayed by ∼550 ms in discriminating target from sound-sharing competitors, relative to higher span listeners. This follows an assumption that the interference effect of a memory preload is not a fixed value, but rather, its effect is greater for individuals with a smaller memory span. Interestingly, span differences affected the timeline for spoken word recognition in noise, but not offline accuracy. This highlights the significance of using eye-tracking as a measure for online speech processing. Results further emphasize the importance of considering differences in cognitive capacity, even when testing normal hearing young adults.

Swedish Version of the Hayling Test: Clinical Utility in Frontotemporal Dementia Syndromes

OBJECTIVES

The aim of this study was to assess the psychometric properties of a Swedish version of the Hayling test (HT-S) and its clinical utility in a group of patients with different frontotemporal dementia (FTD) syndromes. Early diagnosis of FTD is a challenge and requires a broad arsenal of assessment methods, neuropsychological tests not the least. The Hayling test assesses executive functions including initiation, efficiency and response inhibition.

METHODS

Seventy-six healthy controls were included as well as patients with the behavioral variant FTD (bvFTD; n = 17), semantic dementia (SD, n = 6), and progressive supranuclear palsy (n = 12). The Color Word Interference Test was administered to examine the construct validity.

RESULTS

Age showed a correlation with better performances in younger participants whereas the importance of sex and education were less evident. The split half reliability and internal consistency were equal to, or better, than reported for the original version. The interrater reliability was excellent. The construct validity was supported, nevertheless indicating partly different processes behind the performances of the two tests. The FTD group performed significantly worse than healthy controls on efficiency and response inhibition and there were also significant differences in performances between the syndromes despite small samples.

CONCLUSIONS

The psychometric properties and clinical utility of the Swedish version are satisfactory for measuring efficiency and response inhibition with results indicating dissimilar profiles in the performances in the different syndromes. These results need to be corroborated in larger samples. (JINS, 2019, 25, 195-203).

Extended high-frequency pure tone hearing thresholds and core executive functions

OBJECTIVE

To examine the relationship between extended high-frequency pure tone hearing thresholds (frequencies 10 to 14 kHz) and working memory capacity (WMC), inhibitory control, and cognitive flexibility.

DESIGN

Experimental study measuring correlations between different high-frequency hearing threshold measures and cognitive measures.

STUDY

Pure tone audiometry was assessed in the extended high-frequency (frequencies 10, 12.5 and 14 kHz). Subjects were also tested regarding WMC, inhibitory control (response inhibition), and cognitive flexibility (information updating and shifting ability).

SAMPLE

Forty-three subjects between 20 and 29 years old with normal hearing (≤ 20 dB HL) in the frequency range between 0.125 to 8 kHz.

RESULTS

No significant correlations were seen between high-frequency hearing thresholds defined as average best and worst ear high-frequency hearing thresholds and the cognitive measures. Differences between the best and the worst ear showed significant negative correlations with inhibitory control and global executive function (combination score for WMC, inhibitory control and cognitive flexibility).

CONCLUSIONS

The present study suggests that global executive functions, more specifically response inhibition, and hearing threshold asymmetry in the extended high-frequency range are interrelated.

The Association Between Cognitive Performance and Speech-in-Noise Perception for Adult Listeners: A Systematic Literature Review and Meta-Analysis

Published studies assessing the association between cognitive performance and speech-in-noise (SiN) perception examine different aspects of each, test different listeners, and often report quite variable associations. By examining the published evidence base using a systematic approach, we aim to identify robust patterns across studies and highlight any remaining gaps in knowledge. We limit our assessment to adult unaided listeners with audiometric profiles ranging from normal hearing to moderate hearing loss. A total of 253 articles were independently assessed by two researchers, with 25 meeting the criteria for inclusion. Included articles assessed cognitive measures of attention, memory, executive function, IQ, and processing speed. SiN measures varied by target (phonemes or syllables, words, and sentences) and masker type (unmodulated noise, modulated noise, >2-talker babble, and ≤2-talker babble. The overall association between cognitive performance and SiN perception was r = .31. For component cognitive domains, the association with (pooled) SiN perception was as follows: processing speed ( r = .39), inhibitory control ( r = .34), working memory ( r = .28), episodic memory ( r = .26), and crystallized IQ ( r = .18). Similar associations were shown for the different speech target and masker types. This review suggests a general association of r≈.3 between cognitive performance and speech perception, although some variability in association appeared to exist depending on cognitive domain and SiN target or masker assessed. Where assessed, degree of unaided hearing loss did not play a major moderating role. We identify a number of cognitive performance and SiN perception combinations that have not been tested and whose future investigation would enable further fine-grained analyses of these relationships.

On The (Un)importance of Working Memory in Speech-in-Noise Processing for Listeners with Normal Hearing Thresholds

With the advent of cognitive hearing science, increased attention has been given to individual differences in cognitive functioning and their explanatory power in accounting for inter-listener variability in the processing of speech in noise (SiN). The psychological construct that has received much interest in recent years is working memory. Empirical evidence indeed confirms the association between WM capacity (WMC) and SiN identification in older hearing-impaired listeners. However, some theoretical models propose that variations in WMC are an important predictor for variations in speech processing abilities in adverse perceptual conditions for all listeners, and this notion has become widely accepted within the field. To assess whether WMC also plays a role when listeners without hearing loss process speech in adverse listening conditions, we surveyed published and unpublished studies in which the Reading-Span test (a widely used measure of WMC) was administered in conjunction with a measure of SiN identification, using sentence material routinely used in audiological and hearing research. A meta-analysis revealed that, for young listeners with audiometrically normal hearing, individual variations in WMC are estimated to account for, on average, less than 2% of the variance in SiN identification scores. This result cautions against the (intuitively appealing) assumption that individual variations in WMC are predictive of SiN identification independently of the age and hearing status of the listener.

Investigating the Role of Working Memory in Speech-in-noise Identification for Listeners with Normal Hearing

With the advent of cognitive hearing science, increased attention has been given to individual differences in cognitive functioning and their explanatory power in accounting for inter-listener variability in understanding speech in noise (SiN). The psychological construct that has received most interest is working memory (WM), representing the ability to simultaneously store and process information. Common lore and theoretical models assume that WM-based processes subtend speech processing in adverse perceptual conditions, such as those associated with hearing loss or background noise. Empirical evidence confirms the association between WM capacity (WMC) and SiN identification in older hearing-impaired listeners. To assess whether WMC also plays a role when listeners without hearing loss process speech in acoustically adverse conditions, we surveyed published and unpublished studies in which the Reading-Span test (a widely used measure of WMC) was administered in conjunction with a measure of SiN identification. The survey revealed little or no evidence for an association between WMC and SiN performance. We also analysed new data from 132 normal-hearing participants sampled from across the adult lifespan (18-91 years), for a relationship between Reading-Span scores and identification of matrix sentences in noise. Performance on both tasks declined with age, and correlated weakly even after controlling for the effects of age and audibility (r = 0.39, p ≤ 0.001, one-tailed). However, separate analyses for different age groups revealed that the correlation was only significant for middle-aged and older groups but not for the young (< 40 years) participants.