1.
Bianchi, Federica, et al.
(author)
Benefit of Higher Maximum Force Output on Listening Effort in Bone-Anchored Hearing System Users: A Pupillometry Study
2019
In: Ear and Hearing. - : LIPPINCOTT WILLIAMS & WILKINS. - 0196-0202 .- 1538-4667. ; 40:5, s. 1220-1232
Journal article (peer-reviewed) abstract
Objectives: The aim of this study was to compare listening effort, as estimated via pupillary response, during a speech-in-noise test in bone-anchored hearing system (BAHS) users wearing three different sound processors. The three processors, Ponto Pro (PP), Ponto 3 (P3), and Ponto 3 SuperPower (P3SP), differ in terms of maximum force output (MFO) and MFO algorithm. The hypothesis was that listeners would allocate lower listening effort with the P3SP than with the PP, as a consequence of a higher MFO and, hence, fewer saturation artifacts in the signal. Design: Pupil dilations were recorded in 21 BAHS users with a conductive or mixed hearing loss, during a speech-in-noise test performed at positive signal-to-noise ratios (SNRs), where the speech and noise levels were individually adjusted to lead to 95% correct intelligibility with the PP. The listeners had to listen to a sentence in noise, retain it for 3 seconds and then repeat it, while an eye-tracking camera recorded their pupil dilation. The three sound processors were tested in random order with a single-blinded experimental design. Two conditions were performed at the same SNR: Condition 1, where the speech level was designed to saturate the PP but not the P3SP, and condition 2, where the overall sound level was decreased relative to condition 1 to reduce saturation artifacts. Results: The P3SP led to higher speech intelligibility than the PP in both conditions, while the performance with the P3 did not differ from the performance with the PP and the P3SP. Pupil dilations were analyzed in terms of both peak pupil dilation (PPD) and overall pupil dilation via growth curve analysis (GCA). In condition 1, a significantly lower PPD, indicating a decrease in listening effort, was obtained with the P3SP relative to the PP. The PPD obtained with the P3 did not differ from the PPD obtained with the other two sound processors. In condition 2, no difference in PPD was observed across the three processors. The GCA revealed that the overall pupil dilation was significantly lower, in both conditions, with both the P3SP and the P3 relative to the PP, and, in condition 1, also with the P3SP relative to the P3. Conclusions: The overall effort to process a moderate to loud speech signal was significantly reduced by using a sound processor with a higher MFO (P3SP and P3), as a consequence of fewer saturation artifacts. These findings suggest that sound processors with a higher MFO may help BAHS users in their everyday listening scenarios, in particular in noisy environments, by improving sound quality and, thus, decreasing the amount of cognitive resources utilized to process incoming speech sounds.
2.
Boenitz, Hanna, et al.
(author)
How Do We Allocate Our Resources When Listening and Memorizing Speech in Noise? A Pupillometry Study
2021
In: Ear and Hearing. - : Lippincott Williams & Wilkins. - 0196-0202 .- 1538-4667. ; 42:4, s. 846-859
Journal article (peer-reviewed) abstract
Objectives:Actively following a conversation can be demanding and limited cognitive resources must be allocated to the processing of speech, retaining and encoding the perceived content, and preparing an answer. The aim of the present study was to disentangle the allocation of effort into the effort required for listening (listening effort) and the effort required for retention (memory effort) by means of pupil dilation.Design: Twenty-five normal-hearing German speaking participants underwent a sentence final word identification and recall test, while pupillometry was conducted. The participants task was to listen to a sentence in four-talker babble background noise and to repeat the final word afterward. At the end of a list of sentences, they were asked to recall as many of the final words as possible. Pupil dilation was recorded during different list lengths (three sentences versus six sentences) and varying memory load (recall versus no recall). Additionally, the effect of a noise reduction algorithm on performance, listening effort, and memory effort was evaluated.Results:We analyzed pupil dilation both before each sentence (sentence baseline) as well as the dilation in response to each sentence relative to the sentence baseline (sentence dilation). The pupillometry data indicated a steeper increase of sentence baseline under recall compared to no recall, suggesting higher memory effort due to memory processing. This increase in sentence baseline was most prominent toward the end of the longer lists, that is, during the second half of six sentences. Without a recall task, sentence baseline declined over the course of the list. Noise reduction appeared to have a significant influence on effort allocation for listening, which was reflected in generally decreased sentence dilation.Conclusion:Our results showed that recording pupil dilation in a speech identification and recall task provides valuable insights beyond behavioral performance. It is a suitable tool to disentangle the allocation of effort to listening versus memorizing speech.
3.
Brännström, Jonas, et al.
(author)
The Process of Developing an Internet-Based Support System for Audiologists and First-Time Hearing Aid Clients
2015
In: American Journal of Audiology. - : American Speech-Language-Hearing Association. - 1059-0889 .- 1558-9137. ; 24:3, s. 320-324
Journal article (peer-reviewed) abstract
Background: In audiologic practice, complementary information sources and access to the clinician between appointments improve information retention and facilitate adjustment behaviors. An Internet-based support system is a novel way to support information sharing and clinician access. Purpose: This research forum article describes the process of developing an Internet-based support system for audiologists and their first-time hearing aid clients. Method: The iterative development process, including revisions by 4 research audiologists and 4 clinical audiologists, is described. The final system is exemplified. Conclusion: An Internet-based support system was successfully developed for audiologic practice.
4.
Ellis, Rachel, et al.
(author)
Predicting Speech-in-Noise Recognition from Performance on the Trail Making Test: Results from a Large-Scale Internet Study
2016
In: Ear and Hearing. - : Lippincott Williams & Wilkins. - 0196-0202 .- 1538-4667. ; 37:1, s. 73-79
Journal article (peer-reviewed) abstract
Objective: The aim of the study was to investigate the utility of an internet-based version of the trail making test (TMT) to predict performance on a speech-in-noise perception task.Design: Data were taken from a sample of 1509 listeners aged between 18 and 91 years old. Participants completed computerized versions of the TMT and an adaptive speech-in-noise recognition test. All testing was conducted via the internet.Results: The results indicate that better performance on both the simple and complex subtests of the TMT are associated with better speech-in-noise recognition scores. Thirty-eight percent of the participants had scores on the speech-in-noise test that indicated the presence of a hearing loss.Conclusions: The findings suggest that the TMT may be a useful tool in the assessment, and possibly the treatment, of speech-recognition difficulties. The results indicate that the relation between speech-in-noise recognition and TMT performance relates both to the capacity of the TMT to index processing speed and to the more complex cognitive abilities also implicated in TMT performance.
5.
Laplante-Lévesque, Ariane, et al.
(author)
Quality and readability of English-language internet information for adults with hearing impairment and their significant others
2012
In: International Journal of Audiology. - : Informa Healthcare. - 1499-2027 .- 1708-8186. ; 51:8, s. 618-626
Journal article (peer-reviewed) abstract
Objective: This study evaluated the quality and readability of English-language internet information for adults with hearing impairment and their significant others. Design: Two keyword pairs (hearing loss and hearing aids) were entered into five country-specific versions of the most commonly used internet search engine in May 2011. Sample: For each of the 10 searches, the first 10 relevant websites were included. After removing duplicates, a total of 66 websites were assessed. Their origin (commercial, non-profit organization, or government), date of last update, quality (Health On the Net (HON) certification and DISCERN scores), and readability (Flesch Reading Ease Score, Flesch-Kincaid Grade Level Formula, and Simple Measure Of Gobbledygook) were assessed. Results: Most websites were of commercial origin and had been updated within the last 18 months. Their quality and readability was highly variable. Only 14% of the websites had HON certification. Websites that were of non-profit organization origin had significantly higher DISCERN scores. Readability measures show that on average, only people with at least 11-12 years of education could read and understand the internet information presented. Conclusions: Based on these results, this article provides a list of recommendations for website developers and clinicians wishing to incorporate internet information into their practice.
6.
Laplante-Lévesque, Ariane, et al.
(author)
Stages of Change in Adults Who Have Failed an Online Hearing Screening
2015
In: Ear and Hearing. - : LIPPINCOTT WILLIAMS and WILKINS. - 0196-0202 .- 1538-4667. ; 36:1, s. 92-101
Journal article (peer-reviewed) abstract
Objectives: Hearing screening has been proposed to promote help-seeking and rehabilitation in adults with hearing impairment. However, some longitudinal studies point to low help-seeking and subsequent rehabilitation after a failed hearing screening (positive screening result). Some barriers to help-seeking and rehabilitation could be intrinsic to the profiles and needs of people who have failed a hearing screening. Theories of health behavior change could help to understand this population. One of these theories is the transtheoretical (stages-of-change) model of health behavior change, which describes profiles and needs of people facing behavior changes such as seeking help and taking up rehabilitation. According to this model, people go through distinct stages toward health behavior change: precontemplation, contemplation, action, and finally, maintenance. The present study describes the psychometric properties (construct validity) of the stages of change in adults who have failed an online hearing screening. Stages of change were measured with the University of Rhode Island Change Assessment (URICA). Principal component analysis is presented, along with cluster analysis. Internal consistency was investigated. Finally, relationships between URICA scores and speech-in-noise recognition threshold, self-reported hearing disability, and self-reported duration of hearing disability are presented. Design: In total, 224 adults who had failed a Swedish online hearing screening test (measure of speech-in-noise recognition) completed further questionnaires online, including the URICA. Results: A principal component analysis identified the stages of precontemplation, contemplation, and action, plus an additional stage, termed preparation (between contemplation and action). According to the URICA, half (50%) of the participants were in the preparation stage of change. The contemplation stage was represented by 38% of participants, while 9% were in the precontemplation stage. Finally, the action stage was represented by approximately 3% of the participants. Cluster analysis identified four stages-of-change clusters: they were named decision making (44% of sample), participation (28% of sample), indecision (16% of sample), and reluctance (12% of sample). The construct validity of the model was good. Participants who reported a more advanced stage of change had significantly greater self-reported hearing disability. However, participants who reported a more advanced stage of change did not have a significantly worse speech-in-noise recognition threshold or reported a significantly longer duration of hearing impairment. Conclusions: The additional stage this study uncovered, and which other studies have also uncovered, preparation, highlights the need for adequate guidance for adults who are yet to seek help for their hearing. The fact that very few people were in the action stage (approximately 3% of the sample) signals that screening alone is unlikely to be enough to improve help-seeking and rehabilitation rates. As expected, people in the later stages of change reported significantly greater hearing disability. The lack of significant relationships between stages-of-change measures and speech-in-noise recognition threshold and self-reported duration of hearing disability highlights the complex interplay between impairment, disability, and behaviors in adults who have failed an online hearing screening and who are yet to seek help.
7.
Ohlenforst, Barbara, et al.
(author)
Effects of Hearing Impairment and Hearing Aid Amplification on Listening Effort : A Systematic Review
2017
In: Ear and Hearing. - : Lippincott Williams & Wilkins. - 0196-0202 .- 1538-4667. ; 38:3, s. 267-281
Research review (peer-reviewed) abstract
Objectives: To undertake a systematic review of available evidence on the effect of hearing impairment and hearing aid amplification on listening effort. Two research questions were addressed: Q1) does hearing impairment affect listening effort? and Q2) can hearing aid amplification affect listening effort during speech comprehension? Design: English language articles were identified through systematic searches in PubMed, EMBASE, Cinahl, the Cochrane Library, and PsyclNFO from inception to August 2014. References of eligible studies were checked. The Population, Intervention, Control, Outcomes, and Study design strategy was used to create inclusion criteria for relevance. It was not feasible to apply a meta-analysis of the results from comparable studies. For the articles identified as relevant, a quality rating, based on the 2011 Grading of Recommendations Assessment, Development, and Evaluation Working Group guidelines, was carried out to judge the reliability and confidence of the estimated effects. Results: The primary search produced 7017 unique hits using the keywords: hearing aids OR hearing impairment AND listening effort OR perceptual effort OR ease of listening. Of these, 41 articles fulfilled the Population, Intervention, Control, Outcomes, and Study design selection criteria of: experimental work on hearing impairment OR hearing aid technologies AND listening effort OR fatigue during speech perception. The methods applied in those articles were categorized into subjective, behavioral, and physiological assessment of listening effort. For each study, the statistical analysis addressing research question Q1 and/or Q2 was extracted. In seven articles more than one measure of listening effort was provided. Evidence relating to Q1 was provided by 21 articles that reported 41 relevant findings. Evidence relating to Q2 was provided by 27 articles that reported 56 relevant findings. The quality of evidence on both research questions (Q1 and Q2) was very low, according to the Grading of Recommendations Assessment, Development, and Evaluation Working Group guidelines. We tested the statistical evidence across studies with nonparametric tests. The testing revealed only one consistent effect across studies, namely that listening effort was higher for hearing-impaired listeners compared with normal-hearing listeners (Q1) as measured by electroencephalographic measures. For all other studies, the evidence across studies failed to reveal consistent effects on listening effort. Conclusion: In summary, we could only identify scientific evidence from physiological measurement methods, suggesting that hearing impairment increases listening effort during speech perception (Q1). There was no scientific, finding across studies indicating that hearing aid amplification decreases listening effort (Q2). In general, there were large differences in the study population, the control groups and conditions, and the outcome measures applied between the studies included in this review. The results of this review indicate that published listening effort studies lack consistency, lack standardization across studies, and have insufficient statistical power. The findings underline the need for a common conceptual framework for listening effort to address the current shortcomings.
8.
Rönnberg, Niklas, 1973-, et al.
(author)
Testing listening effort for speech comprehension
2011
Conference paper (other academic/artistic) abstract
One aim of hearing aid fitting is to reduce the effort of understanding speech, especially in noisy environments. For a good hearing aid fitting, knowledge about the patient’s auditory abilities is necessary, but knowledge about cognitive abilities may also be important. The Auditory Inference Span Test (AIST) is a dual-task hearing-in-noise test, that combines auditory and memory processing. In AIST, Hagerman sentences are presented in steady state speech-shaped noise at -2dB, -4dB or -6dB SNR and the subject is required to recall and process the information from the sentences by giving button-press responses to multiple-choice questions thereby assessing what the subject could infer from what was heard. AIST will be administered to 40 normal hearing subjects (29 to date) and performance related to speech reception threshold, working memory capacity and updating ability, as well as subjective rating of listening effort. Preliminary results show a greater SNR-related improvement in AIST scores at low SNRs than can be explained by improved audibility alone, consistent with release of memory resources due to reduced listening effort. There is also a trend towards a positive relationship between AIST scores and individual working memory capacity and updating ability.
9.
Wang, Yang, et al.
(author)
Relations Between Self-Reported Daily-Life Fatigue, Hearing Status, and Pupil Dilation During a Speech Perception in Noise Task
2018
In: Ear and Hearing. - : LIPPINCOTT WILLIAMS & WILKINS. - 0196-0202 .- 1538-4667. ; 39:3, s. 573-582
Journal article (peer-reviewed) abstract
Objective: People with hearing impairment are likely to experience higher levels of fatigue because of effortful listening in daily communication. This hearing-related fatigue might not only constrain their work performance but also result in withdrawal from major social roles. Therefore, it is important to understand the relationships between fatigue, listening effort, and hearing impairment by examining the evidence from both subjective and objective measurements. The aim of the present study was to investigate these relationships by assessing subjectively measured daily-life fatigue (self-report questionnaires) and objectively measured listening effort (pupillometry) in both normally hearing and hearing-impaired participants. Design: Twenty-seven normally hearing and 19 age-matched participants with hearing impairment were included in this study. Two self-report fatigue questionnaires Need For Recovery and Checklist Individual Strength were given to the participants before the test session to evaluate the subjectively measured daily fatigue. Participants were asked to perform a speech reception threshold test with single-talker masker targeting a 50% correct response criterion. The pupil diameter was recorded during the speech processing, and we used peak pupil dilation (PPD) as the main outcome measure of the pupillometry. Results: No correlation was found between subjectively measured fatigue and hearing acuity, nor was a group difference found between the normally hearing and the hearing-impaired participants on the fatigue scores. A significant negative correlation was found between self-reported fatigue and PPD. A similar correlation was also found between Speech Intelligibility Index required for 50% correct and PPD. Multiple regression analysis showed that factors representing "hearing acuity" and "self-reported fatigue" had equal and independent associations with the PPD during the speech in noise test. Less fatigue and better hearing acuity were associated with a larger pupil dilation. Conclusions: To the best of our knowledge, this is the first study to investigate the relationship between a subjective measure of daily-life fatigue and an objective measure of pupil dilation, as an indicator of listening effort. These findings help to provide an empirical link between pupil responses, as observed in the laboratory, and daily-life fatigue.
10.
