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Cognition in Hearing Aid Users: Memory for Everyday Speech
Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
2013 (English)Doctoral thesis, comprehensive summary (Other academic)Alternative title
Kognition hos hörapparatsanvändare : Att minnas talade vardagsmeningar (Swedish)
Abstract [en]

The thesis investigated the importance of cognition for speech understanding in experienced and new hearing aid users. The aims were 1) to develop a cognitive test (Sentence-final Word Identification and Recall, or SWIR test) to measure the effects of a noise reduction algorithm on processing of highly intelligible speech (everyday sentences); 2) to investigate, using the SWIR test, whether hearing aid signal processing would affect memory for heard speech in experienced hearing aid users; 3) to test whether the effects of signal processing on the ability to recall speech would interact with background noise and individual differences in working memory capacity; 4) to explore the potential clinical application of the SWIR test; and 5) to examine the relationship between cognition and speech recognition in noise in new users over the first six months of hearing aid use. Results showed that, for experienced users, noise reduction freed up cognitive resources and alleviated the negative  impact of noise on memory when speech stimuli were presented in a background of speech babble spoken in the listener’s native language. The possible underlying mechanisms are that noise reduction facilitates auditory stream segregation between target and irrelevant speech and reduces the attention captured by the linguistic information in irrelevant speech. The effects of noise reduction and SWIR performance were modulated by individual differences in working memory capacity. SWIR performance was related to the self-reported outcome of hearing aid use. For new users, working memory capacity played a more important role in speech recognition in noise before acclimatization to hearing aid amplification than after six months. This thesis demonstrates for the first time that hearing aid signal processing can significantly improve the ability of individuals with hearing impairment to recall highly intelligible speech stimuli presented in babble noise. It also adds to the literature showing the key role of working memory capacity in listening with hearing aids, especially for new users. By virtue of its relation to subjective measures of hearing aid outcome, the SWIR test can potentially be used as a tool in assessing hearing aid outcome.

Abstract [sv]

Avhandlingens övergripande mål var att studera kognitionens betydelse för talförståelse hos vana och nya hörapparatsanvändare. Syftena var att 1) utveckla ett kognitivt test (Sentence-final Word Identification and Recall, eller SWIR test) för att mäta en brusreducerande algoritms effekt på bearbetningen av tydligt tal (vardagsmeningar); 2) att med hjälp av SWIR testet undersöka huruvida hörapparatens signalbehandling påverkade återgivningen av uppfattat tal hos vana hörapparatsanvändare; 3) att utvärdera om effekten av signalbehandling på förmågan att komma ihåg tal påverkas av störande bakgrundsljud samt individuella skillnader i arbetsminnets kapacitet; 4) att undersöka den potentiella kliniska tillämpningen av SWIR testet och 5) att undersöka förhållandet mellan kognition och taluppfattning i störande bakgrundsljud hos nya hörapparatsanvändare under de första sex månaderna med hörapparater. Resultaten visade att för vana hörapparatsanvändare lindrade brusreduceringen det störande ljudets negativa inverkan på minnet när meningar presenterades i form av irrelevant tal på deltagarnas modersmål. De möjliga underliggande mekanismerna är att brusreducering underlättar diskriminering av de auditiva informationsflödena mellan det som ska uppfattas och det som är irrelevant, samt minskar graden av uppmärksamhet som fångas av den språkliga informationen i det irrelevanta talet. Effekterna av brusreducering och resultaten av SWIR var beroende av individuella skillnader i arbetsminnets kapacitet. Resultaten av SWIR har också samband med det självrapporterade utfallet av  hörapparatsanvändning. För nya användare spelar arbetsminnets kapacitet initialt en viktigare roll för taluppfattning i störande bakgrundsljud, innan anpassningen till hörapparatens förstärkning skett, än efter sex månader. Denna avhandling visar för första gången att hörapparatens signalbehandling kan signifikant förbättra möjligheten för individer med hörselnedsättning att minnas tydligt tal, som presenteras i störande bakgrundsljud. Avhandlingen bidrar till litteraturen med en diskussion om hur arbetsminnets kapacitet spelar roll i taluppfattning med hörapparat, i synnerhet för nya användare. Med stöd av dess samband med det självrapporterade utfallet, kan SWIR testet användas som redskap i bedömning av hörapparaters effekt.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2013. , 61 p.
Series
Linköping Studies in Arts and Science, ISSN 0282-9800 ; 593Studies from the Swedish Institute for Disability Research, ISSN 1650-1128 ; 53
Keyword [en]
Hearing aid, working memory, free recall, noise reduction, speech recognition
Keyword [sv]
Hörapparat, arbetsminne, återgivning, brusreducering, taluppfattning
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-98286DOI: 10.3384/diss.diva-98286ISBN: 978-91-7519-494-3 (print)OAI: oai:DiVA.org:liu-98286DiVA: diva2:654009
Public defence
2013-10-29, I:101, Hus I, Campus Valla, Linköpings universietet, Linköping, 13:00 (English)
Opponent
Supervisors
Available from: 2013-10-07 Created: 2013-10-07 Last updated: 2013-10-07Bibliographically approved
List of papers
1. Effects of noise and working memory capacity on memory processing of speech for hearing-aid users
Open this publication in new window or tab >>Effects of noise and working memory capacity on memory processing of speech for hearing-aid users
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2013 (English)In: International Journal of Audiology, ISSN 1499-2027, E-ISSN 1708-8186, Vol. 52, no 7, 433-441 p.Article in journal (Refereed) Published
Abstract [en]

Objectives: It has been shown that noise reduction algorithms can reduce the negative effects of noise on memory processing in persons with normal hearing. The objective of the present study was to investigate whether a similar effect can be obtained for persons with hearing impairment and whether such an effect is dependent on individual differences in working memory capacity.

Design: A sentence-final word identification and recall (SWIR) test was conducted in two noise backgrounds with and without noise reduction as well as in quiet. Working memory capacity was measured using a reading span (RS) test.

Study sample: Twenty-six experienced hearing-aid users with moderate to moderately severe sensorineural hearing loss.

Results: Noise impaired recall performance. Competing speech disrupted memory performance more than speech-shaped noise. For late list items the disruptive effect of the competing speech background was virtually cancelled out by noise reduction for persons with high working memory capacity.

Conclusions: Noise reduction can reduce the adverse effect of noise on memory for speech for persons with good working memory capacity. We argue that the mechanism behind this is faster word identification that enhances encoding into working memory.

Place, publisher, year, edition, pages
Informa Healthcare, 2013
National Category
Social Sciences
Identifiers
urn:nbn:se:liu:diva-91780 (URN)10.3109/14992027.2013.776181 (DOI)000320450800001 ()23550584 (PubMedID)
Available from: 2013-05-01 Created: 2013-05-01 Last updated: 2017-12-06Bibliographically approved
2. Relationships between self-report and cognitive measures of hearing aid outcome
Open this publication in new window or tab >>Relationships between self-report and cognitive measures of hearing aid outcome
2013 (English)In: Speech, Language and Hearing, ISSN 2050-571X, Vol. 16, no 4, 197-207 p.Article in journal (Refereed) Published
Abstract [en]

This present study examined the relationship between cognitive measures and self-report hearing aid outcome. A sentence-final word identification and recall (SWIR) test was used to investigate how hearing aid use may relate to experienced explicit cognitive processing. A visually based cognitive test battery was also administered. To measure self-report hearing aid outcome, the International Outcome Inventory – Hearing Aids (IOI-HA) and the Speech, Spatial and Qualities of Hearing Scale (SSQ) were employed. Twenty-six experienced hearing aid users (mean age of 59 years) with symmetrical moderate-tomoderately severe sensorineural hearing loss were recruited. Free recall performance in the SWIR test correlated negatively with item 3 of IOI-HA, which measures residual difficulty in adverse listening situations. Cognitive abilities related to verbal information processing were correlated positively with selfreported hearing aid use and overall success. The present study showed that reported residual difficulty with hearing aid may relate to experienced explicit processing in difficult listening conditions, such that individuals with better cognitive capacity tended to report more remaining difficulty in challenging listening situations. The possibility of using cognitive measures to predict hearing aid outcome in real life should be explored in future research.

Place, publisher, year, edition, pages
Maney Publishing, 2013
Keyword
Hearing aid, Outcome measures, Self-reported, Working memory, Cognitive abilities
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-98283 (URN)10.1179/2050572813Y.0000000013 (DOI)
Available from: 2013-10-07 Created: 2013-10-07 Last updated: 2017-11-06Bibliographically approved
3. Noise reduction improves memory for target language speech in competing native but not foreign language speech
Open this publication in new window or tab >>Noise reduction improves memory for target language speech in competing native but not foreign language speech
2015 (English)In: Ear and Hearing, ISSN 0196-0202, E-ISSN 1538-4667, Vol. 36, no 1, 82-91 p.Article in journal (Refereed) Published
Abstract [en]

Objectives: A hearing aid noise reduction (NR) algorithm reduces the adverse effect of competing speech on memory for target speech for individuals with hearing impairment with high working memory capacity. In the present study, we investigated whether the positive effect of NR could be extended to individuals with low working memory capacity, as well as how NR influences recall performance for target native speech when the masker language is non-native.

Design: A sentence-final word identification and recall (SWIR) test was administered to 26 experienced hearing aid users. In this test, target spoken native language (Swedish) sentence lists were presented in competing native (Swedish) or foreign (Cantonese) speech with or without binary masking NR algorithm. After each sentence list, free recall of sentence final words was prompted. Working memory capacity was measured using a reading span (RS) test.

Results: Recall performance was associated with RS. However, the benefit obtained from NR was not associated with RS. Recall performance was more disrupted by native than foreign speech babble and NR improved recall performance in native but not foreign competing speech.

Conclusions: Noise reduction improved memory for speech heard in competing speech for hearing aid users. Memory for native speech was more disrupted by native babble than foreign babble, but the disruptive effect of native speech babble was reduced to that of foreign babble when there was NR.

Place, publisher, year, edition, pages
Wolters Kluwer, 2015
Keyword
Noise reduction, free recall, working memory, masker language, competing speech
National Category
Basic Medicine
Identifiers
urn:nbn:se:liu:diva-98284 (URN)10.1097/AUD.0000000000000080 (DOI)000346911200009 ()
Note

On the day of the defence date the status of this article was Manuscript.

Available from: 2013-10-07 Created: 2013-10-07 Last updated: 2017-12-06Bibliographically approved
4. Dynamic relation between working memory capacity and speech recognition in noise during the first six months of hearing aid use
Open this publication in new window or tab >>Dynamic relation between working memory capacity and speech recognition in noise during the first six months of hearing aid use
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2014 (English)In: Trends in Hearing, ISSN 2331-2165, Vol. 18, 1-10 p.Article in journal (Refereed) Published
Abstract [en]

The present study aimed to investigate the changing relationship between aided speech recognition and cognitive function during the first six months of hearing aid use. Twentyseven first-time hearing aid users with symmetrical mild to moderate sensorineural hearing loss were recruited. Aided speech recognition thresholds in noise (SRTs) were obtained in the hearing aid fitting session as well as at three and six months post-fitting. Cognitive abilities were assessed using a reading span test, which is a measure of working memory capacity, and a cognitive test battery. Results showed a significant correlation between reading span and SRT during the hearing aid fitting session. This relation was significantly weakened over the first six months of hearing aid use. Multiple regression analysis showed that reading span was the main predictor of SRT when hearing aids were first fitted, but that pure-tone average hearing threshold (PTA) was the main predictor six months later. This indicates that working memory capacity plays a more important role in speech recognition in noise before than after six months of use. We argue that new hearing aid users engage working memory capacity to recognize unfamiliar processed speech signals but that as familiarization proceeds, engagement of working memory capacity is reduced.

Place, publisher, year, edition, pages
Sage Publications, 2014
Keyword
Speech recognition, cognitive abilities, working memory, acclimatization, hearing aid
National Category
Health Sciences Other Social Sciences
Identifiers
urn:nbn:se:liu:diva-98285 (URN)10.1177/2331216514558688 (DOI)000354484700002 ()
Available from: 2013-10-07 Created: 2013-10-07 Last updated: 2017-11-06Bibliographically approved

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Output format
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