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Representing sounds and spellings: Phonological decline and compensatory working memory in acquired hearing impairment
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
Representationer av ljud och stavning : Försämrad fonologisk förmåga och kompensatoriskt arbetsminne vid förvärvad hörselnedsättning (Swedish)
Abstract [en]

This thesis examined phonological processing in adults with postlingually acquired moderate-to-severe hearing impairment (HI) and whether explicit working memory processing of phonology and individual working memory capacity (WMC) can compensate for degraded phonological representations in this group (papers I-III). A second aim was to provide reference data for a test of WMC, the reading span test, and to examine the relation between reading span test performance and speech recognition in noise in a larger sample of 50-89 year olds with HI (paper IV). Non-auditory tasks of phonological processing, episodic long-term memory and WMC were used in papers I-III, and both behavioral and electrophysiological measures were collected. Results showed that phonological processing was impaired in the group with HI but that WMC and explicit working memory processing of phonology could be employed to compensate for degraded phonological representations. However, this compensation may come at the cost of interfering with episodic memory encoding. An  electrophysiological marker of HI in text-based rhyme judgments was found. Paper IV presented reference data for reading span test performance in two versions of the test in individuals with HI, and results suggesting that WMC may be differentially predictive of speech recognition in noise in different age groups of older adults with HI. The clinical implications of the present results concerns the double disadvantage of individuals with lower WMC and HI. A structured assessment of WMC in rehabilitative settings would help to identify these individuals and tailor treatment to their needs. The reading span test is suggested as a suitable future candidate for clinical WMC assessment.

Abstract [sv]

I denna avhandling undersöktes fonologiska processer hos personer med postlingualt förvärvad, måttlig till mycket grav hörselnedsättning (HNS) och om inkoppling av explicit bearbetning av fonologi eller individuell arbetsminneskapacitet kan kompensera för försämrade ljudminnen i denna grupp (studie I-III). Ett andra syfte var att sammanställa referensdata för ett test av arbetsminneskapacitet, lässpann, och undersöka relationen mellan prestation på lässpann ochigenkänning av tal-i-brus i en större grupp av 50-89 åriga personer  med HNS (studie IV). Icke-auditiva test av fonologisk förmåga, episodiskt långtidsminne och arbetsminneskapacitet användes i studie I-III och både beteendedata och elektrofysiologiska data samlades in. Resultaten visade på försämrad fonologisk förmåga i gruppen med HNS men också att explicit bearbetning av fonologi och arbetsminneskapacitet kunde användas för att kompensera för försämrade fonologiska representationer i denna grupp. Denna kompensation kan dock ske på bekostnad av att inkodning i episodiska långtidsminnet störs. Vidare identifierades en elektrofysiologisk markör för HNS i en textbaserad rimuppgift. I studie IV presenterades referensdata i två versioner av lässpanntestet för personer med mild till mycket grav HN och resultat som pekar mot möjliga skillnader mellan olika åldersgrupper i hur väl arbetsminneskapacitet predicerar igenkänning av tal-i-brus. Kliniska implikationer rör den dubbla belastning det innebär att ha både en HN och relativt sänkt arbetsminneskapacitet. En strukturerad bedömning av arbetsminneskapacitet i samband med rehabilitering skulle kunna bidra till att synliggöra dessa personer och anpassa insatser efter deras behov. Lässpanntestet är ett test som i framtiden skulle kunna vara användbart i det sammanhanget.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2013. , 57 p.
Series
Linköping Studies in Arts and Science, ISSN 0282-9800 ; 591Studies from the Swedish Institute for Disability Research, ISSN 1650-1128 ; 54
Keyword [en]
Acquired hearing impairment, phonology, WMC, reading span
Keyword [sv]
Förvärvad hörselnedsättning, fonologi, arbetsminne, lässpann
National Category
Medical and Health Sciences Social Sciences
Identifiers
URN: urn:nbn:se:liu:diva-99786DOI: 10.3384/diss.diva-99786ISBN: 978-91-7519-500-1 (print)OAI: oai:DiVA.org:liu-99786DiVA: diva2:658177
Public defence
2013-11-08, I:101, Hus I, Campus Valla, Linköpings universitet, Linköping, 13:00 (English)
Opponent
Supervisors
Available from: 2013-10-21 Created: 2013-10-21 Last updated: 2013-10-30Bibliographically approved
List of papers
1. Early ERP signature of hearing impairment in visual rhyme judgment
Open this publication in new window or tab >>Early ERP signature of hearing impairment in visual rhyme judgment
2013 (English)In: Frontiers in Psychology, ISSN 1664-1078, E-ISSN 1664-1078, Vol. 4, no 241Article in journal (Refereed) Published
Abstract [en]

Postlingually acquired hearing impairment (HI) is associated with changes in the representation of sound in semantic long-term memory. An indication of this is the lower performance on visual rhyme judgment tasks in conditions where phonological and orthographic cues mismatch, requiring high reliance on phonological representations. In this study, event-related potentials (ERPs) were used for the first time to investigate the neural correlates of phonological processing in visual rhyme judgments in participants with acquired HI and normal hearing (NH). Rhyme task word pairs rhymed or not and had matching or mismatching orthography. In addition, the inter-stimulus interval (ISI) was manipulated to be either long (800 ms) or short (50 ms). Long ISIs allow for engagement of explicit, top-down processes, while short ISIs limit the involvement of such mechanisms. We hypothesized lower behavioral performance and N400 and N2 deviations in HI in the mismatching rhyme judgment conditions, particularly in short ISI. However, the results showed a different pattern. As expected, behavioral performance in the mismatch conditions was lower in HI than in NH in short ISI, but ERPs did not differ across groups. In contrast, HI performed on a par with NH in long ISI. Further, HI, but not NH, showed an amplified N2-like response in the non-rhyming, orthographically mismatching condition in long ISI. This was also the rhyme condition in which participants in both groups benefited the most from the possibility to engage top-down processes afforded with the longer ISI. Taken together, these results indicate an early ERP signature of HI in this challenging phonological task, likely reflecting use of a compensatory strategy. This strategy is suggested to involve increased reliance on explicit mechanisms such as articulatory recoding and grapheme-to-phoneme conversion.

Place, publisher, year, edition, pages
Switzerland: Frontiers Research Foundation, 2013
Keyword
event-related potentials, hearing impairment, phonology, visual rhyme judgment, inter-stimulus interval, N2, N400, FP
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-92284 (URN)10.3389/fpsyg.2013.00241 (DOI)000330942000001 ()
Available from: 2013-05-08 Created: 2013-05-08 Last updated: 2017-12-06Bibliographically approved
2. Working memory capacity compensates for hearing related phonological processing deficit
Open this publication in new window or tab >>Working memory capacity compensates for hearing related phonological processing deficit
2013 (English)In: Journal of Communication Disorders, ISSN 0021-9924, E-ISSN 1873-7994, Vol. 46, no 1, 17-29 p.Article in journal (Refereed) Published
Abstract [en]

Acquired hearing impairment is associated with gradually declining phonological representations. According to the Ease of Language Understanding (ELU) model, poorly defined representations lead to mismatch in phonologically challenging tasks. To resolve the mismatch, reliance on working memory capacity (WMC) increases. This study investigated whether WMC modulated performance in a phonological task in individuals with hearing impairment. A visual rhyme judgment task with congruous or incongruous orthography, followed by an incidental episodic recognition memory task, was used. In participants with hearing impairment, WMC modulated both rhyme judgment performance and recognition memory in the orthographically similar non-rhyming condition; those with high WMC performed exceptionally well in the judgment task, but later recognized few of the words. For participants with hearing impairment and low WMC the pattern was reversed; they performed poorly in the judgment task but later recognized a surprisingly large proportion of the words. Results indicate that good WMC can compensate for the negative impact of auditory deprivation on phonological processing abilities by allowing for efficient use of phonological processing skills. They also suggest that individuals with hearing impairment and low WMC may use a non-phonological approach to written words, which can have the beneficial side effect of improving memory encoding. less thanbrgreater than less thanbrgreater thanLearning outcomes: Readers will be able to: (1) describe cognitive processes involved in rhyme judgment, (2) explain how acquired hearing impairment affects phonological processing and (3) discuss how reading strategies at encoding impact memory performance.

Place, publisher, year, edition, pages
ELSEVIER, 2013
Keyword
Hearing impairment, Phonology, Working memory capacity, Episodic recognition
National Category
Social Sciences
Identifiers
urn:nbn:se:liu:diva-74276 (URN)10.1016/j.jcomdis.2012.10.001 (DOI)000314140200002 ()
Available from: 2012-01-23 Created: 2012-01-23 Last updated: 2017-12-08
3. Verbal fluency in adults with postlingually acquired hearing impairment
Open this publication in new window or tab >>Verbal fluency in adults with postlingually acquired hearing impairment
2013 (English)In: Speech, Language and Hearing, ISSN 2050-571X, Vol. 17, no 2, 88-100 p.Article in journal (Refereed) Published
Abstract [en]

This study examined verbal retrieval in participants with acquired moderate-to-severe sensorineural hearing impairment (M age = 63, M education level = 13 years) compared to participants with normal hearing thresholds (M age = 62, M education level = 14 years) using the letter and category fluency tasks. Analyses of number of words produced, clustering, and switching, were conducted. There was no significant difference between the groups in category fluency performance. In letter fluency, however, the participants with hearing impairment produced significantly fewer words than the normal hearing participants and their production was characterized by fewer switches. Regression analyses were conducted to examine the relationship between demographic, auditory, and cognitive variables and letter fluency performance in the two groups. Phonological skills and auditory acuity predicted letter fluency output only in participants with hearing impairment and a hearing-related link between phonological skills, working memory capacity, and letter fluency switching was found.

Keyword
Hearing impairment, Letter fluency, Category fluency, Clustering, Switching, Phonology, Working memory capacity
National Category
Other Social Sciences
Identifiers
urn:nbn:se:liu:diva-99778 (URN)10.1179/205057113X13781290153457 (DOI)
Available from: 2013-10-21 Created: 2013-10-21 Last updated: 2017-11-06Bibliographically approved
4. Reading span performance in 339 Swedish 50-89 year old individuals with hearing impairment: Effects of test version and age, and relation to speech recognition in noise
Open this publication in new window or tab >>Reading span performance in 339 Swedish 50-89 year old individuals with hearing impairment: Effects of test version and age, and relation to speech recognition in noise
Show others...
2013 (English)Manuscript (preprint) (Other academic)
Abstract [en]

The Swedish reading span test (Rönnberg, Lyxell, Arlinger, & Kinnefors, 1989) is often used to assess working memory capacity (WMC) in the field of cognitive hearing science. The test has proven useful as a predictor of speech recognition in noise in adverse conditions. It has been used in a wide range of experimental studies and has been translated to several languages. The purpose of this paper was to provide reference data for the Swedish reading span test (Rönnberg et al., 1989) in a large sample of adults with hearing impairment aged 50-89 years that are representative of patients seeking rehabilitation at audiological clinics. Data from finished and ongoing projects were collated and reanalyzed for this purpose. The original full version and a shortened version of the test were compared, in terms of percentage correct. In addition, performance on the full version was compared across two different age-cohorts, 50-69 year olds and 70-89 year olds. Frequency distributions and percentile scores are reported, as well as relations with demographic variables, and speech recognition in noise. Results showed that reading span performance was related to age, but not sex, with lower scores in older participants. Pure tone hearing thresholds accounted for a small but significant amount of the variance such that higher reading span scores were related to better hearing. The frequency distributions of scores did not differ across the two versions of the test, but the long version seemed to be more sensitive to age. Performance in both versions was significantly correlated with speech recognition in noise. Regression analyses however showed that reading span explained additional variance in speech in noise recognition, after the effects of age and pure tone hearing thresholds were accounted for, only in the 50-69 year olds. These findings are discussed in relation to  age-related differences in the ability to recruit cognitive resources in the service of speech communication.

National Category
Social Sciences
Identifiers
urn:nbn:se:liu:diva-99780 (URN)
Available from: 2013-10-21 Created: 2013-10-21 Last updated: 2017-11-06Bibliographically approved

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