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  • 201.
    Rudner, Mary
    et al.
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research. Linköping University, Linnaeus Centre HEAD.
    Mishra, Sachin
    Linköping University, Department of Physics, Chemistry and Biology.
    Stenfelt, Stefan
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Linköping University, The Swedish Institute for Disability Research.
    Lunner, Thomas
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research. Snekkersten, Oticon A/S, Eriksholm Research Centre.
    Rönnberg, Jerker
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research. Linköping University, Linnaeus Centre HEAD.
    Working memory capacity and executive ability can compensate for lower cognitive spare capacity in older adults with hearing loss compared to young adults with normal hearing2013In: Again and speech communication 5th International and Interdisciplinary Research Conference  Indiana University, Bloomington  October 6-9, 2013, 2013Conference paper (Other academic)
  • 202.
    Rudner, Mary
    et al.
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research.
    Mishra, Sushmit
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research.
    Stenfeldt, S
    Lunner, Thomas
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Eriksholm Research Centre, Snekkersten, Denmark.
    Rönnberg, Jerker
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research.
    Good working memory capacity facilitates long-term memory encoding of speech in stationary noise2015Conference paper (Refereed)
    Abstract [en]

    Background noise makes listening more cognitively demanding, especially for persons with hearingimpairment, and this seems to aect memory encoding. It is not clear whether this decrement can berestored by providing visual cues. In the present study, we investigated whether long term memoryencoding of speech, in quiet and in background noise adjusted to retain intelligibility, improves whenthe talkers face is visible, and whether such an enhancement is associated with working memorycapacity. Twenty adults with normal hearing in Experiment 1 and 24 adults with hearing loss inExperiment 2 listened to lists of 13 two-digit numbers, with or without seeing the talkers face, andthen recalled as many numbers as possible in any order. The lists were presented in quiet as wellin a steady-state speech-weighted noise and the International Speech Testing Signal at a signal-tonoiseratio individually adapted to give an intelligibility level of approximately 90%. Amplicationcompensated for loss of audibility. Working memory capacity was measured using the reading spantest. Seeing the talkers face did enhance free recall performance. However, whereas the eect size foradults with normal hearing was large, for adults with hearing impairment it was small. Further, therewas no evidence that visual cues specically compensated for performance decrements due to noiseor serial position and there was no evidence of an association between working memory capacity andperformance with visual cues. However, good working memory capacity did improve performance forearly list items, reecting facilitation of long-term memory encoding, for both groups when stimuliwere presented in steady-state noise. For participants with hearing impairment, good working memorycapacity was associated with good performance on late list items in quiet, reecting facilitationof working memory encoding. This pattern of results indicates that steady-state background noisereduces the cognitive capacity available for the long-term memory encoding of speech that is necessaryfor enduring retention of spoken information, irrespective of hearing status, but provides no evidencethat this is specically compensated for by visual cues. It also demonstrates that for individuals withhearing impairment, short term retention of speech heard even under the most favourable conditionsis a function of individual working memory capacity. These ndings support and extend the Ease ofLanguage Understanding Model.

  • 203.
    Rudner, Mary
    et al.
    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.
    Mishra, Sushmit
    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.
    Stenfelt, Stefan
    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. Linköping University, Department of Clinical and Experimental Medicine.
    Lunner, Thomas
    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. Linköping University, Department of Clinical and Experimental Medicine. Eriksholm Research Centre, Snekkersten, Denmark.
    Rönnberg, Jerker
    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.
    Age-related individual differences in working memory capacity and executive ability influence cognitive spare capacity2013Conference paper (Refereed)
  • 204.
    Rudner, Mary
    et al.
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research.
    Mishra, Sushmit
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Behavioural Sciences, The Swedish Institute for Disability Research.
    Stenfelt, Stefan
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences.
    Lunner, Thomas
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research. Snekkersten, Oticon A/S, Eriksholm Research Centre.
    Rönnberg, Jerker
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research. Linnaeus Centre HEAD.
    Seeing the talker’s face improves free recall of speech for young adults with normal hearing but not older adults with hearing loss2016In: Journal of Speech, Language and Hearing Research, ISSN 1092-4388, E-ISSN 1558-9102, Vol. 59, p. 590-599Article in journal (Refereed)
    Abstract [en]

    Purpose Seeing the talker's face improves speech understanding in noise, possibly releasing resources for cognitive processing. We investigated whether it improves free recall of spoken two-digit numbers.

    Method Twenty younger adults with normal hearing and 24 older adults with hearing loss listened to and subsequently recalled lists of 13 two-digit numbers, with alternating male and female talkers. Lists were presented in quiet as well as in stationary and speech-like noise at a signal-to-noise ratio giving approximately 90% intelligibility. Amplification compensated for loss of audibility.

    Results Seeing the talker's face improved free recall performance for the younger but not the older group. Poorer performance in background noise was contingent on individual differences in working memory capacity. The effect of seeing the talker's face did not differ in quiet and noise.

    Conclusions We have argued that the absence of an effect of seeing the talker's face for older adults with hearing loss may be due to modulation of audiovisual integration mechanisms caused by an interaction between task demands and participant characteristics. In particular, we suggest that executive task demands and interindividual executive skills may play a key role in determining the benefit of seeing the talker's face during a speech-based cognitive task

  • 205.
    Rudner, Mary
    et al.
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research.
    Ng, EH
    Rönnberg, Niklas
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuroscience. Linköping University, Faculty of Health Sciences.
    Mishra, Sushmit
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research.
    Rönnberg, Jerker
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research.
    Lunner, Thomas
    Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences. Eriksholm Research Centre, Snekkersten, Denmark.
    Stenfelt, Stefan
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
    Cognitive spare capacity as a measure of listening effort2011In: Journal of Hearing Science, ISSN 2083-389X, Vol. 1, no 2, p. EA47-49Article in journal (Refereed)
    Abstract [en]

    There has been a recent interest in listening effort as a factor to be taken into account in the audiological clinic. However, the term “listening effort” is poorly determined and needs to be defined before it can be used as a clinical or research tool. One way of understanding listening effort is in terms of the cognitive resources expended during listening. Cognitive capacity is finite and thus if cognitive capacity is used up during the act of listening to speech there will be fewer cognitive resources left to process the content of the message conveyed. We have introduced the term Cognitive Spare Capacity (CSC) to refer to residual cognitive capacity once successful listening has taken place. This extended abstract described the work we have carried out to date on measures of CSC for research and clinical use. In the course of this work we have developed tests to assess the role of memory load, executive function and audiovisual integration in CSC under challenging conditions. When these tests are fully developed, our aim is that they should allow objective individual assessment of listening effort in cognitive terms. Results to date indicate that under challenging conditions, CSC is an arena for executive processing of temporarily stored information; it is related to individual working memory capacity and can be enhanced by hearing aid signal processing.

  • 206.
    Rudner, Mary
    et al.
    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.
    Ng, Hoi Ning, Elaine
    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.
    Rönnberg, Niklas
    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.
    Mishra, Sushmit
    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.
    Rönnberg, Jerker
    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.
    Lunner, Thomas
    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.
    Stenfelt, Stefan
    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.
    Cognitive spare capacity as a measure of listening effort2011In: Journal of Hearing Science, ISSN 2083-389X, Vol. 1, no 2, p. 47-49Article in journal (Refereed)
    Abstract [en]

    There has been a recent interest in listening effort as a factor to be taken into account in the audiological clinic. However, the term “listening effort” is poorly determined and needs to be defined before it can be used as a clinical or research tool. One way of understanding listening effort is in terms of the cognitive resources expended during listening. Cognitive capacity is finite and thus if cognitive capacity is used up during the act of listening to speech there will be fewer cognitive resources left to process the content of the message conveyed. We have introduced the term Cognitive Spare Capacity (CSC) to refer to residual cognitive capacity once successful listening has taken place. This extended abstract described the work we have carried out to date on measures of CSC for research and clinical use. In the course of this work we have developed tests to assess the role of memory load, executive function and audiovisual integration in CSC under challenging conditions. When these tests are fully developed, our aim is that they should allow objective individual assessment of listening effort in cognitive terms. Results to date indicate that under challenging conditions, CSC is an arena for executive processing of temporarily stored information; it is related to individual working memory capacity and can be enhanced by hearing aid signal processing.

  • 207.
    Rudner, Mary
    et al.
    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.
    Ng, Hoi Ning, Elaine
    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.
    Rönnberg, Niklas
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology. Linköping University, Faculty of Health Sciences.
    Mishra, Sushmit
    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.
    Rönnberg, Jerker
    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.
    Lunner, Thomas
    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.
    Stenfelt, Stefan
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology. Linköping University, Faculty of Health Sciences.
    Understanding auditory effort by measuring cognitive spare capacity2011Conference paper (Other academic)
  • 208.
    Rudner, Mary
    et al.
    Linköping University, Department of Behavioural Sciences and Learning, Cognition, Development and Disability. Linköping University, Faculty of Arts and Sciences.
    Rönnberg, Jerker
    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.
    Lunner, Thomas
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology. Linköping University, Faculty of Health Sciences.
    Working Memory Supports Listening in Noise for Persons with Hearing Impairment2011In: JOURNAL OF THE AMERICAN ACADEMY OF AUDIOLOGY, ISSN 1050-0545, Vol. 22, no 3, p. 156-167Article in journal (Refereed)
    Abstract [en]

    Background: Previous studies have demonstrated a relation between cognitive capacity, in particular working memory, and the ability to understand speech in noise with different types of hearing aid signal processing. Purpose: The present study investigates the relation between working memory capacity and the speech recognition performance of persons with hearing impairment under both aided and unaided conditions, following a period of familiarization to both fast- and slow-acting compression settings in the participants own hearing aids. Research Design: Speech recognition was tested in modulated and steady state noise with fast and slow compression release settings (for aided conditions) with each of two materials. Working memory capacity was also measured. Study Sample: Thirty experienced hearing aid users with a mean age of 70 yr (SD = 7.8) and pure-tone average hearing threshold across the frequencies 0.25, 0.5, 1, 2, 3, 4, and 6 kHz (PTA(7)) and for both ears of 45.8 dB HL (SD = 6.6). Intervention: 9 wk experience with each of fast-acting and slow-acting compression. Data Collection and Analysis: Speech recognition data were analyzed using repeated measures analysis of variance with the within-subjects factors of material (high constraint, low constraint), noise type (steady state, modulated), and compression (fast, slow), and the between-subjects factor working memory capacity (high, low). Results: With high constraint material, there were three-way interactions including noise type and working memory as well as compression, in aided conditions, and performance level, in unaided conditions, but no effects of either working memory or compression with low constraint material. Investigation of simple main effects showed a significant effect of working memory during speech recognition under conditions of both "high degradation" (modulated noise, fast-acting compression, low signal-to-noise ratio [SNR]) and "low degradation" (steady state noise, slow-acting compression, high SNR). The finding of superior performance of persons with high working memory capacity in modulated noise with fast-acting compression agrees with findings of previous studies including a familiarization period of at least 9 wk, in contrast to studies with familiarization of 4 wk or less that have shown that persons with lower cognitive capacity may benefit from slow-acting compression. Conclusions: Working memory is a crucial factor in speech understanding in noise for persons with hearing impairment, irrespective of whether hearing is aided or unaided. Working memory supports speech understanding in noise under conditions of both "high degradation" and "low degradation." A subcomponent view of working memory may contribute to our understanding of these phenomena. The effect of cognition on speech understanding in modulated noise with fast-acting compression may only pertain after a period of 4-9 wk of familiarization and that prior to such a period, persons with lower cognitive capacity may benefit more from slow-acting compression.

  • 209.
    Rönnberg, Jerker
    et al.
    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.
    Dahlström, Örjan
    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.
    Rudner, Mary
    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.
    Sörqvist, Patrik
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Johnsrude, Ingrid
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Lunner, Tomas
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Stenfelt, Stefan
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology. Linköping University, Faculty of Health Sciences.
    Speech understanding in noise: the role of working memory capacity2012In: 41st International Congress and Exposition on Noise Control Engineering 2012 (INTER-NOISE 2012) / [ed] Burroughs, C., Institute of Noise Control Engineering , 2012, Vol. 10, p. 508-516Conference paper (Other academic)
  • 210.
    Rönnberg, Jerker
    et al.
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research.
    Lunner, Thomas
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research. Oticon AS, Denmark.
    Ng, Elaine Hoi Ning
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research.
    Lidestam, Björn
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Zekveld, Adriana
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, The Swedish Institute for Disability Research. Linköping University, Faculty of Arts and Sciences. Vrije University of Amsterdam, Netherlands; Vrije University of Amsterdam, Netherlands.
    Sörqvist, Patrik
    Linköping University, Department of Behavioural Sciences, Cognition, Development and Disability. Linköping University, Faculty of Arts and Sciences. University of Gavle, Sweden.
    Lyxell, Björn
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research.
    Träff, Ulf
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Yumba, Wycliffe
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Classon, Elisabet
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Linköping University, The Swedish Institute for Disability Research. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Acute Internal Medicine and Geriatrics.
    Hällgren, Mathias
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Larsby, Birgitta
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences.
    Signoret, Carine
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research.
    Pichora-Fuller, Kathleen
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, The Swedish Institute for Disability Research. Linköping University, Faculty of Arts and Sciences. University of Toronto, Canada; University of Health Network, Canada; Baycrest Hospital, Canada.
    Rudner, Mary
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research.
    Danielsson, Henrik
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research.
    Stenfelt, Stefan
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences.
    Hearing impairment, cognition and speech understanding: exploratory factor analyses of a comprehensive test battery for a group of hearing aid users, the n200 study2016In: International Journal of Audiology, ISSN 1499-2027, E-ISSN 1708-8186, Vol. 55, no 11, p. 623-642Article in journal (Refereed)
    Abstract [en]

    Objective: The aims of the current n200 study were to assess the structural relations between three classes of test variables (i.e. HEARING, COGNITION and aided speech-in-noise OUTCOMES) and to describe the theoretical implications of these relations for the Ease of Language Understanding (ELU) model. Study sample: Participants were 200 hard-of-hearing hearing-aid users, with a mean age of 60.8 years. Forty-three percent were females and the mean hearing threshold in the better ear was 37.4dB HL. Design: LEVEL1 factor analyses extracted one factor per test and/or cognitive function based on a priori conceptualizations. The more abstract LEVEL 2 factor analyses were performed separately for the three classes of test variables. Results: The HEARING test variables resulted in two LEVEL 2 factors, which we labelled SENSITIVITY and TEMPORAL FINE STRUCTURE; the COGNITIVE variables in one COGNITION factor only, and OUTCOMES in two factors, NO CONTEXT and CONTEXT. COGNITION predicted the NO CONTEXT factor to a stronger extent than the CONTEXT outcome factor. TEMPORAL FINE STRUCTURE and SENSITIVITY were associated with COGNITION and all three contributed significantly and independently to especially the NO CONTEXT outcome scores (R-2 = 0.40). Conclusions: All LEVEL 2 factors are important theoretically as well as for clinical assessment.

  • 211.
    Rönnberg, Jerker
    et al.
    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.
    Lunner, Thomas
    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. Oticon A/S, Eriksholm Research Centre, Denmark.
    Zekveld, Adriana
    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.
    Sörqvist, Patrik
    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. University of Gävle, Sweden.
    Danielsson, Henrik
    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.
    Lyxell, Björn
    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. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Dahlström, Örjan
    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.
    Signoret, Carine
    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.
    Stenfelt, Stefan
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology. Linköping University, Faculty of Health Sciences.
    Pichora-Fuller, Kathleen
    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. 4Department of Psychology, University of Toronto, Canada.
    Rudner, Mary
    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.
    On the development of a working memory model for Ease-of Language Understanding (ELU)2013Conference paper (Other academic)
    Abstract [en]

    Working memory is important for online language processing in a dialogue. We use it to store relevant information, to inhibit or ignore irrelevant information, and to attend to conversation selectively. Working memory helps us keep track of a dialogue while taking turns and following the gist. This paper examines the Ease-of Language Understanding model (i.e., the ELU model, Rönnberg, 2003; Rönnberg et al., 2008) in light of new behavioral and neural findings concerning the role of working memory capacity (WMC) in sound and speech processing. The new ELU model is a meaning prediction system that depends on phonological and semantic interactions in rapid implicit and slower explicit processing mechanisms that both depend on working memory, albeit in different ways. New predictions and clinical implications are outlined.

  • 212.
    Rönnberg, Jerker
    et al.
    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.
    Lunner, Thomas
    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. Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences. Eriksholm Research Centre, Snekkersten, Denmark.
    Zekveld, Adriana
    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. VU University Medical Center, Amsterdam, Netherlands.
    Sörqvist, Patrik
    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. University of Gävle, Sweden.
    Danielsson, Henrik
    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.
    Lyxell, Björn
    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. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Dahlström, Örjan
    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.
    Signoret, Carine
    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.
    Stenfelt, Stefan
    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. Linköping University, Department of Clinical and Experimental Medicine, Division of Neuroscience. Linköping University, Faculty of Health Sciences.
    Pichora-Fuller, Kathleen
    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. University of Toronto, ON, Canada.
    Rudner, Mary
    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.
    The Ease of Language Understanding (ELU) model: theoretical, empirical, and clinical advances2013In: Frontiers in Systems Neuroscience, ISSN 1662-5137, E-ISSN 1662-5137, Vol. 7, no 31Article in journal (Refereed)
    Abstract [en]

    Working memory is important for online language processing during conversation. We use it to maintain relevant information, to inhibit or ignore irrelevant information, and to attend to conversation selectively. Working memory helps us to keep track of and actively participate in conversation, including taking turns and following the gist. This paper examines the Ease of Language Understanding model (i.e., the ELU model, Rönnberg, 2003; Rönnberg et al., 2008) in light of new behavioral and neural findings concerning the role of working memory capacity (WMC) in uni-modal and bimodal language processing. The new ELU model is a meaning prediction system that depends on phonological and semantic interactions in rapid implicit and slower explicit processing mechanisms that both depend on WMC albeit in different ways. It is based on findings that address the relationship between WMC and (a) early attention processes in listening to speech, (b) signal processing in hearing aids and its effects on short-term memory, (c) inhibition of speech maskers and its effect on episodic long-term memory, (d) the effects of hearing impairment on episodic and semantic long-term memory, and finally, (e) listening effort. New predictions and clinical implications are outlined. Comparisons with other WMC and speech perception models are made.

    Keywords: working memory capacity, speech in noise, attention, long-term memory, hearing loss, brain imaging analysis, oscillations, language understanding

  • 213.
    Rönnberg, Jerker
    et al.
    Linköping University, Department of Behavioural Sciences, The Swedish Institute for Disability Research. Linköping University, Faculty of Arts and Sciences.
    Rudner, Mary
    Linköping University, Department of Behavioural Sciences and Learning, Cognition, Development and Disability. Linköping University, Faculty of Arts and Sciences.
    Karlsson Foo, Catharina
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Lunner, Thomas
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology . Linköping University, Faculty of Health Sciences.
    Cognition counts: A working memory system for ease of language understanding (ELU)2008In: International Journal of Audiology, ISSN 1499-2027, E-ISSN 1708-8186, Vol. 47, no Suppl. 2, p. 99-105Article in journal (Refereed)
    Abstract [en]

    A general working memory system for ease of language understanding (ELU, Rnnberg, 2003a) is presented. The purpose of the system is to describe and predict the dynamic interplay between explicit and implicit cognitive functions, especially in conditions of poorly perceived or poorly specified linguistic signals. In relation to speech understanding, the system based on (1) the quality and precision of phonological representations in long-term memory, (2) phonologically mediated lexical access speed, and (3) explicit, storage, and processing resources. If there is a mismatch between phonological information extracted from the speech signal and the phonological information represented in long-term memory, the system is assumed to produce a mismatch signal that invokes explicit processing resources. In the present paper, we focus on four aspects of the model which have led to the current, updated version: the language generality assumption; the mismatch assumption; chronological age; and the episodic buffer function of rapid, automatic multimodal binding of phonology (RAMBPHO). We evaluate the language generality assumption in relation to sign language and speech, and the mismatch assumption in relation to signal processing in hearing aids. Further, we discuss the effects of chronological age and the implications of RAMBPHO.

  • 214.
    Rönnberg, Jerker
    et al.
    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.
    Rudner, Mary
    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.
    Lunner, Thomas
    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.
    Cognitive Hearing Science: The lagacy of Stuart Gatehouse2010Conference paper (Other academic)
  • 215.
    Rönnberg, Jerker
    et al.
    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.
    Rudner, Mary
    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.
    Lunner, Thomas
    Eriksholm Research Centre, Oticon A/S, Snekkersten, Denmark.
    Cognitive hearing science: the legacy of Stuart Gatehouse2011In: Trends in Amplification, ISSN 1084-7138, Vol. 15, no 3, p. 140-148Article in journal (Refereed)
    Abstract [en]

    Stuart Gatehouse was one of the pioneers of cognitive hearing science. The ease of language understanding (ELU) model (Rönnberg) is one example of a cognitive hearing science model where the interplay between memory systems and signal processing is emphasized. The mismatch notion is central to ELU and concerns how phonological information derived from the signal, matches/mismatches phonological representations in lexical and semantic long-term memory (LTM). When signals match, processing is rapid, automatic and implicit, and lexical activation proceeds smoothly. Given a mismatch, lexical activation fails, and working or short-term memory (WM/STM) is assumed to be invoked to engage in explicit repair strategies to disambiguate what was said in the conversation. In a recent study, negative long-term consequences of mismatch were found by means of relating hearing loss to episodic LTM in a sample of old hearing-aid wearers. STM was intact (Rönnberg et al.). Beneficial shortterm consequences of a binary masking noise reduction scheme on STM was obtained in 4-talker babble for individuals with high WM capacity, but not in stationary noise backgrounds (Ng et al.). This suggests that individuals high on WM capacity inhibit semantic auditory distraction in 4-talker babble while exploiting the phonological benefits in terms of speech quality provided by binary masking (Wang). Both long-term and short-term mismatch effects, apparent in data sets including behavioral as well as subjective (Rudner et al.) data, need to be taken into account in the design of future hearing instruments.

  • 216.
    Rönnberg, Jerker
    et al.
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Rudner, Mary
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Lunner, Thomas
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Editorial Material: Listening effort and fatigue: What exactly are we measuring? A British Society of Audiology Cognition in Hearing Special Interest Group white paper Comments from Dr. Jerker Ronnberg, Mary Rudner, Thomas Lunner2014In: International Journal of Audiology, ISSN 1499-2027, E-ISSN 1708-8186, Vol. 53, no 7, p. 441-442Article in journal (Other academic)
    Abstract [en]

    n/a

  • 217.
    Rönnberg, Jerker
    et al.
    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.
    Rudner, Mary
    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.
    Lunner, Thomas
    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.
    Zekveld, Adriana
    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.
    Ease of Language Understanding in Noise2011Conference paper (Other academic)
  • 218.
    Rönnberg, Jerker
    et al.
    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.
    Rudner, Mary
    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.
    Lunner, Thomas
    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.
    Zekveld, Adriana
    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.
    Ease of language understanding in noise: mismatch in the short-term and long-term2011Conference paper (Other academic)
    Abstract [en]

    A working memory based model for Ease of Language Understanding (ELU) hasbeen developed (Rönnberg, 2003; Rönnberg et al., 2008). It predicts that speechunderstanding in adverse conditions, for example in the presence of high levels ofbackground noise, phonological distortion or misleading semantic context, is dependenton explicit processing resources such as working memory capacity. Thispresentation will outline the details of this prediction by addressing (1) how matchingvs. mismatching semantic cues affect speech understanding at differentSNRs behaviorally and neurally, (2) how working memory capacity interacts withsignal processing in hearing aids under “high degradation” (i.e. modulated noise,fast compression) and “low” degradation (i.e. steady state noise, slow compression)conditions, and (3) how different memory systems are selectively affectedby hearing impairment.

  • 219.
    Rönnberg, Jerker
    et al.
    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.
    Rudner, Mary
    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.
    Lunner, Tomas
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology. Linköping University, Faculty of Health Sciences.
    Zekveld, Adriana
    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.
    When cognition kicks in: Working memory and speech understanding in noise.2010In: Noise & Health, ISSN 1463-1741, E-ISSN 1998-4030, Vol. 12, no 49, p. 263-269Article in journal (Refereed)
    Abstract [en]

    Perceptual load and cognitive load can be separately manipulated and dissociated in their effects on speech understanding in noise. The Ease of Language Understanding model assumes a theoretical position where perceptual task characteristics interact with the individual's implicit capacities to extract the phonological elements of speech. Phonological precision and speed of lexical access are important determinants for listening in adverse conditions. If there are mismatches between the phonological elements perceived and phonological representations in long-term memory, explicit working memory (WM)-related capacities will be continually invoked to reconstruct and infer the contents of the ongoing discourse. Whether this induces a high cognitive load or not will in turn depend on the individual's storage and processing capacities in WM. Data suggest that modulated noise maskers may serve as triggers for speech maskers and therefore induce a WM, explicit mode of processing. Individuals with high WM capacity benefit more than low WM-capacity individuals from fast amplitude compression at low or negative input speech-to-noise ratios. The general conclusion is that there is an overarching interaction between the focal purpose of processing in the primary listening task and the extent to which a secondary, distracting task taps into these processes.

  • 220.
    Rönnberg, Jerker
    et al.
    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.
    Sörqvist, Patrik
    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.
    Dahlström, Örjan
    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.
    Rudner, Mary
    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.
    Johnsrude, Ingrid
    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.
    Lunner, Thomas
    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.
    Stenfelt, Stefan
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology. Linköping University, Faculty of Health Sciences.
    Speech in noise and ease of language understanding: When and how working memory capacity plays a role2012In: Acoustics 2012, 2012Conference paper (Refereed)
  • 221.
    Rönnberg, Niklas
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuroscience. Linköping University, Faculty of Health Sciences.
    Rudner, Mary
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, The Swedish Institute for Disability Research. Linköping University, Faculty of Arts and Sciences.
    Lunner, Thomas
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, The Swedish Institute for Disability Research. Linköping University, Faculty of Arts and Sciences.
    Stenfelt, Stefan
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuroscience. Linköping University, Faculty of Health Sciences.
    Adverse listening conditions affect short-term memory storage and processing of speech for older adults with hearing impairmentManuscript (preprint) (Other academic)
    Abstract [en]

    Purpose: Previous work has shown an effect of noise type on memory for intelligible speech. The aim ofthis study was to investigate the effect of background noise on memory performance of intelligible speech for older adults with hearing impairment using the Auditory Inference Span Test (AIST).

    Method: Twenty participants with ages between 67 and 80 years with symmetrical hearing loss (29 to 47dB HL) performed the AIST, which requires processing of five-word sentences at three memoryload levels (MLLs) in three listening conditions: Quiet, steady-state noise (SSN), and backgroundvoices (ISTS). Individualized SNRs targeted 90% speech intelligibility. AIST performance reflects the amount of cognitive capacity occupied in listening, and consequently indicates the amount of listening effort. Working memory capacity (WMC) was assessed using the reading span test, and updating ability (UA) was assessed using the letter memory test.

    Results: AIST performance decreased in background noise and with increasing MLL. It was related to UA and age but not to WMC. Response times on questions designed to probe sentence recognition increased with the addition of background noise.

    Conclusions: The results demonstrate that the addition of background noise requires more cognitive resourcesto maintain speech recognition performance, leading to higher demands on the cognitive capacity,higher listening effort as measured by poorer memory performance, and longer AIST responsetimes. However, the type of background noise, SSN or ISTS, affected memory performance similarly.

  • 222.
    Rönnberg, Niklas
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuroscience. Linköping University, Faculty of Health Sciences. Linköping University, The Swedish Institute for Disability Research.
    Rudner, Mary
    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.
    Lunner, Thomas
    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. Linköping University, Department of Clinical and Experimental Medicine, Division of Neuroscience. Linköping University, Faculty of Health Sciences. Eriksholm Research Centre, Oticon A/S, Snekkersten.
    Stenfelt, Stefan
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuroscience. Linköping University, Faculty of Health Sciences. Linköping University, The Swedish Institute for Disability Research.
    Assessing listening effort by measuring short-term memory storage and processing of speech in noise2014In: Speech, Language and Hearing, ISSN 2050-5728, Vol. 17, no 3, p. 123-132Article in journal (Refereed)
    Abstract [en]

    Objective

    The aim of this study was to investigate the effect of working memory capacity (WMC) and updating ability (UA) on listening effort measured using a new test, the Auditory Inference Span Test (AIST), as an objective measure of listening effort.

    Design

    The AIST is based on Swedish five-word sentences and taps into three memory load levels (MLLs). It was administered in stationary speech-shaped noise at −2, −4, and −6 dB signal-to-noise ratio (SNR). WMC was assessed using the reading span test, and UA was assessed using the letter memory test. We also collected data on speech-in-noise performance and subjectively rated listening effort at the three SNRs.

    Study sample

    Thirty-nine participants with normal hearing thresholds (≤20 dB HL for 250 to 4000 Hz) took part in the study.

    Results

    AIST performance decreased with increasing MLL and was related to WMC and UA. Participants with high WMC performed better than those with low WMC at more favorable SNRs. Participants with high UA performed better than participants with low UA at the intermediate MLL, which made particular demands on the UA. Neither speech recognition scores nor subjectively rated listening effort was associated with AIST performance or either of the cognitive variables.

    Conclusion

    AIST taps into cognitive functions necessary for understanding speech in noise. However, in its current form AIST may be too cognitively taxing to successfully measure graded listening effort in participants with lower cognitive capacity.

  • 223.
    Rönnberg, Niklas
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuroscience. Linköping University, Faculty of Health Sciences. Linköping University, The Swedish Institute for Disability Research.
    Rudner, Mary
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research.
    Lunner, Thomas
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research. Oticon Research Centre Eriksholm, Denmark.
    Stenfelt, Stefan
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuroscience. Linköping University, Faculty of Health Sciences.
    Memory performance on the Auditory Inference Span Test is independent of background noise type for young adults with normal hearing at high speech intelligibility2014In: Frontiers in Psychology, ISSN 1664-1078, E-ISSN 1664-1078, Vol. 5, no 1490Article in journal (Refereed)
    Abstract [en]

    Listening in noise is often perceived to be effortful. This is partly because cognitive resources are engaged in separating the target signal from background noise, leaving fewer resources for storage and processing of the content of the message in working memory. The Auditory Inference Span Test (AIST) is designed to assess listening effort by measuring the ability to maintain and process heard information. The aim of this study was to use AIST to investigate the effect of background noise types and signal-to-noise ratio (SNR) on listening effort, as a function of working memory capacity (WMC) and updating ability (UA). The AIST was administered in three types of background noise: steady-state speech-shaped noise, amplitude modulated speech-shaped noise, and unintelligible speech. Three SNRs targeting 90% speech intelligibility or better were used in each of the three noise types, giving nine different conditions. The reading span test assessed VVMC, while UA was assessed with the letter memory test. Twenty young adults with normal hearing participated in the study. Results showed that AIST performance was not influenced by noise type at the same intelligibility level, but became worse with worse SNR when background noise was speech-like. Performance on AIST also decreased with increasing memory load level. Correlations between AIST performance and the cognitive measurements suggested that WMC is of more importance for listening when SNRs are worse, while UA is of more importance for listening in easier SNRs. The results indicated that in young adults with normal hearing, the effort involved in listening in noise at high intelligibility levels is independent of the noise type. However, when noise is speech-like and intelligibility decreases, listening effort increases, probably due to extra demands on cognitive resources added by the informational masking created by the speech fragments and vocal sounds in the background noise.

  • 224.
    Rönnberg, Niklas
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology. Linköping University, Faculty of Health Sciences.
    Stenfelt, Stefan
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology. Linköping University, Faculty of Health Sciences.
    Rudner, Mary
    Linköping University, Department of Behavioural Sciences and Learning, Cognition, Development and Disability. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning, Disability Research.
    Lunner, Thomas
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology. Linköping University, Faculty of Health Sciences. Linköping University, Department of Behavioural Sciences and Learning, Cognition, Development and Disability. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning, Disability Research.
    An objective measure of listening effort: The Auditory Inference Span Test2011Conference paper (Refereed)
    Abstract [en]

    One aim of hearing aid fitting is to ease the patient’s effort in understanding speech, i.e. the listening effort needed to perceive speech in different sound environments. To obtain a good hearing aid fitting, knowledge about the patient’s auditory as well as cognitive abilities seems to be important. However, listening effort is usually not included as a fitting criterion, partly as it is not clear how to measure listening effort objectively.

    The Auditory Inference Span Test (AIST) is a dual-task hearing-in-noise test, that combines auditory and memory processing. The basis for the test is that when more cognitive resources are required for understanding speech, less cognitive resources are available for storage and processing of the speech information. In AIST, Hagerman sentences are presented in noise and the subject is required to recall and process the sentence information. Recall ability is tested with different cognitive loads. Button-press responses are recorded and used as an estimate of listening effort. In a pilot study, listeners showed decreasing accuracy with increasing cognitive load and longer reaction time at maximum cognitive load, suggesting that the test may be suited as a clinical test for listening effort.

    In an ongoing study, the AIST is being evaluated in relation to other auditory and cognitive measures: baseline audiometry (audiogram) and speech in noise test (Hagerman sentences) as well as text based dual processing and storage test (reading span) and updating (letter memory test), as well as subjective rating of listening effort. Data from this study will be presented.

  • 225.
    Rönnberg, Niklas
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology. Linköping University, Faculty of Health Sciences.
    Stenfelt, Stefan
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology. Linköping University, Faculty of Health Sciences.
    Rudner, Mary
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research.
    Lunner, Thomas
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research. Eriksholm Research Centre, Oticon A/S, Snekkersten, Denmark.
    Frequency discrimination and human communication2013Conference paper (Other academic)
    Abstract [en]

    The voice is the most common means of communication and tends to change, sliding up and down the pitch scale when forming phonemes and words, as different emotions and thoughts are expressed. Therefore the ability to discriminate frequencies is of importance for speech intelligibility in a communication situation. Furthermore, this ability is also of importance in speech recognition in noise, by separating the target and noise by spectral and temporal differences of the sources. The choice of rehabilitation is crucial for the frequency discrimination ability. Cochlear implants, for example, lack the ability to pass the temporal fine structure of acoustic waves to the auditory nerve, which in turn lead to reduced precision of phase locking, inferior frequency discrimination ability, and a relatively poor ability to understand speech when background sounds are present.The aim of the study is to investigate how frequency discrimination and temporal resolution abilities interact with performance in speech recognition in noise using a psychoacoustic, speech, and cognitive test battery. These tests will give insight to interactions between performance and hearing status, type of rehabilitation(hearing aid, cochlear implant, and electro-acoustic stimulation), cognitive capacity, and language ability. It is hypothesized that normal hearing participants have a better frequency discrimination ability than hearing impaired participants and by that, better understanding of speech. It is also hypothesized that type of rehabilitation effects performance on frequency discrimination, and that this performance correlates with speech recognition in noise. Finally, it is hypothesized that cognitive capacity and language ability can, to some extent, compensate for loss of frequency resolution in the peripheral auditory system. Preliminary results from the study will be presented and discussed.

  • 226.
    Rönnberg, Niklas
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology. Linköping University, Faculty of Health Sciences.
    Stenfelt, Stefan
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology. Linköping University, Faculty of Health Sciences.
    Rudner, Mary
    Linköping University, Department of Behavioural Sciences and Learning, Cognition, Development and Disability. 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.
    Lunner, Thomas
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology. Linköping University, Department of Behavioural Sciences and Learning, Cognition, Development and Disability. Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Health Sciences.
    Testing listening effort for speech comprehension2011Conference paper (Other academic)
    Abstract [en]

    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.

  • 227.
    Rönnberg, Niklas
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology. Linköping University, Faculty of Health Sciences.
    Stenfelt, Stefan
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology. Linköping University, Faculty of Health Sciences.
    Rudner, Mary
    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.
    Lunner, Thomas
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research. Eriksholm Research Centre, Oticon A/S, Snekkersten, Denmark.
    Testing listening effort for speech comprehension2012In: Speech Perception and Auditory Disorders, Danavox Jubilee Foundation , 2012, p. 73-80Chapter in book (Other academic)
  • 228.
    Stenfelt, Stefan
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences.
    Lunner, Thomas
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research. Eriksholm Research Centre, Oticon A/S, Helsingor, Denmark.
    Ng, Elaine
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Lidestam, Björn
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Zekveld, Adriana
    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. VU University Medical Center, Amsterdam, Netherlands.
    Sörqvist, Patrik
    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. University of Gävle, Gävle, Sweden.
    Lyxell, Björn
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research.
    Träff, Ulf
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Yumba, Wycliffe
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Classon, Elisabet
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Linköping University, The Swedish Institute for Disability Research.
    Hällgren, Mathias
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences.
    Larsby, Birgitta
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Linköping University, The Swedish Institute for Disability Research.
    Signoret, Carine
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research.
    Pichora-Fuller, Kathleen
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research. University of Toronto, Toronto, Canada.
    Rudner, Mary
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research.
    Danielsson, Henrik
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research.
    Rönnberg, Jerker
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research.
    Auditory, signal processing, and cognitive factors  influencing  speech  perception  in  persons with hearing loss fitted with hearing aids – the N200 study2016Conference paper (Other academic)
    Abstract [en]

    Objective: The aim of the current study was to assess aided speech-in-noise outcomes and relate those measures to auditory sensitivity and processing, different types of cognitive processing abilities, and signal processing in hearing aids.

    Material and method: Participants were 200 hearing-aid wearers, with a mean age of 60.8 years, 43% females, with average hearing thresholds in the better ear of 37.4 dB HL. Tests of auditory functions were hearing thresholds, DPOAEs, tests of fine structure processing, IHC dead regions, spectro-temporal modulation, and speech recognition in quiet (PB words). Tests of cognitive processing function were tests of phonological skills, working memory, executive functions and inference making abilities, and general cognitive tests (e.g., tests of cognitive decline and IQ). The outcome test variables were the Hagerman sentences with 50 and 80% speech recognition levels, using two different noises (stationary speech weighted noise and 4-talker babble), and three types of signal processing (linear gain, fast acting compression, and linear gain plus a non-ideal binary mask). Another sentence test included typical and atypical sentences with contextual cues that were tested both audio-visually and in an auditory mode only. Moreover, HINT and SSQ were administrated.

    Analysis: Factor analyses were performed separate for the auditory, cognitive, and outcome tests.

    Results: The auditory tests resulted in two factors labeled SENSITIVITY and TEMPORAL FINE STRUCTURE, the cognitive tests in one factor (COGNITION), and the outcome tests in the two factors termed NO CONTEXT and CONTEXT that relates to the level of context in the different outcome tests. When age was partialled out, COGNITION was moderately correlated with the TEMPORAL FINE STRUCTURE and NO CONTEXT factors but only weakly correlated with the CONTEXT factor. SENSITIVITY correlated weakly with TEMPORAL FINE STRUCTURE and CONTEXT, and moderately with NO CONTEXT, while TEMPORAL FINE STRUCTURE showed weak correlation with CONTEXT and moderate correlation with NO CONTEXT. CONTEXT and NO CONTEXT had a  moderate correlation. Moreover, the overall results of the Hagerman sentences showed 0.9 dB worse SNR with fast acting compression compared with linear gain and 5.5 dB better SNR with linear  gain and noise reduction compared with only linear gain.

    Conclusions: For hearing aid wearers, the ability to recognize speech in noise is associated with both sensory and cognitive processing abilities when the speech materials have low internal context. These associations are less prominent when the speech material has contextual cues.

  • 229.
    Sundewall Thoren, Elisabet
    et al.
    Eriksholm Research Centre, Oticon A/S, Snekkersten, Denmark.
    Öberg, Marie
    Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping. Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Karolinska Institute, Sweden.
    Lunner, Thomas
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research. Eriksholm Research Centre, Oticon A/S, Snekkersten, Denmark.
    Internet Interventions for Hearing Loss2015In: American Journal of Audiology, ISSN 1059-0889, E-ISSN 1558-9137, Vol. 24, no 3, p. 316-319Article in journal (Refereed)
    Abstract [en]

    Purpose: The purpose of the two studies presented in this research forum article was to develop audiological rehabilitation programs for experienced hearing aid users and evaluate them in online versions. In this research forum article, the differences between the two studies are discussed. Method: Two randomized controlled trials (RCTs) were performed evaluating the efficacy of online rehabilitation, including professional guidance by an audiologist. In each RCT, the effects of the online programs were compared with the effects measured in a control group. Results: The results from the first RCT showed a significant increase in activity and participation for both groups with participants in the intervention group improving more than those in the control group. At the 6-month follow-up, after the study, the significant increase was maintained; however, amounts of increase in the two groups were no longer significantly different. The results from the second RCT showed significant increase in activity and participation for the intervention group, although the control group did not improve. Conclusions: The results from the RCTs provide evidence that the Internet can be used to deliver rehabilitation to hearing-aid users and that their problems are reduced by the intervention; however, the content of the online rehabilitation program requires further investigation.

  • 230.
    Sundewall Thorén, Elisabet
    et al.
    Eriksholm Research Centre, Oticon A/S, Snekkersten, Denmark .
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Lunner, Thomas
    Eriksholm Research Centre, Oticon A/S, Snekkersten, Denmark .
    The use of research questionnaires with hearing impaired adults: online vs. paper-and-pencil administration2012In: BMC Ear, Nose and Throat Disorders, ISSN 1472-6815, E-ISSN 1472-6815, Vol. 12, no 12, p. 14-Article in journal (Refereed)
    Abstract [en]

    Background

    When evaluating hearing rehabilitation, it is reasonable to use self-report questionnaires as outcome measure. Questionnaires used in audiological research are developed and validated for the paper-and-pencil format. As computer and Internet use is increasing, standardized questionnaires used in the audiological context should be evaluated to determine the viability of the online administration format.

    The aim of this study was to compare administration of questionnaires online versus paper- and pencil of four standardised questionnaires used in hearing research and clinic. We included the Hearing Handicap Inventory for the Elderly (HHIE), the International Outcome Inventory for Hearing Aids (IOI-HA), Satisfaction with Amplification in Daily Life (SADL), and the Hospital Anxiety and Depression Scale (HADS).

    Methods

    A cross-over design was used by randomly letting the participants complete the questionnaires either online or on paper. After 3 weeks the participants filled out the same questionnaires again but in the other format. A total of 65 hearing-aid users were recruited from a hearing clinic to participate on a voluntary basis and of these 53 completed both versions of the questionnaires.

    Results

    A significant main effect of format was found on the HHIE (p < 0.001), with participants reporting higher scores on the online format than in the paper format. There was no interaction effect. For the other questionnaires were no significant main or interaction effects of format. Significant correlations between the two ways of presenting the measures was found for all questionnaires (p<0.05). The results from reliability tests showed Cronbachs α’s above .70 for all four questionnaires and differences in Cronbachs α between administration formats were negligible.

    Conclusions

    For three of the four included questionnaires the participants’ scores remained consistent across administrations and formats. For the fourth included questionnaire (HHIE) a significant difference of format with a small effect size was found. The relevance of the difference in scores between the formats depends on which context the questionnaire is used in. On balance, it is recommended that the administration format remain stable across assessment points.

  • 231.
    Sundewall Thorén, Elisabet
    et al.
    Eriksholm Research Centre, Oticon A/S, Snekkersten, Denmark.
    Lunner, Thomas
    Eriksholm Research Centre, Oticon A/S, Snekkersten, Denmark.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Öberg, Marie
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Sinnescentrum, Department of ENT - Head and Neck Surgery UHL.
    Professional online rehabilitation of hearing-impaired adults2012Conference paper (Other academic)
  • 232.
    Sundewall Thorén, Elisabet
    et al.
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
    Svensson, Monica
    Lund University.
    Tornqvist, Anna
    Lund University.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Clinical and Social Psychology. Linköping University, Faculty of Arts and Sciences.
    Carlbring, Per
    Umeå University.
    Lunner, Thomas
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology. Linköping University, Faculty of Health Sciences.
    Online self-help via a controlled discussion forum2009In: Binaural Processing and Spatial Hearing, Ballerup: The Danavox Jubilee Foundation , 2009Conference paper (Other academic)
    Abstract [en]

    Recent studies on hearing rehabilitation with group discussions show similar long-term benefits as conventional professional counselling (Abrams et al., 2002; Hickson et al., 2007). The use of professional support for self-help via Internet may reduce anxiety and depression (Andersson et al., 2005). Inspired by those results, we created an online discussion forum for self-help where 29 experienced hearing-aid users communicated, on their own for five weeks. Each week they started the discussions from a given topic, without any professional assistance. We measured their reported subjective hearing problems online using standardized questionnaires (HHIE, IOI-HA and SADL) pre and post the online intervention. The findings show that the participants reduced their reported subjective hearing problems significantly by taking part in the discussions. Six months after the online intervention was finished the significant reduction was persistent.

    By using manifest qualitative content analysis of the participants’ online communication we will present results including typical categories and themes in the discussions, as well as peer-to-peer helping behavior.

    The findings indicates that interacting with peers have a positive significant effect on the long-term outcome of their hearing rehabilitation. Further development of this tool could be a very useful instrument in the rehabilitation of hearing impaired adults.

     

    References: Abrams, H., Chisholm., T. H., McArdle, R. (2002). A cost-utility analysis of adults group audiologic rehabilitation: Are the benefits worth the cost? Journal of Rehabilitation Research and Development, 5, 549-558.

    Andersson, G., Bergström, J., Carlbring, P., Lindefors, N. (2005). The use of internet in the treatment of anxiety disorders. Current opinion in Psychiatry, 18, 73-77.

    Hickson, L., Worrall, L., Scarinci, N. (2007). A randomized controlled trial evaluating the Active Communication Education program for older people with hearing impairment. Ear and Hearing, 28, 212-230.

  • 233.
    Sundewall Thorén, Elisabet
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology.
    Svensson, Monica
    Lund University.
    Tornqvist, Anna
    Lund University.
    Andersson, Gerhard
    Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Behavioural Sciences and Learning, Psychology.
    Carlbring, Per
    Umeå University.
    Lunner, Thomas
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology. Linköping University, Faculty of Health Sciences.
    Rehabilitative Online Education versus Internet Discussion Group for Hearing Aid Users: A Randomized Controlled Trial2011In: JOURNAL OF THE AMERICAN ACADEMY OF AUDIOLOGY, ISSN 1050-0545, Vol. 22, no 5, p. 274-285Article in journal (Refereed)
    Abstract [en]

    Background: By using the Internet in the audiological rehabilitation process, it might be possible in a cost-effective way to include additional rehabilitation components by informing and guiding hearing aid users about such topics as communication strategies, hearing tactics, and how to handle hearing aids. Purpose: To evaluate the effectiveness of an online education program for adult experienced hearing aid users including professional guidance by an audiologist and compare it with the effects of participation in an online discussion forum without any professional contact. Research Design: A randomized controlled study with two groups of participants. Repeated measures at prestudy, immediate follow-up, and a 6 mo follow-up. Study Sample: Fifty-nine experienced hearing aid users participated in the study, ranging in age from 24 to 84 yr (mean 63.5 yr). Intervention: The intervention group (N=29) underwent a five-week rehabilitative online education in which activities for each week included information, tasks, and assignments, and contact with a professional audiologist was included. The participants in the control group (N=30) were referred to an online discussion forum without any audiologist contact.. Data Collection and Analysis: A set of questionnaires administered online were used as outcome measures: (1) Hearing Handicap Inventory for the Elderly, (2) International Outcome Inventory for Hearing Aids, (3) Satisfaction with Amplification in Daily Life, and (4) Hospital Anxiety and Depression Scale. Results: Significant improvements measured by the Hearing Handicap Inventory for the Elderly were found in both groups of participants, and the effects were maintained at the 6 mo follow-up. The results on the Hospital Anxiety and Depression Scale showed that the participants in the intervention group showed reduced symptoms of depression immediately/6 mo after the intervention. At the 6 mo follow-up participants in the control group reported fewer symptoms of anxiety than they did before the intervention started. Conclusions: This study provides preliminary evidence that the Internet can be used to deliver education to experienced hearing aid users who report residual hearing problems such that their problems are reduced by the intervention. The study also suggests that online discussion forums could be used in rehabilitation. A combination of online professional supervised education and online informal discussions could be a promising rehabilitation tool.

  • 234.
    Thorén, Elisabet
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuroscience. Linköping University, Faculty of Health Sciences.
    Öberg, Marie
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuroscience. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Wänström, Gunilla
    Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Lunner, Thomas
    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. Eriksholm Research Centre, Oticon A/S, Snekkersten, Denmark.
    A randomized controlled trial evaluating the effects of online rehabilitative intervention for adult hearing-aid users2014In: International Journal of Audiology, ISSN 1499-2027, E-ISSN 1708-8186, Vol. 53, no 7, p. 452-461Article in journal (Refereed)
    Abstract [en]

    Objective: Previous research shows that the internet can be used in the rehabilitation of hearing aid users. By further developing the online program, it might be possible to foster behavioral changes that will positively affect hearing aid users.

    Design: A randomized controlled study with two groups of participants. The intervention group underwent a five-week online intervention while the control group was referred to a waiting-list. Questionnaires were used as outcome measures.

    Study Sample: Seventy-six experienced hearing aid users participated in the study, ranging in age from 26 to 81 years (mean 69.3 years).

    Results: The findings showed significant improvements in the intervention group after the intervention, measured by the Hearing Handicap Inventory for the Elderly. The effects were maintained and improved at the follow-up. Furthermore, the results indicated that the participants in the intervention group improved at two items of the International Outcome Inventory for Hearing Aids, and the effects were partly maintained at the followup. Finally, significant improvements in the domain of psychosocial wellbeing were found at the follow-up.

    Conclusions: This study provides further evidence that the internet can be used to deliver intervention of rehabilitation to hearing aid users.

  • 235.
    Thorén, Elisabet
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology. Linköping University, Faculty of Health Sciences.
    Öberg, Marie
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Wänström, Gunilla
    Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Lunner, Thomas
    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. Eriksholm Research Centre, Oticon A/S, Snekkersten, Denmark.
    Internet Access and Use in Adults With Hearing Loss2013In: Journal of Medical Internet Research, ISSN 1438-8871, E-ISSN 1438-8871, Vol. 15, no 5, p. e91-Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:

    The future rehabilitation of adults with hearing loss is likely to involve online tools used by individuals at home. Online tools could also be useful for people who are not seeking professional help for their hearing problems. Hearing impairment is a disability that increases with age, and increased age is still associated with reduced use of the Internet. Therefore, to continue the research on online audiological rehabilitative tools for people with hearing loss, it is important to determine if and to what extent adults with hearing loss use the Internet.

    OBJECTIVE:

    To evaluate the use of the Internet and email in a group of adults with hearing loss and to investigate if their use of Internet and email differed between genders, among different age groups, and how it compared with the general population in Sweden.

    METHODS:

    Questionnaires containing multiple-choice questions about Internet access, email use, and educational level were mailed to individuals with hearing loss, who were registered as patients at a hearing aid clinic. Out of the 269 invited participants, 158 returned a completed questionnaire, which was a response rate of 58.7%.

    RESULTS:

    The results showed that 60% (94/158) of the participants with hearing loss used computers and the Internet. The degree of hearing loss in the group of participants did not explain the level of Internet usage, while factors of age, gender, and education did (P<.001). More men than women used the Internet (OR 2.54, 95% CI 1.32-4.91, P<.001). Use of the Internet was higher in the youngest age group (25-64 years) compared to the oldest age group (75-96 years, P=.001). A higher usage of the Internet was observed in the participants with hearing loss, especially the elderly, when compared with the general population of Sweden (OR 1.74, 95% CI 1.23-3.17, P=.04).

    CONCLUSIONS:

    We conclude that the use of computers and the Internet overall is at least at the same level for people with hearing loss as for the general age-matched population in Sweden, but that this use is even higher in specific age groups. These results are important for the future work in developing and evaluating rehabilitative educational online tools for adults with hearing loss.

  • 236.
    Vlaescu, George
    et al.
    Linköping University, Sweden.
    Carlbring, Per
    University of Stockholm, Sweden.
    Lunner, Thomas
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research. Eriksholm Research Centre, Denmark; Karolinska Institute, Sweden.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Karolinska Institute, Sweden.
    An E-Platform for Rehabilitation of Persons With Hearing Problems2015In: American Journal of Audiology, ISSN 1059-0889, E-ISSN 1558-9137, Vol. 24, no 3, p. 271-275Article in journal (Refereed)
    Abstract [en]

    Purpose: The aim of this research forum article was to describe a feasible web-based solution for improving the quality of life of persons with hearing problems, such as hearing loss or tinnitus. The online platform was developed at the Department of Behavioural Sciences and Learning at Linkoping University, Sweden, and has been running for a number of years and used in numerous studies and treatments. Method: The security aspects of the platform as well as the process flow for running a study or treatment are described, focusing primarily on the technical and practical considerations. Also presented are the design characteristics and the main features and functions available in the platform. Results: We point out the many advantages of running Internet-assisted intervention treatments, the challenges that we have faced, and some intended developments. Many of our research colleagues, both from Sweden and other countries, have already implemented or intend to implement their own studies on this platform. Conclusions: Audiological rehabilitation can be delivered via the Internet using a stable online platform. Security and usability are important factors to have in mind for the design as well as adaptability to the patients. A next development step is to implement and test blended treatments using video conferencing inside the platform.

  • 237.
    Wang, DeLiang
    et al.
    Ohio State University, Columbus, USA .
    Kjems, Ulrik
    Oticon A/S, Smørum, Denmark .
    Pedersen, Michael S
    Oticon A/S, Smørum, Denmark .
    Boldt, Jesper B
    Oticon A/S, Smørum, Denmark .
    Lunner, Thomas
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology. Linköping University, Faculty of Health Sciences. Oticon Research Centre Eriksholm, Snekkersten, Denmark.
    Speech intelligibility improvements in noise with ideal binary time-frequency masking2008Conference paper (Other academic)
  • 238.
    Wang, DeLiang
    et al.
    Ohio State University, USA.
    Kjems, Ulrik
    Oticon A/S, Smørum, Denmark .
    Pedersen, Michael S
    Oticon A/S, Smørum, Denmark .
    Boldt, Jesper B
    Oticon A/S, Smørum, Denmark .
    Lunner, Thomas
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology. Linköping University, Faculty of Health Sciences. Oticon Research Centre Eriksholm, Snekkersten, Denmark .
    Speech intelligibility in background noise with ideal binary time-frequency masking2009In: Journal of the Acoustical Society of America, ISSN 0001-4966, E-ISSN 1520-8524, Vol. 125, no 4, p. 2336-2347Article in journal (Refereed)
    Abstract [en]

    Ideal binary time-frequency masking is a signal separation technique that retains mixture energy in time-frequency units where local signal-to-noise ratio exceeds a certain threshold and rejects mixture energy in other time-frequency units. Two experiments were designed to assess the effects of ideal binary masking on speech intelligibility of both normal-hearing (NH) and hearing-impaired (HI) listeners in different kinds of background interference. The results from Experiment 1 demonstrate that ideal binary masking leads to substantial reductions in speech-reception threshold for both NH and HI listeners, and the reduction is greater in a cafeteria background than in a speech-shaped noise. Furthermore, listeners with hearing loss benefit more than listeners with normal hearing, particularly for cafeteria noise, and ideal masking nearly equalizes the speech intelligibility performances of NH and HI listeners in noisy backgrounds. The results from Experiment 2 suggest that ideal binary masking in the low-frequency range yields larger intelligibility improvements than in the high-frequency range, especially for listeners with hearing loss. The findings from the two experiments have major implications for understanding speech perception in noise, computational auditory scene analysis, speech enhancement, and hearing aid design.

  • 239.
    Wang, DeLiang
    et al.
    Department of Computer Science & Engineering, and Center for Cognitive Science, The Ohio State University, Columbus, USA.
    Kjems, Ulrik
    Oticon A/S, Smørum, Denmark .
    Pedersen, Michael S
    Oticon A/S, Smørum, Denmark.
    Boldt, Jesper B
    Oticon A/S, Smørum, Denmark.
    Lunner, Thomas
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology. Linköping University, Faculty of Health Sciences. Oticon Research Centre Eriksholm, Snekkersten, Denmark and Department of Clinical and Experimental Medicine, and Technical Audiology, Linköping University, S-58183 Linköping, Sweden .
    Speech perception of noise with binary gains2008In: Journal of the Acoustical Society of America, ISSN 0001-4966, E-ISSN 1520-8524, Vol. 124, no 4, p. 2303-2307Article in journal (Refereed)
    Abstract [en]

    For a given mixture of speech and noise, an ideal binary time-frequency mask is constructed by comparing speech energy and noise energy within local time-frequency units. It is observed that listeners achieve nearly perfect speech recognition from gated noise with binary gains prescribed by the ideal binary mask. Only 16 filter channels and a frame rate of 100Hz are sufficient for high intelligibility. The results show that, despite a dramatic reduction of speech information, a pattern of binary gains provides an adequate basis for speech perception

  • 240.
    Wang, Yang
    et al.
    Vrije Univ Amsterdam Med Ctr, Netherlands; Amsterdam Publ Hlth Res Inst, Netherlands; Oticon AS, Denmark.
    Kramer, Sophia E.
    Vrije Univ Amsterdam Med Ctr, Netherlands; Amsterdam Publ Hlth Res Inst, Netherlands.
    Wendt, Dorothea
    Oticon AS, Denmark; Tech Univ Denmark, Denmark.
    Naylor, Graham
    Univ Nottingham, Scotland.
    Lunner, Thomas
    Linköping University, Department of Electrical Engineering, Automatic Control. Linköping University, Faculty of Science & Engineering. Linköping University, The Swedish Institute for Disability Research. Oticon AS, Denmark; Tech Univ Denmark, Denmark; Orebro Univ, Sweden.
    Zekveld, Adriana
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research. Vrije Univ Amsterdam Med Ctr, Netherlands; Amsterdam Publ Hlth Res Inst, Netherlands; Orebro Univ, Sweden.
    The Pupil Dilation Response During Speech Perception in Dark and Light: The Involvement of the Parasympathetic Nervous System in Listening Effort2018In: TRENDS IN HEARING, ISSN 2331-2165, Vol. 22, article id 2331216518816603Article in journal (Refereed)
    Abstract [en]

    Recently, the measurement of the pupil dilation response has been applied in many studies to assess listening effort. Meanwhile, the mechanisms underlying this response are still largely unknown. We present the results of a method that separates the influence of the parasympathetic and sympathetic branches of the autonomic nervous system on the pupil response during speech perception. This is achieved by changing the background illumination level. In darkness, the influence of the parasympathetic nervous system on the pupil response is minimal, whereas in light, there is an additional component from the parasympathetic nervous system. Nineteen hearing-impaired and 27 age-matched normal-hearing listeners performed speech reception threshold tests targeting a 50% correct performance level while pupil responses were recorded. The target speech was masked with a competing talker. The test was conducted twice, once in dark and once in a light condition. Need for Recovery and Checklist Individual Strength questionnaires were acquired as indices of daily-life fatigue. In dark, the peak pupil dilation (PPD) did not differ between the two groups, but in light, the normal-hearing group showed a larger PPD than the hearing-impaired group. Listeners with better hearing acuity showed larger differences in dilation between dark and light. These results indicate a larger effect of parasympathetic inhibition on the pupil dilation response of listeners with better hearing acuity, and a relatively high parasympathetic activity in those with worse hearing. Previously observed differences in PPD between normal and impaired listeners are probably not solely because of differences in listening effort.

  • 241.
    Wang, Yang
    et al.
    Vrije Univ Amsterdam, Netherlands; Amsterdam Publ Hlth Res Inst, Netherlands; Oticon AS, Denmark.
    Naylor, Graham
    MRC, Scotland.
    Kramer, Sophia E.
    Vrije Univ Amsterdam, Netherlands; Amsterdam Publ Hlth Res Inst, Netherlands.
    Zekveld, Adriana
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, The Swedish Institute for Disability Research. Linköping University, Faculty of Arts and Sciences. Vrije Univ Amsterdam, Netherlands; Amsterdam Publ Hlth Res Inst, Netherlands.
    Wendt, Dorothea
    Oticon AS, Denmark; Tech Univ Denmark, Denmark.
    Ohlenforst, Barbara
    Vrije Univ Amsterdam, Netherlands; Amsterdam Publ Hlth Res Inst, Netherlands; Oticon AS, Denmark.
    Lunner, Thomas
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research. Oticon AS, Denmark; Tech Univ Denmark, Denmark.
    Relations Between Self-Reported Daily-Life Fatigue, Hearing Status, and Pupil Dilation During a Speech Perception in Noise Task2018In: Ear and Hearing, ISSN 0196-0202, E-ISSN 1538-4667, Vol. 39, no 3, p. 573-582Article in journal (Refereed)
    Abstract [en]

    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.

  • 242.
    Wang, Yang
    et al.
    VU University Medical Center, ENT/audiology.
    Zekveld, Adriana
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, The Swedish Institute for Disability Research. VU University Medical Center, ENT/audiology.
    Naylor, Graham
    Snekkersten, Oticon A/S, Eriksholm Research Centre.
    Lunner, Thomas
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research. Snekkersten, Oticon A/S, Eriksholm Research Centre.
    Ohlenforst, Barbara
    The Netherlands, VU University Medical Center, ENT/audiology.
    Koelewijn, Thomas
    VU University Medical Center, ENT/audiology.
    Kramer, Sophia E.
    VU University Medical Center, ENT/audiology.
    The Pupil Light Reflex and its possible connection to Hearing Impairment2015Conference paper (Other academic)
  • 243.
    Wang, Yang
    et al.
    Vrije University of Amsterdam Medical Centre, Netherlands; Vrije University of Amsterdam Medical Centre, Netherlands; Oticon AS, Denmark.
    Zekveld, Adriana
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, The Swedish Institute for Disability Research. Linköping University, Faculty of Arts and Sciences. Vrije University of Amsterdam Medical Centre, Netherlands.
    Naylor, Graham
    MRC CSO Institute Hearing Research, Scotland.
    Ohlenforst, Barbara
    Vrije University of Amsterdam Medical Centre, Netherlands;Oticon AS, Denmark.
    Jansma, Elise P.
    Vrije University of Amsterdam, Netherlands.
    Lorens, Artur
    Institute Physiol and Pathol Hearing, Poland.
    Lunner, Thomas
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research. Oticon AS, Denmark.
    Kramer, Sophia E.
    Vrije University of Amsterdam Medical Centre, Netherlands.
    Parasympathetic Nervous System Dysfunction, as Identified by Pupil Light Reflex, and Its Possible Connection to Hearing Impairment2016In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 11, no 4, p. e0153566-Article in journal (Refereed)
    Abstract [en]

    Context Although the pupil light reflex has been widely used as a clinical diagnostic tool for autonomic nervous system dysfunction, there is no systematic review available to summarize the evidence that the pupil light reflex is a sensitive method to detect parasympathetic dysfunction. Meanwhile, the relationship between parasympathetic functioning and hearing impairment is relatively unknown. Objectives To 1) review the evidence for the pupil light reflex being a sensitive method to evaluate parasympathetic dysfunction, 2) review the evidence relating hearing impairment and parasympathetic activity and 3) seek evidence of possible connections between hearing impairment and the pupil light reflex. Methods Literature searches were performed in five electronic databases. All selected articles were categorized into three sections: pupil light reflex and parasympathetic dysfunction, hearing impairment and parasympathetic activity, pupil light reflex and hearing impairment. Results Thirty-eight articles were included in this review. Among them, 36 articles addressed the pupil light reflex and parasympathetic dysfunction. We summarized the information in these data according to different types of parasympathetic-related diseases. Most of the studies showed a difference on at least one pupil light reflex parameter between patients and healthy controls. Two articles discussed the relationship between hearing impairment and parasympathetic activity. Both studies reported a reduced parasympathetic activity in the hearing impaired groups. The searches identified no results for pupil light reflex and hearing impairment. Discussion and Conclusions As the first systematic review of the evidence, our findings suggest that the pupil light reflex is a sensitive tool to assess the presence of parasympathetic dysfunction. Maximum constriction velocity and relative constriction amplitude appear to be the most sensitive parameters. There are only two studies investigating the relationship between parasympathetic activity and hearing impairment, hence further research is needed. The pupil light reflex could be a candidate measurement tool to achieve this goal.

  • 244.
    Wang, Yang
    et al.
    Vrije Univ Amsterdam Med Ctr, Netherlands; Amsterdam Publ Hlth Res Inst, Netherlands; Oticon AS, Denmark.
    Zekveld, Adriana
    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. Vrije Univ Amsterdam Med Ctr, Netherlands; Amsterdam Publ Hlth Res Inst, Netherlands.
    Wendt, Dorothea
    Oticon AS, Denmark; Tech Univ Denmark, Denmark.
    Lunner, Thomas
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research. Oticon AS, Denmark; Tech Univ Denmark, Denmark.
    Naylor, Graham
    MRC, Scotland.
    Kramer, Sophia E.
    Vrije Univ Amsterdam Med Ctr, Netherlands; Amsterdam Publ Hlth Res Inst, Netherlands.
    Pupil light reflex evoked by light-emitting diode and computer screen: Methodology and association with need for recovery in daily life2018In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 13, no 6, article id e0197739Article in journal (Refereed)
    Abstract [en]

    Objectives Pupil light reflex (PLR) has been widely used as a method for evaluating parasympathetic activity. The first aim of the present study is to develop a PLR measurement using a computer screen set-up and compare its results with the PLR generated by a more conventional setup using light-emitting diode (LED). The parasympathetic nervous system, which is known to control the rest and digest response of the human body, is considered to be associated with daily life fatigue. However, only few studies have attempted to test the relationship between self-reported daily fatigue and physiological measurement of the parasympathetic nervous system. Therefore, the second aim of this study was to investigate the relationship between daily-life fatigue, assessed using the Need for Recovery scale, and parasympathetic activity, as indicated by the PLR parameters. Design A pilot study was conducted first to develop a PLR measurement set-up using a computer screen. PLRs evoked by light stimuli with different characteristics were recorded to confirm the influence of light intensity, flash duration, and color on the PLRs evoked by the system. In the subsequent experimental study, we recorded the PLR of 25 adult participants to light flashes generated by the screen set-up as well as by a conventional LED set-up. PLR parameters relating to parasympathetic and sympathetic activity were calculated from the pupil responses. We tested the split-half reliability across two consecutive blocks of trials, and the relationships between the parameters of PLRs evoked by the two set-ups. Participants rated their need for recovery prior to the PLR recordings. Results PLR parameters acquired in the screen and LED set-ups showed good reliability for amplitude related parameters. The PLRs evoked by both set-ups were consistent, but showed systematic differences in absolute values of all parameters. Additionally, higher need for recovery was associated with faster and larger constriction of the PLR. Conclusions This study assessed the PLR generated by a computer screen and the PLR generated by a LED. The good reliability within set-ups and the consistency between the PLRs evoked by the set-ups indicate that both systems provides a valid way to evoke the PLR. A higher need for recovery was associated with faster and larger constricting PLRs, suggesting increased levels of parasympathetic nervous system activity in people experiencing higher levels of need for recovery on a daily basis.

  • 245.
    Weineland, Sandra
    et al.
    Linköping University.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Lunner, Thomas
    Oticon AS, Denmark.
    Carlbring, Per
    Stockholm University, Sweden.
    Hesser, Hugo
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Ingo, Elisabeth
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Molander, Peter
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Nordqvist, Peter
    Horselskadades Riksforbund, Sweden.
    Laplante-Lévesque, Ariane
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Oticon AS, Denmark.
    Bridging the Gap Between Hearing Screening and Successful Rehabilitation: Research Protocol of a Randomized Controlled Trial of Motivational Interviewing via Internet2015In: American Journal of Audiology, ISSN 1059-0889, E-ISSN 1558-9137, Vol. 24, no 3, p. 302-306Article in journal (Refereed)
    Abstract [en]

    Purpose: Studies point to low help-seeking after a failed hearing screening. This research forum article presents the research protocol for a randomized controlled trial of motivational interviewing via the Internet to promote help-seeking in people who have failed an online hearing screening. Method: Adults who fail a Swedish online hearing screening, including a speech-in-noise recognition test, will be randomized to either an intervention group (participating in motivational interviewing) or an active control group (reading a book on history of hearing aids). Both of the conditions will be delivered via the Internet. The primary outcome is experience with seeking health care and using hearing aids 9 months after the intervention. Secondary outcomes are changes in before and after measures of self-reported hearing difficulties, anxiety, depression, and quality of life. Stages of change and self-efficacy in hearing help-seeking are measured immediately after intervention and at a 9-month follow-up for the purpose of mediation analysis. Results: The results of this randomized controlled trial may help bridge the gap between hearing screening and successful hearing rehabilitation. Conclusion: Although no large instantaneous benefits are expected, a slow change toward healthy behaviors-seeking health care and using hearing aids-would shed light on how to use the Internet to assist people with hearing impairment.

  • 246.
    Wendt, Dorothea
    et al.
    Eriksholm Res Ctr, Denmark; Tech Univ Denmark, Denmark.
    Hietkamp, Renskje K.
    Eriksholm Res Ctr, Denmark.
    Lunner, Thomas
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research. Eriksholm Res Ctr, Denmark; Tech Univ Denmark, Denmark.
    Impact of Noise and Noise Reduction on Processing Effort: A Pupillometry Study2017In: Ear and Hearing, ISSN 0196-0202, E-ISSN 1538-4667, Vol. 38, no 6, p. 690-700Article in journal (Refereed)
    Abstract [en]

    Objectives: Speech perception in adverse listening situations can be exhausting. Hearing loss particularly affects processing demands, as it requires increased effort for successful speech perception in background noise. Signal processing in hearing aids and noise reduction (NR) schemes aim to counteract the effect of noise and reduce the effort required for speech recognition in adverse listening situations. The present study examined the benefit of NR schemes, applying a combination of a digital NR and directional microphones, for reducing the processing effort during speech recognition. Design: The effect of noise (intelligibility level) and different NR schemes on effort were evaluated by measuring the pupil dilation of listeners. In 2 different experiments, performance accuracy and peak pupil dilation (PPD) were measured in 24 listeners with hearing impairment while they performed a speech recognition task. The listeners were tested at 2 different signal to noise ratios corresponding to either the individual 50% correct (L50) or the 95% correct (L95) performance level in a 4-talker babble condition with and without the use of a NR scheme. Results: In experiment 1, the PPD differed in response to both changes in the speech intelligibility level (L50 versus L95) and NR scheme. The PPD increased with decreasing intelligibility, indicating higher processing effort under the L50 condition compared with the L95 condition. Moreover, the PPD decreased when the NR scheme was applied, suggesting that the processing effort was reduced. In experiment 2, 2 hearing aids using different NR schemes (fast-acting and slow-acting) were compared. Processing effort changed as indicated by the PPD depending on the hearing aids and therefore on the NR scheme. Larger PPDs were measured for the slow-acting NR scheme. Conclusions: The benefit of applying an NR scheme was demonstrated for both L50 and L95, that is, a situation at which the performance level was at a ceiling. This opens the opportunity for new means of evaluating hearing aids in situations in which traditional speech reception measures are shown not to be sensitive.

  • 247.
    Wendt, Dorothea
    et al.
    Eriksholm Res Ctr, Denmark; Tech Univ Denmark, Denmark.
    Koelewijn, Thomas
    Vrije Univ Amsterdam Med Ctr, Netherlands.
    Ksiazek, Patrycja
    Eriksholm Res Ctr, Denmark.
    Kramer, Sophia E.
    Vrije Univ Amsterdam Med Ctr, Netherlands.
    Lunner, Thomas
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research. Eriksholm Res Ctr, Denmark; Tech Univ Denmark, Denmark.
    Toward a more comprehensive understanding of the impact of masker type and signal-to-noise ratio on the pupillary response while performing a speech-in-noise test2018In: Hearing Research, ISSN 0378-5955, E-ISSN 1878-5891, Vol. 369, p. 67-78Article in journal (Refereed)
    Abstract [en]

    Difficulties arising in everyday speech communication often result from the acoustical environment, which may contain interfering background noise or competing speakers. Thus, listening and understanding speech in noise can be exhausting. Two experiments are presented in the current study that further explored the impact of masker type and Signal-to-Noise Ratio (SNR) on listening effort by means of pupillometry. In both studies, pupillary responses of participants were measured while performing the Danish Hearing in Noise Test (HINT; Nielsen and Dau, 2011). The first experiment aimed to replicate and extend earlier observed effects of noise type and semantic interference on listening effort (Koelewijn et al., 2012). The impact of three different masker types, i.e. a fluctuating noise, a 1-talker masker and a 4-talker masker on listening effort was examined at a fixed speech intelligibility. In a second experiment, effects of SNR on listening effort were examined while presenting the HINT sentences across a broad range of fixed SNRs corresponding to intelligibility scores ranging from 100% to 0% correct performance. A peak pupil dilation (PPD) was calculated and a Growth Curve Analysis (GCA) was performed to examine listening effort involved in speech recognition as a function of SNR. The results of two experiments showed that the pupil dilation response is highly affected by both masker type and SNR when performing the HINT. The PPD was highest, suggesting the highest level of effort, for speech recognition in the presence of the 1-talker masker in comparison to the 4-talker babble and the fluctuating noise masker. However, the disrupting effect of one competing talker disappeared for intelligibly levels around 50%. Furthermore, it was demonstrated that the pupillary response strongly varied as a function of SNRs. Listening effort was highest for intermediate SNRs with performance accuracies ranging between 30% and 70% correct. GCA revealed time-dependent effects of the SNR on the pupillary response that were not reflected in the PPD. (C) 2018 Elsevier B.V. All rights reserved.

  • 248.
    Wendt, Dorothea
    et al.
    Snekkersten, Oticon A/S, Eriksholm Research Centre.
    Koelewijn, Thomas
    VU University Medical Center, ENT/audiology.
    Zekveld, Adriana
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, The Swedish Institute for Disability Research. VU University Medical Center, ENT/audiology.
    Lunner, Thomas
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research. Snekkersten, Oticon A/S, Eriksholm Research Centre.
    Investigating the effect of competing talkers on speech processing load as shown by task invoked pupil-dilation2015Conference paper (Other academic)
  • 249.
    Wänström, Gunilla
    et al.
    Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Öberg, Marie
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuroscience. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Rydberg, Emelie
    Swedish Institute for Disability Research, School of Health and Medical Science, Linnaeus Centre HEAD, Örebro University.
    Lunner, Thomas
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research. Eriksholm Research Centre, Oticon A/S, Snekkersten, Denmark.
    Laplante-Lévesque, Ariane
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research. Eriksholm Research Centre, Oticon A/S, Snekkersten, Denmark.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research.
    The psychological process from avoidance to acceptance in adults with acquired hearing impairment2014In: Hearing, Balance and Communication, ISSN 2169-5717, Vol. 12, no 1, p. 27-35Article in journal (Refereed)
    Abstract [en]

    Objective: This study explored the psychological process from avoidance to acceptance in adults with acquired hearing impairment. Study design: A descriptive qualitative interview study was conducted in Sweden in 2010. Participants were 18 adults with an acquired sensorineural hearing impairment aged 50-70 years, who had recently obtained hearing aids at the Audiology Clinic of the Örebro University Hospital. The sample included both first-time hearing aid users (n = 10) and experienced hearing aid users (n = 8). Each participant took part in one semi-structured interview. Qualitative content analysis was performed on the manifest content of the interview transcripts. Results: Participants described the process from avoidance to acceptance as a slow and gradual process rooted in the awareness of the frequency and severity of hearing disability and of its psychological consequences. Facilitators included adaptive coping mechanisms, other peoples comments and positive experiences, accessibility of help-seeking and routine health assessments. In contrast, barriers included maladaptive coping mechanisms and stigma. Conclusions: Participants described the process of acceptance as a personal process that involved, to some extent, their social network of family, friends and colleagues. It was also a trade-off between the consequences of untreated hearing impairment and the threat to normal identity that, through stigma, hearing impairment carries. Further studies are needed to fully investigate the role of access to information on hearing impairment acceptance. How professionals and society can facilitate the process of acceptance should also be a focus of future research efforts. 

  • 250.
    Öberg, Marie
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology . Linköping University, Faculty of Health Sciences.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Clinical and Social Psychology. Linköping University, Faculty of Arts and Sciences.
    Wänström, Gunilla
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
    Lunner, Thomas
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology . Linköping University, Faculty of Health Sciences.
    The effects of a pre-fitting intervention on hearing aid benefit:a randomized controlled trial2009In: Audiological Medicine, ISSN 1651-386X, E-ISSN 1651-3835, Vol. 7, no 4, p. 211-215Article in journal (Other (popular science, discussion, etc.))
    Abstract [en]

    Thirty-nine first time hearing aid users with mild to moderate hearing losses were randomly assigned to a pre-fitting intervention group (N=19) or a control group (N=20). The pre-fitting intervention consisted of three weekly visits, where the user adjusted the amplification of an experimental hearing aid to preferred settings, and wore the aid between the visits. After the pre-fitting intervention phase, both groups received conventional hearing aid fitting. Standardized questionnaires (IOI-HA, HHIE, ECHO, SADL, HADS) were administered before and after pre-fitting intervention, after conventional hearing aid fitting, and at one-year follow-up. Hearing aid success was evaluated by an independent audiologist at the one- year follow-up appointment. The pre-fitting intervention phase showed positive effects for the intervention group but not for the control group on activity limitation and participation restriction, and expectations. However, the intervention in its current version had no lasting effects beyond the control group after conventional hearing aid fitting or after a year. Furthermore, both groups showed mostly successful hearing aid fittings, improved psychosocial well-being, quality of life, and reduced participation restriction.

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