BackgroundThe impact of hearing impairment is typically studied in terms of its effects on speech perception, yet this fails to account for the interactive nature of communication. Recently, there has been a move towards studying the effects of age-related hearing impairment on interaction, often using referential communication tasks; however, little is known about how interaction in these tasks compares to everyday communication. AimsTo investigate utterances and requests for clarification used in one-to-one conversations between older adults with hearing impairment and younger adults without hearing impairment, and between two younger adults without hearing impairment. Methods & ProceduresA total of 42 participants were recruited to the study and split into 21 pairs, 10 with two younger adults without hearing impairment and 11 with one younger adult without hearing impairment and one older participant with age-related hearing impairment (hard of hearing). Results from three tasks-spontaneous conversation and two trials of a referential communication task-were compared. A total of 5 min of interaction in each of the three tasks was transcribed, and the frequency of requests for clarification, mean length of utterance and total utterances were calculated for individual participants and pairs. Outcomes & ResultsWhen engaging in spontaneous conversation, participants made fewer requests for clarification than in the referential communication, regardless of hearing status/age (p & LE; 0.012). Participants who were hard of hearing made significantly more requests for clarification than their partners without hearing impairment in only the second trial of the referential communication task (U = 25, p = 0.019). Mean length of utterance was longer in spontaneous conversation than in the referential communication task in the pairs without hearing impairment (p & LE; 0.021), but not in the pairs including a person who was hard of hearing. However, participants who were hard of hearing used significantly longer utterances than their partners without hearing impairment in the spontaneous conversation (U = 8, p < 0.001) but not in the referential communication tasks. Conclusions & ImplicationsThe findings suggest that patterns of interaction observed in referential communication tasks differ to those observed in spontaneous conversation. The results also suggest that fatigue may be an important consideration when planning studies of interaction that use multiple conditions of a communication task, particularly when participants are older or hard of hearing. WHAT THIS PAPER ADDSWhat is already known on this subjectAge-related hearing impairment is known to affect communication; however, the majority of studies have focused on its impact on speech perception in controlled conditions. This indicates little about the impact on everyday, interactive, communication. What this study adds to the existing knowledgeWe investigated utterance length and requests for clarification in one-to-one conversations between pairs consisting of one older adult who is hard of hearing and one younger adult without hearing impairment, or two younger adults without hearing impairment. Results from three tasks (two trials of a referential communication task and spontaneous conversation) were compared. The findings demonstrated a significant effect of task type on requests for clarification in both groups. Furthermore, in spontaneous conversation, older adults who were hard of hearing used significantly longer utterances than their partners without hearing impairment. This pattern was not observed in the referential communication task. What are the potential or actual clinical implications of this work?These findings have important implications for generalizing results from controlled communication tasks to more everyday conversation. Specifically, they suggest that the previously observed strategy of monopolizing conversation, possibly as an attempt to control it, may be more frequently used by older adults who are hard of hearing in natural conversation than in a more contrived communication task.

Objective

Using data from the n200-study, we aimed to investigate the relationship between behavioural (the Swedish HINT and Hagerman speech-in-noise tests) and self-report (Speech, Spatial and Qualities of Hearing Questionnaire (SSQ)) measures of listening under adverse conditions.

Design

The Swedish HINT was masked with a speech-shaped noise (SSN), the Hagerman was masked with a SSN and a four-talker babble, and the subscales from the SSQ were used as a self-report measure. The HINT and Hagerman were administered through an experimental hearing aid.

Study sample

This study included 191 hearing aid users with hearing loss (mean PTA4 = 37.6, SD = 10.8) and 195 normally hearing adults (mean PTA4 = 10.0, SD = 6.0).ResultsThe present study found correlations between behavioural measures of speech-in-noise and self-report scores of the SSQ in normally hearing individuals, but not in hearing aid users.

Conclusion

The present study may help identify relationships between clinically used behavioural measures, and a self-report measure of speech recognition. The results from the present study suggest that use of a self-report measure as a complement to behavioural speech in noise tests might help to further our understanding of how self-report, and behavioural results can be generalised to everyday functioning.

Objectives To investigate associations between sensitivity to temporal fine structure (TFS) and performance in cognitive and speech-in-noise recognition tests. Design A binaural test of TFS sensitivity (the TFS-LF) was used. Measures of cognition included the reading span, Ravens, and text-reception threshold tests. Measures of speech recognition included the Hearing in noise (HINT) and the Hagerman matrix sentence tests in three signal processing conditions. Study sample Analyses are based on the performance of 324/317 adults with and without hearing impairment. Results Sensitivity to TFS was significantly correlated with both the reading span test and the recognition of speech-in-noise processed using noise reduction, the latter only when limited to participants with hearing impairment. Neither association was significant when the effects of age were partialled out. Conclusions The findings are consistent with previous research in finding no evidence of a link between sensitivity to TFS and working memory once the effects of age had been partialled out. The results provide some evidence of an influence of signal processing strategy on the association between TFS sensitivity and speech-in-noise recognition. However, further research is necessary to assess the generalisability of the findings before any claims can be made regarding any clinical implications of these findings.

Objective: The aim of this study was to investigate how sensitivity to temporal fine structure (TFS) correlates with cognitive abilities and speech recognition in adult hearing aid users. Design: The cognitive tests included measures of working memory and executive function. Aided speech recognition was assessed using an adaptive sentence-in-noise recognition task, and a matrix sentence test presented in two types of noise, using three signal processing strategies. Study sample: One hundred eighty-nine adults with symmetrical sensorineural hearing loss, and at least one year of hearing aid experience. Results: After partialling out the effects of age, sensitivity to TFS correlated with the measures of executive function, but not with working memory. While TFS correlated with some of the speech recognition tasks, neither signal processing condition, difficulty, or background noise type affected the degree to which TFS correlated with performance. Conclusions: The results provide some evidence of an association between TFS and speech-in-noise recognition. That this association was not significantly affected by signal processing strategy goes against the idea that TFS sensitivity is likely to impact on the success of a particular hearing aid signal processing strategy. The results, together with previous findings, suggest a possible link between sensitivity to TFS and visuospatial processing.

When children start formal education, they are expected to be able to express complex thoughts. However, in order to do so, they need to be able to use both complex grammatical structures and a variety of words. One group that is at risk of having a delay in terms of their expressive language ability is children with cochlear implants (CI). In this study, we evaluated whether children with CI perform comparably to children with typical hearing (TH) on a standard expressive spoken grammar and a standard expressive spoken vocabulary task when the groups were matched on non-verbal intelligence and working memory capacity. It was found that the children with CI in this study performed more poorly on a standard expressive spoken vocabulary task but not on a standard expressive spoken grammar task when compared to the children with TH. Differences in terms of expressive spoken vocabulary do not seem to be explained by differences in cognitive ability. In addition, the variation in terms of expressive spoken language ability was larger in the children with CI compared to the children with TH. This might be explained by additional confounding factors, like the time of language deprivation or by a greater influence of cognitive differences for the acquisition of spoken language for children with CI.

Pragmatic language ability refers to the ability to use language in a social context. It has been found to be correlated with success in general education for deaf and hard of hearing children. It is therefore of great importance to study why deaf and hard of hearing children often perform more poorly than their hearing peers on tests measuring pragmatic language ability. In the current study the Pragmatics Profile questionnaire from the CELF-IV battery was used to measure pragmatic language ability in children using cochlear implants (N = 14) and children without a hearing loss (N = 34). No significant difference was found between the children with cochlear implants (CI) and the children without hearing loss (HL) for the sum score of the pragmatics language measure. However, 35.71% of the children with CI performed below age norm, while only 5.89% of the children without HL performed below age norm. In addition, when dividing the sum score into three sub-measures: Rituals and Conversational skills (RCS), Asking for, Giving, and Responding to Information (AGRI), and Nonverbal Communication skills (NCS), significant differences between the groups were found for the NCS measure and a tendency for a difference was found for the RCS measure. In addition, all three sub-measures (NCS, AGRI, RCS) were correlated to verbal fluency in the children with CI, but not the children without HL.

n/a

Purpose: To examine the relation between speech recognition and cognitive skills in bimodal cochlear implant (CI) and hearing aid users.

Method: Seventeen bimodal CI users (28-74 years) were recruited to the study. Speech recognition tests were carried out in quiet and in noise. The cognitive tests employed included the Reading Span Test and the Trail Making Test (Daneman & Carpenter, 1980; Reitan, 1958, 1992), measuring working memory capacity and processing speed and executive functioning, respectively. Data were analyzed using paired-sample t tests, Pearson correlations, and partial correlations controlling for age.

Results: The results indicate that performance on some cognitive tests predicts speech recognition and that bimodal listening generates a significant improvement in speech in quiet compared to unilateral CI listening. However, the current results also suggest that bimodal listening requires different cognitive skills than does unimodal CI listening. This is likely to relate to the relative difficulty of having to integrate 2 different signals and then map the integrated signal to representations stored in the long-term memory.

Conclusions: Even though participants obtained speech recognition benefit from bimodal listening, the results suggest that processing bimodal stimuli involves different cognitive skills than does unimodal conditions in quiet. Thus, clinically, it is important to consider this when assessing treatment outcomes.

Objective: The aim of the study was to investigate the utility of an internet-based version of the trail making test (TMT) to predict performance on a speech-in-noise perception task.

Design: Data were taken from a sample of 1509 listeners aged between 18 and 91 years old. Participants completed computerized versions of the TMT and an adaptive speech-in-noise recognition test. All testing was conducted via the internet.

Results: The results indicate that better performance on both the simple and complex subtests of the TMT are associated with better speech-in-noise recognition scores. Thirty-eight percent of the participants had scores on the speech-in-noise test that indicated the presence of a hearing loss.

Conclusions: The findings suggest that the TMT may be a useful tool in the assessment, and possibly the treatment, of speech-recognition difficulties. The results indicate that the relation between speech-in-noise recognition and TMT performance relates both to the capacity of the TMT to index processing speed and to the more complex cognitive abilities also implicated in TMT performance.

Objective: The aim was to investigate whether frequency compression (FC) hearing aids provide additional benefit to that conferred by conventional amplification. Design: Participants wore the same hearing aid with FC enabled and disabled for six weeks (ABA design) in each condition. Speech recognition tests (in both quiet and in noise) were administered alongside two questionnaires. Performance was compared across the two signal processing conditions and at different time points. Study sample: Twelve experienced hearing-aid users (aged 65-84 years old) with moderate-to-severe high-frequency hearing loss participated in the study. Results: FC resulted in statistically significantly higher mean scores in all of the administered speech tests. Improvements over time were limited to high frequency phoneme perception. No effect of FC on self-report outcomes was observed. Conclusions: FC may lead to significant improvements in speech perception outcomes in both quiet and noise for many individuals. No participant was significantly disadvantaged by the use of FC.

Proactive interference (PI) is the capacity to resist interference to the acquisition of new memories from information stored in the long-term memory. Previous research has shown that PI correlates significantly with the speech-in-noise recognition scores of younger adults with normal hearing. In this study, we report the results of an experiment designed to investigate the extent to which tests of visual PI relate to the speech-in-noise recognition scores of older adults with hearing loss, in aided and unaided conditions. The results suggest that measures of PI correlate significantly with speech-in-noise recognition only in the unaided condition. Furthermore the relation between PI and speech-in-noise recognition differs to that observed in younger listeners without hearing loss. The findings suggest that the relation between PI tests and the speech-in-noise recognition scores of older adults with hearing loss relates to capability of the test to index cognitive flexibility.

Hearing loss is common, but often both undetected and untreated. In this two-part study we evaluated an online hearing test and used this test to explore potential links between hearing status, cognitive abilities, psychological distress as well as quality of life.

Out of a total of 1370 online recruited participants who completed the procedure, 16.2% failed the online hearing test. Hearing difficulties were more prevalent among the older participants. Poor self-rated hearing ability, as measured by the Amsterdam Inventory of Auditory Handicap, increased the odds ratio for failing the hearing test (OR 2.34, 95 % CI 1.74-3.15). The same was true for scoring above the cut-off score of 11 on the anxiety subscale on the Hospital Anxiety and Depression Scale (OR 2.55, 95 % CI 1.22-5.33). On the other hand, good performance on the cognitive tasks lowered the risk for a failed hearing test.

We conclude that online hearing tests may have the potential to reduce the time lag between noticing hearing difficulties and beginning a process to address the problem. Moreover, online data collection facilitate large scale investigations on the links between hearing, cognition and perceived communication and mental health problems.

The purpose of this study was to investigate the utility of an internet-based version of the trail making test (TMT) to predict performance on a speech-in-noise perception task. Computerised versions of the tests were completed, via the internet, by a large (1500+) sample of listeners aged between 18 and 91 years old, both with and without hearing loss. The results show that better performance on both the simple and complex versions of the TMT are associated with better speech-in-noise recognition scores. The findings suggest that the relation between performance in the TMT and speech recognition test may be due to the capacity of the TMT to index perceptual speed, as opposed to the more complex cognitive abilities also implicated in TMT performance.

OBJECTIVE: The aim was to investigate whether cognitive and/or audiological measures predict aided speech recognition, both with and without frequency compression (FC).

DESIGN: Participants wore hearing aids, with and without FC for a total of 12 weeks (six weeks in each signal processing condition, ABA design). Performance on a sentence-in-noise recognition test was assessed at the end of each six-week period. Audiological (severity of high frequency hearing loss, presence of dead regions) and cognitive (reading span and trail making test scores) measures were obtained and assessed as predictors of sentence-in-noise recognition with and without FC enabled.

STUDY SAMPLE: Twelve experienced hearing-aid users (aged 65-84 years old) with moderate-to-severe high-frequency hearing loss took part in the study.

RESULTS: The results suggest that both auditory and cognitive factors can be predictive of sentence-in-noise recognition with conventional amplification. However, only auditory factors were significantly correlated with the degree of benefit obtained from FC.

CONCLUSIONS: The strongest predictor of aided speech recognition, both with and without FC, was high frequency hearing loss. Cognitive performance was also a predictor of benefit from conventional amplification, but not of additional benefit from the use of FC.

Background: Complex working memory (WM) span tasks have been shown to predict speech-in-noise (SIN) recognition. Studies of complex WM span tasks suggest that, rather than indexing a single cognitive process, performance on such tasks may be governed by separate cognitive subprocesses embedded within WM. Previous research has suggested that one such subprocess indexed by WM tasks is proactive interference (PI), which refers to difficulties memorizing current information because of interference from previously stored long-term memory representations for similar information. Purpose: The aim of the present study was to investigate phonological PI and to examine the relationship between PI (semantic and phonological) and SIN perception. Research Design: A within-subjects experimental design was used. Study Sample: An opportunity sample of 24 young listeners with normal hearing was recruited. Data Collection and Analysis: Measures of resistance to, and release from, semantic and phonological PI were calculated alongside the signal-to-noise ratio required to identify 50% of keywords correctly in a SIN recognition task. The data were analyzed using t-tests and correlations. Results: Evidence of release from and resistance to semantic interference was observed. These measures correlated significantly with SIN recognition. Limited evidence of phonological PI was observed. Conclusions: The results show that capacity to resist semantic PI can be used to predict SIN recognition scores in young listeners with normal hearing. On the basis of these findings, future research will focus on investigating whether tests of PI can be used in the treatment and/or rehabilitation of hearing loss.

The aim of the following study was to examine the relationship between working memory capacity (WMC), executive functions (EFs) and perceived effort (PE) after completing a work-related task in quiet and in noise in employees with aided hearing impairment (HI) and normal hearing. The study sample consisted of 20 hearing-impaired and 20 normally hearing participants. Measures of hearing ability, WMC and EFs were tested prior to performing a work-related task in quiet and in simulated traffic noise. PE of the work-related task was also measured. Analysis of variance was used to analyze within-and between-group differences in cognitive skills, performance on the work-related task and PE. The presence of noise yielded a significantly higher PE for both groups. However, no significant group differences were observed in WMC, EFs, PE and performance in the work-related task. Interestingly, significant negative correlations were only found between PE in the noise condition and the ability to update information for both groups. In summary, noise generates a significantly higher PE and brings explicit processing capacity into play, irrespective of hearing. This suggest that increased PE involves other factors such as type of task that is to be performed, performance in the cognitive skill required solving the task at hand and whether noise is present. We therefore suggest that special consideration in hearing care should be made to the individuals prerequisites on these factors in the labor market.

Objective:The aim was to investigate the relationship between cognitive ability and frequency compressed speech recognition in listeners with normal hearing and normal cognition. Design:Speech-in-noise recognition was measured using Institute of Electrical and Electronic Engineers sentences presented over earphones at 65 dB SPL and a range of signal-to-noise ratios. There were three conditions:unprocessed, and at frequency compression ratios of 2:1 and 3:1 (cut-off frequency, 1.6 kHz). Working memory and cognitive ability were measured using the reading span test and the trail making test, respectively. Study sample:Participants were 15 young normally-hearing adults with normal cognition. Results:There was a statistically significant reduction in mean speech recognition from around 80% when unprocessed to 40% for 2:1 compression and 30% for 3:1 compression. There was a statistically significant relationship between speech recognition and cognition for the unprocessed condition but not for the frequency-compressed conditions. Conclusions:The relationship between cognitive functioning and recognition of frequency compressed speech-in-noise was not statistically significant. The findings may have been different if the participants had been provided with training and/or time to acclimatize to the frequency-compressed conditions.

As recent results encourage the inclusion of speech in noise (SIN) testing as part of a routine hearing screening test (Arlinger, Lunner, Lyxell, & Pichora-Fuller, 2009), we need to understand exactly which abilities SIN tests are actually indexing. In this study, we investigated the effect of top-down support on speech-in-noi-se perception and the influence of cognitive ability on this relationship by using monosyllabic words presented with stationary background noise in an adaptive threshold procedure. Participants with normal-hearing had to identify (Condition 1) or recognize (Conditions 2 and 3) a target word in noise in descending (Conditions 1 and 3) or ascending (Condition 2) levels of difficulty. Cognitive ability was measured using the reading span and letter memory tests. The results showed a significant effect of top-down support on speech in noise perception thresholds. The magnitude of this effect was predicted by performance on the letter memory test, indicating that good updating ability is, in presence of top-down support, a good predictor of speech in noise perception, in accordance with the Ease of Language Understanding model (Rönnberg, Rudner, Foo, & Lunner, 2008; Rönnberg, 2003; Stenfelt & Rönnberg, 2009). The results of the study highlight the importance of considering that non-auditory factors may play a significant role in speech-in-noise perception. The degree to which non-auditory factors influence speech-in-noise perception is affected by both the test procedure chosen and the cognitive ability of the listener.

Complex working memory capacity (WMC) span tasks have been shown to predict aided and unaided speech in noise recognition (see Akeroyd, 2008 for a review). Studies of complex WMC span tasks suggest that rather than indexing a single cognitive process, performance on such tasks may be governed by separate cognitive subprocesses embedded within WMC (see for example, Sörqvist, Ljungberg, & Ljung, 2010). Thus, the predictive relationship between scores on complex WMC span tasks and the perception of speech-in-noise may not due to WMC per se, but rather to one or more of the component processes that WMC tasks may index. Previous research has suggested that subprocesses may include executive functioning (Whitney et al., 2001) and resistance to proactive interference (Kane and Engle, 2000). Proactive interference (PI) refers to difficulties memorizing current information due to interference from previously stored long-term memory representations for similar information. Although PI is typically investigated in relation to semantic interference, the present research aims to examine PI caused by differences in phonological representations, similar to those caused by a hearing loss or different signal processing methods. The results of a study conducted to investigate the relationship between these cognitive processes and the speech in noise recognition scores of listeners with normal hearing will be presented.