Detection and Attention for Auditory, Visual, and Audiovisual Speech in Children with Hearing Loss

Effect of hearing experience on preschool-aged children's eye gaze to a talker during spoken language processing

Speechreading-gathering speech information from talkers' faces-supports speech perception when speech acoustics are degraded. Benefitting from speechreading, however, requires listeners to visually fixate talkers during face-to-face interactions. The purpose of this study is to test the hypothesis that preschool-aged children allocate their eye gaze to a talker when speech acoustics are degraded. We implemented a looking-while-listening paradigm to quantify children's eye gaze to an unfamiliar female talker and two images of familiar objects presented on a screen while the children listened to speech. We tested 31 children (12 girls), ages 26-48 months, who had normal hearing (NH group, n = 19) or bilateral sensorineural hearing loss and used hearing devices (D/HH group, n = 12). Children's eye gaze was video-recorded as the talker verbally labeled one of the images, either in quiet or in the presence of an unfamiliar two-talker male speech masker. Children's eye gaze to the target image, distractor image, and female talker was coded every 33 ms off-line by trained observers. Bootstrapped differences of time series (BDOTS) analyses and ternary plots were used to determine differences in visual fixations of the talker between listening conditions in the NH and D/HH groups. Results suggest that the NH group visually fixated the talker more in the masker condition than in quiet. We did not observe statistically discernable differences in visual fixations of the talker between the listening conditions for the D/HH group. Gaze patterns of the NH group in the masker condition looked like gaze patterns of the D/HH group.

The impact of visual information in speech perception for individuals with hearing loss: a mini review

This review examines how visual information enhances speech perception in individuals with hearing loss, focusing on the impact of age, linguistic stimuli, and specific hearing loss factors on the effectiveness of audiovisual (AV) integration. While existing studies offer varied and sometimes conflicting findings regarding the use of visual cues, our analysis shows that these key factors can distinctly shape AV speech perception outcomes. For instance, younger individuals and those who receive early intervention tend to benefit more from visual cues, particularly when linguistic complexity is lower. Additionally, languages with dense phoneme spaces demonstrate a higher dependency on visual information, underscoring the importance of tailoring rehabilitation strategies to specific linguistic contexts. By considering these influences, we highlight areas where understanding is still developing and suggest how personalized rehabilitation strategies and supportive systems could be tailored to better meet individual needs. Furthermore, this review brings attention to important aspects that warrant further investigation, aiming to refine theoretical models and contribute to more effective, customized approaches to hearing rehabilitation.

Somatosensory gating is related to behavioral and verbal outcomes in children with mild-to-severe hearing loss

Sensory gating is a process by which the brain filters out redundant information to preserve neural resources for behaviorally relevant stimuli. Although studies have shown alterations in auditory and visual processing in children who are hard-of-hearing (CHH) relative to children with normal hearing (CNH), it is unclear whether these alterations extend to the somatosensory domain, and how aberrations in sensory processing affect sensory gating. In this study, CHH and CNH were presented with a paired-pulse median nerve stimulation during magnetoencephalography. Stimulus-related gamma neural activity was imaged and virtual time series from peak somatosensory responses were extracted. We found significant effects of both stimulus and group, as well as a significant group-by-stimulus interaction. CHH showed a larger response to stimulation overall, as well as greater differences in gamma power from the first to the second stimulus. However, when looking at the ratio rather than the absolute difference in power, CHH showed comparable gating to CNH. In addition, smaller gating ratios were correlated with better classroom behavior and verbal ability in CHH, but not CNH. Taken together, these data underscore the importance of considering how CHH experience their multisensory environment when interpreting outcomes and designing interventions.

Amount of Hearing Aid Use Impacts Neural Oscillatory Dynamics Underlying Verbal Working Memory Processing for Children With Hearing Loss

OBJECTIVES

Children with hearing loss (CHL) may exhibit spoken language delays and may also experience deficits in other cognitive domains including working memory. Consistent hearing aid use (i.e., more than 10 hours per day) ameliorates these language delays; however, the impact of hearing aid intervention on the neural dynamics serving working memory remains unknown. The objective of this study was to examine the association between the amount of hearing aid use and neural oscillatory activity during verbal working memory processing in children with mild-to-severe hearing loss.

DESIGN

Twenty-three CHL between 8 and 15 years-old performed a letter-based Sternberg working memory task during magnetoencephalography (MEG). Guardians also completed a questionnaire describing the participants' daily hearing aid use. Each participant's MEG data was coregistered to their structural MRI, epoched, and transformed into the time-frequency domain using complex demodulation. Significant oscillatory responses corresponding to working memory encoding and maintenance were independently imaged using beamforming. Finally, these whole-brain source images were correlated with the total number of hours of weekly hearing aid use, controlling for degree of hearing loss.

RESULTS

During the encoding period, hearing aid use negatively correlated with alpha-beta oscillatory activity in the bilateral occipital cortices and right precentral gyrus. In the occipital cortices, this relationship suggested that with greater hearing aid use, there was a larger suppression of occipital activity (i.e., more negative relative to baseline). In the precentral gyrus, greater hearing aid use was related to less synchronous activity (i.e., less positive relative to baseline). During the maintenance period, hearing aid use significantly correlated with alpha activity in the right prefrontal cortex, such that with greater hearing aid use, there was less right prefrontal maintenance-related activity (i.e., less positive relative to baseline).

CONCLUSIONS

This study is the first to investigate the impact of hearing aid use on the neural dynamics that underlie working memory function. These data show robust relationships between the amount of hearing aid use and phase-specific neural patterns during working memory encoding and maintenance after controlling for degree of hearing loss. Furthermore, our data demonstrate that wearing hearing aids for more than ~8.5 hours/day may serve to normalize these neural patterns. This study also demonstrates the potential for neuroimaging to help determine the locus of variability in outcomes in CHL.

Auditory experience modulates frontoparietal theta activity serving fluid intelligence

Children who are hard of hearing are at risk for developmental language and academic delays compared with children with normal hearing. Some work suggests that high-order cognitive function, including fluid intelligence, may relate to language and academic outcomes in children with hearing loss, but findings in these studies have been mixed and to date, there have been no studies of the whole-brain neural dynamics serving fluid intelligence in the context of hearing loss. To this end, this study sought to identify the impact of hearing loss and subsequent hearing aid use on the neural dynamics serving abstract reasoning in children who are hard of hearing relative to children with normal hearing using magnetoencephalography. We found significant elevations in occipital and parietal theta activity during early stimulus evaluation in children who are hard of hearing relative to normal-hearing peers. In addition, we found that greater hearing aid use was significantly related to reduced activity throughout the fronto-parietal network. Notably, there were no differences in alpha dynamics between groups during later-stage processing nor did alpha activity correlate with hearing aid use. These cross-sectional data suggest that differences in auditory experience lead to widespread alterations in the neural dynamics serving initial stimulus processing in fluid intelligence in children.