Listening Effort Is Not the Same as Speech Intelligibility Score

The Effectiveness of Linguistic Intervention in Children With Hearing Loss: A Systematic Review and Meta-Analysis

PURPOSE

Vocabulary, grammar, and discourse skills represent distinct dimensions of language ability in young children. Research suggests that individuals with hearing loss often have difficulties with language skills as compared to their hearing counterparts. The aim of this systematic review and meta-analysis is to analyze the effectiveness of linguistic interventions aimed at improving oral discourse in children with hearing loss.

METHOD

A systematic review was conducted according to the PRISMA 2020 statement in five databases. A total of 23 studies were included in the systematic review. From this sample unit, 12 studies were included in the meta-analysis since they had sufficient data for analysis from a meta-analytic approach. Two meta-analyses were performed, one for each dimension of oral discourse skills, differentiating between macrostructure and microstructure and calculating the effects of the intervention and potential moderating variables.

RESULTS

The results suggest positive effects of the interventions with effect sizes of d = 1.01 (95% confidence interval [CI; 0.58, 1.45], p < .001) for macrostructure and d = 0.87 (95% CI [0.02, 0.60], p < .001) for microstructure. Moderator variable analyses showed that the number of participants was the only significant factor identified for the microstructure dimension.

CONCLUSIONS

Linguistic intervention programs improve the language of children with hearing loss. Most of these interventions include therapies that use visual supports and grammar instruction. However, these results should be interpreted with caution given the small number of studies and their high heterogeneity.

Listening Effort Is Difficult to Detect in a Person's Voice: Implications for Audiology Evaluations and Conversation Partners

PURPOSE

Listening can be effortful for a variety of reasons, including when a person misperceives a word in a sentence and then mentally repairs it using later context. The current study explored whether an external observer (in the role of a tester/clinician) could detect that effort by hearing the listener's voice as they repeat the sentence.

METHOD

Stimuli were audio recordings of 13 adults with cochlear implants repeating sentences that were either intact or with a masked word that could be inferred/repaired using context (the latter of which were previously documented to elicit greater effort). Participants (n = 171, including 28 audiologists) used a continuous visual analog scale to judge whether the talker heard one type of stimulus or the other. Participants were also surveyed for experiences related to detecting effort or confusion in a talker's voice.

RESULTS

Participant judges were unable to discern when the CI users were forced to effortfully infer words from context when repeating a sentence. Ratings indicated a general bias toward assuming the listener heard the original sentence correctly without any need for repair. Acoustic properties of the CI users' voices (hypothesized higher voice pitch and delayed verbal reaction time for stimuli involving repair) did not reliably correlate with ratings of uncertainty. There were also no statistically detectable advantages for audiologists or for people who reported experience or skill in discerning uncertainty in a talker's voice.

CONCLUSIONS

Despite clear evidence that mental repair incurs extra effort, the process of mental repair gives no reliably perceptible signature in a talker's voice, even for audiologists and others who profess to have experience and skill in conversing with people who have hearing loss. Listening effort is at risk of going unnoticed by conversation partners and by audiologists who might underestimate a patient's effort when listening to speech.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.28688012.

Pupillometry Reveals the Role of Signal-to-Noise Ratio in Adaption to Linguistic Interference Over Time

PURPOSE

Studies of speech-in-speech listening show that intelligible maskers are more detrimental to target perception than unintelligible maskers, an effect we refer to as linguistic interference. Research also shows that performance improves over time through adaptation. The extent to which the speed of adaptation differs for intelligible and unintelligible maskers and whether this pattern is reflected in changes in listening effort are open questions.

METHOD

In this preregistered study, native English listeners transcribed English sentences against an intelligible masker (time-forward English talkers) versus an unintelligible masker (time-reversed English talkers). Over 50 trials, transcription accuracy and task-evoked pupil response (TEPR) were recorded, along with self-reported effort and fatigue ratings. In Experiment 1, we used an adaptive procedure to ensure a starting performance of ~50% correct in both conditions. In Experiment 2, we used a fixed signal-to-noise ratio (SNR = -1.5 dB) for both conditions.

RESULTS

Both experiments showed performance patterns consistent with linguistic interference. The speed of adaptation depended on the SNR. When the SNR was higher for the intelligible masker condition as a result of the 50% starting performance across conditions (Experiment 1), adaptation was faster for that condition; TEPRs were not affected by trial number or condition. When the SNR was fixed (Experiment 2), adaptation was similar in both conditions, but TEPRs decreased faster in the unintelligible than intelligible masker condition. Self-reported ratings of effort and fatigue were not affected by masker conditions in either experiment.

CONCLUSIONS

Learning to segregate target speech from maskers depends on both the intelligibility of the maskers and the SNR. We discuss ways in which auditory stream formation is automatic or requires cognitive resources.

Advance Contextual Clues Alleviate Listening Effort During Sentence Repair in Listeners With Hearing Aids

PURPOSE

When words are misperceived, listeners can rely on later context to repair an auditory perception, at the cost of increased effort. The current study examines whether the effort to repair a missing word in a sentence is alleviated when the listener has some advance knowledge of what to expect in the sentence.

METHOD

Sixteen adults with hearing aids and 17 with typical hearing heard sentences with a missing word that was followed by context sufficient to infer what the word was. They repeated the sentences with the missing words repaired. Sentences were preceded by visual text on the screen showing either "XXXX" (unprimed) or a priming word previewing the word that would be masked in the auditory signal. Along with intelligibility measures, pupillometry was used as an index of listening effort over the course of each trial to measure how priming influenced the effort needed to mentally repair a missing word.

RESULTS

When listeners were primed for the word that would need to be repaired in an upcoming sentence, listening effort was reduced, as indicated by pupil size returning more quickly toward baseline after the sentence was heard. Priming reduced the lingering cost of mental repair in both listener groups. For the group with hearing loss, priming also reduced the prevalence of errors on target words and words other than the target word in the sentence, suggesting that priming preserves the cognitive resources needed to process the whole sentence.

CONCLUSION

These results suggest that listeners with typical hearing and with hearing loss can benefit from priming (advance cueing) during speech recognition, to accurately repair speech and to process the speech less effortfully.

Cochlear-implant dichotic listening performance and effort are disrupted with functional ear asymmetry

When speech understanding abilities differ across the ears, auditory attention and listening effort could be impacted. Twenty listeners with bilateral cochlear implants (CIs) completed this experiment. Fourteen listeners had symmetric and six listeners had asymmetric functional hearing. Listeners completed monotic and dichotic digit recall with digit string lengths of four and six digits and attention directed to each ear. Pupil size was monitored as an index of listening effort. Individual differences in working memory and inhibition abilities were measured. It was hypothesized that ear asymmetry would lead to poorer listening performance and higher listening effort, and that cognitive abilities would predict both performance and listening effort. Greater differences in performance across ears were observed with asymmetry. Lower listening effort was observed with asymmetry, regardless of which ear was attended. Poorer working memory abilities predicted higher listening effort. These results suggest that asymmetric listeners may experience reduced perception of a poorer ear, and that individuals with poorer working memory abilities are at risk to experience higher listening effort in complex listening environments with CIs. More broadly, these results suggest that the salience of sensory inputs contributes to auditory attention ability and use of cognitive resources.

Classification of Hearing Status Based on Pupil Measures During Sentence Perception

PURPOSE

Speech understanding in noise can be effortful, especially for people with hearing impairment. To compensate for reduced acuity, hearing-impaired (HI) listeners may be allocating listening effort differently than normal-hearing (NH) peers. We expected that this might influence measures derived from the pupil dilation response. To investigate this in more detail, we assessed the sensitivity of pupil measures to hearing-related changes in effort allocation. We used a machine learning-based classification framework capable of combining and ranking measures to examine hearing-related, stimulus-related (signal-to-noise ratio [SNR]), and task response-related changes in pupil measures.

METHOD

Pupil data from 32 NH (40-70 years old, M = 51.3 years, six males) and 32 HI (31-76 years old, M = 59 years, 13 males) listeners were recorded during an adaptive speech reception threshold test. Peak pupil dilation (PPD), mean pupil dilation (MPD), principal pupil components (rotated principal components [RPCs]), and baseline pupil size (BPS) were calculated. As a precondition for ranking pupil measures, the ability to classify hearing status (NH/HI), SNR (high/low), and task response (correct/incorrect) above random prediction level was assessed. This precondition was met when classifying hearing status in subsets of data with varying SNR and task response, SNR in the NH group, and task response in the HI group.

RESULTS

A combination of pupil measures was necessary to classify the dependent factors. Hearing status, SNR, and task response were predicted primarily by the established measures-PPD (maximum effort), RPC2 (speech processing), and BPS (task anticipation)-and by the novel measures RPC1 (listening) and RPC3 (response preparation) in tasks involving SNR as an outcome or sometimes difficulty criterion.

CONCLUSIONS

A machine learning-based classification framework can assess sensitivity of, and rank the importance of, pupil measures in relation to three effort modulators (factors) during speech perception in noise. This indicates that the effects of these factors on the pupil measures allow for reasonable classification performance. Moreover, the varying contributions of each measure to the classification models suggest they are not equally affected by these factors. Thus, this study enhances our understanding of pupil responses and their sensitivity to relevant factors.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.28225199.

Breathy Vocal Quality, Background Noise, and Hearing Loss: How Do These Adverse Conditions Affect Speech Perception by Older Adults?

OBJECTIVES

Although breathy vocal quality and hearing loss are both prevalent age-related changes, their combined impact on speech communication is poorly understood. This study investigated whether breathy vocal quality affected speech perception and listening effort by older listeners. Furthermore, the study examined how this effect was modulated by the adverse listening environment of background noise and the listener's level of hearing loss.

DESIGN

Nineteen older adults participated in the study. Their hearing ranged from near-normal to mild-moderate sensorineural hearing loss. Participants heard speech material of low-context sentences, with stimuli resynthesized to simulate original, mild-moderately breathy, and severely breathy conditions. Speech intelligibility was measured using a speech recognition in noise paradigm, with pupillometry data collected simultaneously to measure listening effort.

RESULTS

Simulated severely breathy vocal quality was found to reduce intelligibility and increase listening effort. Breathiness and background noise level independently modulated listening effort. The impact of hearing loss was not observed in this dataset, which can be due to the use of individualized signal to noise ratios and a small sample size.

CONCLUSION

Results from this study demonstrate the challenges of listening to speech with a breathy vocal quality. Theoretically, the findings highlight the importance of periodicity cues in speech perception in noise by older listeners. Breathy voice could be challenging to separate from the noise when the noise also lacks periodicity. Clinically, it suggests the need to address both listener- and talker-related factors in speech communication by older adults.

Engaging effort improves efficiency during spoken word recognition in cochlear implant users

Word recognition is generally thought to be supported by an automatic process of lexical competition, at least in normal hearing young adults. When listening becomes challenging, either due to properties of the environment (noise) or the individual (hearing loss), the dynamics of lexical competition change and word recognition can feel effortful and fatiguing. In cochlear implant users, several dimensions of lexical competition have been identified that capture the timing of the onset of lexical competition (Wait-and-See), the degree to which competition is fully resolved (Sustained Activation), and how quickly lexical candidates are activated (Activation Rate). It is unclear, however, how these dimensions relate to listening effort. To address this question, a group of cochlear implant users (N = 79) completed a pupillometry task to index effort and a Visual World Paradigm task to index the dynamics of lexical competition as part of a larger battery of clinical and experimental tasks. Listeners who engaged more effort, as indexed by peak pupil size difference score, fell lower along the Wait-and-See dimension, suggesting that these listeners are engaging effort to be less Wait-and-See (or to begin the process of lexical competition earlier). Listeners who engaged effort earlier had better word and sentence recognition outcomes. The timing of effort was predicted by age and spectral fidelity, but no audiological or demographic factors predicted peak pupil size difference. The dissociation between the magnitude of engaged effort and the timing of effort suggests they perform different goals for spoken word recognition.

Exploring N400 Predictability Effects During Sustained Speech Comprehension: From Listening-Related Fatigue to Speech Enhancement Evaluation

OBJECTIVES

This study investigated the predictability effect on the N400 as an objective measure of listening-related fatigue during speech comprehension by: (1) examining how its characteristics (amplitude, latency, and topographic distribution) changed over time under clear versus noisy conditions to assess its utility as a marker for listening-related fatigue, and (2) evaluating whether these N400 parameters could assess the effectiveness of speech enhancement (SE) systems.

DESIGN

Two event-related potential experiments were conducted on 140 young adults (aged 20 to 30) assigned to four age-matched groups. Using a between-subjects design for listening conditions, participants comprehended spoken sentences ending in high- or low-predictability words while their brain activity was recorded using electroencephalography. Experiment 1 compared the predictability effect on the N400 in clear and noise-masked conditions, while experiment 2 examined this effect under two enhanced conditions (denoised using the transformer- and minimum mean square error-based SE models). Electroencephalography data were divided into two blocks to analyze the changes in the predictability effect on the N400 over time, including amplitude, latency, and topographic distributions.

RESULTS

Experiment 1 compared N400 effects across blocks under different clarity conditions. Clear speech in block 2 elicited a more anteriorly distributed N400 effect without reduction or delay compared with block 1. Noisy speech in block 2 showed a reduced, delayed, and posteriorly distributed effect compared with block 1. Experiment 2 examined N400 effects during enhanced speech processing. Transformer-enhanced speech in block 1 demonstrated significantly increased N400 effect amplitude compared to noisy speech. However, both enhancement methods showed delayed N400 effects in block 2.

CONCLUSIONS

This study suggests that temporal changes in the N400 predictability effect might serve as objective markers of sustained speech processing under different clarity conditions. During clear speech comprehension, listeners appear to maintain efficient semantic processing through additional resource recruitment over time, while noisy speech leads to reduced processing efficiency. When applied to enhanced speech, these N400 patterns reveal both the immediate benefits of SE for semantic processing and potential limitations in supporting sustained listening. These findings demonstrate the potential utility of the N400 predictability effect for understanding sustained listening demands and evaluating SE effectiveness.

The time course of cognitive effort during disrupted speech

Listeners often find themselves in scenarios where speech is disrupted, misperceived, or otherwise difficult to recognise. In these situations, many individuals report exerting additional effort to understand speech, even when repairing speech may be difficult or impossible. This investigation aimed to characterise cognitive efforts across time during both sentence listening and a post-sentence retention interval by observing the pupillary response of participants with normal to borderline-normal hearing in response to two interrupted speech conditions: sentences interrupted by gaps of silence or bursts of noise. The pupillary response serves as a measure of the cumulative resources devoted to task completion. Both interruption conditions resulted in significantly greater levels of pupil dilation than the uninterrupted speech condition. Just prior to the end of a sentence, trials periodically interrupted by bursts of noise elicited greater pupil dilation than the silent-interrupted condition. Compared to the uninterrupted condition, both interruption conditions resulted in increased dilation after sentence end but before repetition, possibly reflecting sustained processing demands. Understanding pupil dilation as a marker of cognitive effort is important for clinicians and researchers when assessing the additional effort exerted by listeners with hearing loss who may use cochlear implants or hearing aids. Even when successful perceptual repair is unlikely, listeners may continue to exert increased effort when processing misperceived speech, which could cause them to miss upcoming speech or may contribute to heightened listening fatigue.

Pupillometry and perceived listening effort for cochlear implant users-a comparison of three speech-in-noise tests

OBJECTIVE

Measuring listening effort using pupillometry is challenging in cochlear implant (CI) users. We assess three validated speech tests (Matrix, LIST, and DIN) to identify the optimal speech material for measuring peak-pupil-dilation (PPD) in CI users as a function of signal-to-noise ratio (SNR).

DESIGN

Speech tests were administered in quiet and two noisy conditions, namely at the speech recognition threshold (0 dB re SRT), i.e. the SNR where speech intelligibility (SI) was 50%, and at a more favourable SNR of +6 dB re SRT. PPDs and subjective ratings of effort were obtained.

STUDY SAMPLE

Eighteen unilaterally implanted CI users.

RESULTS

LIST sentences revealed significantly different PPDs between +6 and 0 dB re SRT and DIN triplets between quiet and +6 dB re SRT. PPDs obtained with the Matrix test were independent of SNR and yielded large PPDs and high subjective ratings even in quiet.

CONCLUSIONS

PPD is a sensitive measure for listening effort when processing LIST sentences near 0 dB re SRT and when processing DIN triplets at more favourable listening conditions around +6 dB re SRT. PPDs obtained with the Matrix test were insensitive to SNR, likely because it is demanding for CI users even in quiet.

Congruent Prosody Reduces Cognitive Effort in Memory for Spoken Sentences: A Pupillometric Study with Young and Older Adults

BACKGROUND

In spite of declines in working memory and other processes, older adults generally maintain good ability to understand and remember spoken sentences. In part this is due to preserved knowledge of linguistic rules and their implementation. Largely overlooked, however, is the support older adults may gain from the presence of sentence prosody (pitch contour, lexical stress, intra-and inter-word timing) as an aid to detecting the structure of a heard sentence.

METHODS

Twenty-four young and 24 older adults recalled recorded sentences in which the sentence prosody corresponded to the clausal structure of the sentence, when the prosody was in conflict with this structure, or when there was reduced prosody uninformative with regard to the clausal structure. Pupil size was concurrently recorded as a measure of processing effort.

RESULTS

Both young and older adults' recall accuracy was superior for sentences heard with supportive prosody than for sentences with uninformative prosody or for sentences in which the prosodic marking and causal structure were in conflict. The measurement of pupil dilation suggested that the task was generally more effortful for the older adults, but with both groups showing a similar pattern of effort-reducing effects of supportive prosody.

CONCLUSIONS

Results demonstrate the influence of prosody on young and older adults' ability to recall accurately multi-clause sentences, and the significant role effective prosody may play in preserving processing effort.

Influence of Noise Reduction on Ocular Markers of Listening Effort in Hearing Aid Users in Darkness and Ambient Light

The combination of directional microphones and noise reduction (DIR + NR) in hearing aids offers substantial improvement in speech intelligibility and reduction in listening effort in spatial acoustic scenarios. Pupil dilation can be used to infer ocular markers of listening effort. However, pupillometry is also known to crucially depend on luminance. The present study investigates the effects of a state-of-the-art DIR + NR algorithm (implemented in commercial hearing aids) on pupil dilation of hearing aid users both in darkness and ambient light conditions. Speech intelligibility and peak pupil dilations (PPDs) of 29 experienced hearing aid users were measured during a spatial speech-in-noise-task at a signal-to-noise ratio (SNR) matching the individual's speech reception threshold. While speech intelligibility improvements due to DIR + NR were substantial (about 35 percentage points) and independent of luminance, PPDs were only significantly reduced due to DIR + NR in ambient light, but not in darkness. This finding suggests that the reduction in PPD due to DIR + NR (most likely through improvement in SNR) is dependent on luminance and should be interpreted with caution as a marker for listening effort. Relations of reduction in PPD due to DIR + NR in ambient light to subjectively reported long-term fatigue, age, and pure-tone average were not statistically significant, which indicates that all patients benefitted similarly in listening effort from DIR + NR, irrespective of these patient-specific factors. In conclusion, careful control of luminance needs to be taken in hearing aid studies inferring listening effort from pupillometry data.

Comparison of Performance for Cochlear-Implant Listeners Using Audio Processing Strategies Based on Short-Time Fast Fourier Transform or Spectral Feature Extraction

OBJECTIVES

We compared sound quality and performance for a conventional cochlear-implant (CI) audio processing strategy based on short-time fast-Fourier transform (Crystalis) and an experimental strategy based on spectral feature extraction (SFE). In the latter, the more salient spectral features (acoustic events) were extracted and mapped into the CI stimulation electrodes. We hypothesized that (1) SFE would be superior to Crystalis because it can encode acoustic spectral features without the constraints imposed by the short-time fast-Fourier transform bin width, and (2) the potential benefit of SFE would be greater for CI users who have less neural cross-channel interactions.

DESIGN

To examine the first hypothesis, 6 users of Oticon Medical Digisonic SP CIs were tested in a double-blind design with the SFE and Crystalis strategies on various aspects: word recognition in quiet, speech-in-noise reception threshold (SRT), consonant discrimination in quiet, listening effort, melody contour identification (MCI), and subjective sound quality. Word recognition and SRTs were measured on the first and last day of testing (4 to 5 days apart) to assess potential learning and/or acclimatization effects. Other tests were run once between the first and last testing day. Listening effort was assessed by measuring pupil dilation. MCI involved identifying a five-tone contour among five possible contours. Sound quality was assessed subjectively using the multiple stimulus with hidden reference and anchor (MUSHRA) paradigm for sentences, music, and ambient sounds. To examine the second hypothesis, cross-channel interaction was assessed behaviorally using forward masking.

RESULTS

Word recognition was similar for the two strategies on the first day of testing and improved for both strategies on the last day of testing, with Crystalis improving significantly more. SRTs were worse with SFE than Crystalis on the first day of testing but became comparable on the last day of testing. Consonant discrimination scores were higher for Crystalis than for the SFE strategy. MCI scores and listening effort were not substantially different across strategies. Subjective sound quality scores were lower for the SFE than for the Crystalis strategy. The difference in performance with SFE and Crystalis was greater for CI users with higher channel interaction.

CONCLUSIONS

CI-user performance was similar with the SFE and Crystalis strategies. Longer acclimatization times may be required to reveal the full potential of the SFE strategy.

Repairing Misperceptions of Words Early in a Sentence is More Effortful Than Repairing Later Words, Especially for Listeners With Cochlear Implants

The process of repairing misperceptions has been identified as a contributor to effortful listening in people who use cochlear implants (CIs). The current study was designed to examine the relative cost of repairing misperceptions at earlier or later parts of a sentence that contained contextual information that could be used to infer words both predictively and retroactively. Misperceptions were enforced at specific times by replacing single words with noise. Changes in pupil dilation were analyzed to track differences in the timing and duration of effort, comparing listeners with typical hearing (TH) or with CIs. Increases in pupil dilation were time-locked to the moment of the missing word, with longer-lasting increases when the missing word was earlier in the sentence. Compared to listeners with TH, CI listeners showed elevated pupil dilation for longer periods of time after listening, suggesting a lingering effect of effort after sentence offset. When needing to mentally repair missing words, CI listeners also made more mistakes on words elsewhere in the sentence, even though these words were not masked. Changes in effort based on the position of the missing word were not evident in basic measures like peak pupil dilation and only emerged when the full-time course was analyzed, suggesting the timing analysis adds new information to our understanding of listening effort. These results demonstrate that some mistakes are more costly than others and incur different levels of mental effort to resolve the mistake, underscoring the information lost when characterizing speech perception with simple measures like percent-correct scores.

Hearing Impairment: Reduced Pupil Dilation Response and Frontal Activation During Degraded Speech Perception

PURPOSE

A relevant aspect of listening is the effort required during speech processing, which can be assessed by pupillometry. Here, we assessed the pupil dilation response of normal-hearing (NH) and hard of hearing (HH) individuals during listening to clear sentences and masked or degraded sentences. We combined this assessment with functional magnetic resonance imaging (fMRI) to investigate the neural correlates of the pupil dilation response.

METHOD

Seventeen NH participants (Mage = 46 years) were compared to 17 HH participants (Mage = 45 years) who were individually matched in age and educational level. Participants repeated sentences that were presented clearly, that were distorted, or that were masked. The sentence intelligibility level of masked and distorted sentences was 50% correct. Silent baseline trials were presented as well. Performance measures, pupil dilation responses, and fMRI data were acquired.

RESULTS

HH individuals had overall poorer speech reception than the NH participants, but not for noise-vocoded speech. In addition, an interaction effect was observed with smaller pupil dilation responses in HH than in NH listeners for the degraded speech conditions. Hearing impairment was associated with higher activation across conditions in the left superior temporal gyrus, as compared to the silent baseline. However, the region of interest analysis indicated lower activation during degraded speech relative to clear speech in bilateral frontal regions and the insular cortex, for HH compared to NH listeners. Hearing impairment was also associated with a weaker relation between the pupil response and activation in the right inferior frontal gyrus. Overall, degraded speech evoked higher frontal activation than clear speech.

CONCLUSION

Brain areas associated with attentional and cognitive-control processes may be increasingly recruited when speech is degraded and are related to the pupil dilation response, but this relationship is weaker in HH listeners.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.27162135.

Speech-evoked cortical activities and speech recognition in adult cochlear implant listeners: a review of functional near-infrared spectroscopy studies

Cochlear implants (CIs) are the most successful neural prostheses, enabling individuals with severe to profound hearing loss to access sounds and understand speech. While CI has demonstrated success, speech perception outcomes vary largely among CI listeners, with significantly reduced performance in noise. This review paper summarizes prior findings on speech-evoked cortical activities in adult CI listeners using functional near-infrared spectroscopy (fNIRS) to understand (a) speech-evoked cortical processing in CI listeners compared to normal-hearing (NH) individuals, (b) the relationship between these activities and behavioral speech recognition scores, (c) the extent to which current fNIRS-measured speech-evoked cortical activities in CI listeners account for their differences in speech perception, and (d) challenges in using fNIRS for CI research. Compared to NH listeners, CI listeners had diminished speech-evoked activation in the middle temporal gyrus (MTG) and in the superior temporal gyrus (STG), except one study reporting an opposite pattern for STG. NH listeners exhibited higher inferior frontal gyrus (IFG) activity when listening to CI-simulated speech compared to natural speech. Among CI listeners, higher speech recognition scores correlated with lower speech-evoked activation in the STG, higher activation in the left IFG and left fusiform gyrus, with mixed findings in the MTG. fNIRS shows promise for enhancing our understanding of cortical processing of speech in CI listeners, though findings are mixed. Challenges include test-retest reliability, managing noise, replicating natural conditions, optimizing montage design, and standardizing methods to establish a strong predictive relationship between fNIRS-based cortical activities and speech perception in CI listeners.

Effects of near-monotonous speech of persons with Parkinson's disease on listening effort and intelligibility

The majority of patients with Parkinson's disease (PD) develop hypokinetic dysarthria with a disturbance of prosody. The most important acoustic characteristic of prosodic impairment in PD is a lack of fundamental frequency (F0)-variability. It is well established that a lack of F0-variability can negatively influence the speech intelligibility of neurotypical speakers in background noise. The purpose of this study was to investigate which aspect of processing speech realised by speakers with PD is affected by lack of intonation: intelligibility as measured by a transcription task, scaled intelligibility and/or perceived listening effort when there is no background noise. F0-flattening of Semantically Unpredictable Sentences (SUS) was achieved, while the natural F0-declination was preserved. This kind of F0-flattening affected scaled intelligibility and perceived listening effort, while transcription performance remained unchanged.

Pupillometry reveals effects of pitch manipulation within and across words on listening effort and short-term memory

For individuals with hearing loss, even successful speech communication comes at a cost. Cochlear implants transmit degraded information, specifically for voice pitch, which demands extra and sustained listening effort. The current study hypothesized that abnormal pitch patterns contribute to the additional listening effort, even in non-tonal language native speaking normally hearing listeners. We manipulated the fundamental frequency (F0) within and across words, while participants listen and repeat (simple intelligibility task), or listen, repeat, and later recall (concurrent encoding task) the words. In both experiments, the F0 manipulations resulted in small changes in intelligibility but no difference in free recall or subjective effort ratings. Pupillary metrics were yet sensitive to these manipulations: pupil dilations were larger when words were monotonized (flat contour) or inverted (the natural contour flipped upside-down), and larger when successive words were organized into a melodic pattern. The most likely interpretation is that the natural or expected F0 contour of a word contributes to its identity and facilitate its matching and retrieval from the phonological representation stored in long-term memory. Consequently, degrading words' F0 contour can result in extra listening effort. Our results call for solutions to improve pitch saliency and naturalness in future development of cochlear implants' signal processing strategies, even for non-tonal languages.

Cortical mechanisms of across-ear speech integration investigated using functional near-infrared spectroscopy (fNIRS)

This study aimed to investigate integration of alternating speech, a stimulus which classically produces a V-shaped speech intelligibility function with minimum at 2-6 Hz in typical-hearing (TH) listeners. We further studied how degraded speech impacts intelligibility across alternating rates (2, 4, 8, and 32 Hz) using vocoded speech, either in the right ear or bilaterally, to simulate single-sided deafness with a cochlear implant (SSD-CI) and bilateral CIs (BiCI), respectively. To assess potential cortical signatures of across-ear integration, we recorded activity in the bilateral auditory cortices (AC) and dorsolateral prefrontal cortices (DLPFC) during the task using functional near-infrared spectroscopy (fNIRS). For speech intelligibility, the V-shaped function was reproduced only in the BiCI condition; TH (with ceiling scores) and SSD-CI conditions had significantly higher scores across all alternating rates compared to the BiCI condition. For fNIRS, the AC and DLPFC exhibited significantly different activity across alternating rates in the TH condition, with altered activity patterns in both regions in the SSD-CI and BiCI conditions. Our results suggest that degraded speech inputs in one or both ears impact across-ear integration and that different listening strategies were employed for speech integration manifested as differences in cortical activity across conditions.

Underlying dimensions of real-time word recognition in cochlear implant users

Word recognition is a gateway to language, linking sound to meaning. Prior work has characterized its cognitive mechanisms as a form of competition between similar-sounding words. However, it has not identified dimensions along which this competition varies across people. We sought to identify these dimensions in a population of cochlear implant users with heterogenous backgrounds and audiological profiles, and in a lifespan sample of people without hearing loss. Our study characterizes the process of lexical competition using the Visual World Paradigm. A principal component analysis reveals that people's ability to resolve lexical competition varies along three dimensions that mirror prior small-scale studies. These dimensions capture the degree to which lexical access is delayed ("Wait-and-See"), the degree to which competition fully resolves ("Sustained-Activation"), and the overall rate of activation. Each dimension is predicted by a different auditory skills and demographic factors (onset of deafness, age, cochlear implant experience). Moreover, each dimension predicts outcomes (speech perception in quiet and noise, subjective listening success) over and above auditory fidelity. Higher degrees of Wait-and-See and Sustained-Activation predict poorer outcomes. These results suggest the mechanisms of word recognition vary along a few underlying dimensions which help explain variable performance among listeners encountering auditory challenge.

Listening Effort for Speech in Noise Perception Using Pupil Dilation: A Comparison Among Percussionists, Non-Percussionists, and Non-Musicians

BACKGROUND AND OBJECTIVES

Most studies in literature attribute the benefits of musical training on speech in noise (SIN) perception to "experience-based" plasticity, which assists in the activation of speech-processing networks. However, whether musicianship provides an advantage for the listening effort (LE) required to comprehend speech in degraded environments has received less attention. The current study aimed to understand the influence of Indian classical music training on SIN perception and its related LE across percussionists, non-percussionists, and non-musicians.

SUBJECTS AND METHODS

A quasi-experiment was conducted on 16 percussionists, 17 non-percussionists, and 26 non-musicians aged 18-35 years with normal hearing. In phase 1, musical abilities were assessed using Mini-Profile of Music Perception Skills (Mini-PROMS). Phase 2 examined SIN using Tamil Phonemically-Balanced Words and Tamil Matrix Sentence Test at +5 dB, 0 dB, and -5 dB SNR and LE using pupillometry, measuring pupil dilations with an eye-tracker.

RESULTS

Fractional Logit and Linear Regression models demonstrated that percussionists outperformed non-percussionists in Tuning and Speed subsets of Mini-PROMS. Percussionists outperformed non-percussionists and non-musicians in SIN and LE at -5 dB SNR for words and at 0 dB and -5 dB SNR for sentences.

CONCLUSIONS

Percussionists have the greatest advantage in decoding SIN with reduced LE followed by non-percussionists and non-musicians, demonstrating musician-advantage in most challenging listening conditions.

The Costs (and Benefits?) of Effortful Listening for Older Adults: Insights from Simultaneous Electrophysiology, Pupillometry, and Memory

Although the impact of acoustic challenge on speech processing and memory increases as a person ages, older adults may engage in strategies that help them compensate for these demands. In the current preregistered study, older adults (n = 48) listened to sentences-presented in quiet or in noise-that were high constraint with either expected or unexpected endings or were low constraint with unexpected endings. Pupillometry and EEG were simultaneously recorded, and subsequent sentence recognition and word recall were measured. Like young adults in prior work, we found that noise led to increases in pupil size, delayed and reduced ERP responses, and decreased recall for unexpected words. However, in contrast to prior work in young adults where a larger pupillary response predicted a recovery of the N400 at the cost of poorer memory performance in noise, older adults did not show an associated recovery of the N400 despite decreased memory performance. Instead, we found that in quiet, increases in pupil size were associated with delays in N400 onset latencies and increased recognition memory performance. In conclusion, we found that transient variation in pupil-linked arousal predicted trade-offs between real-time lexical processing and memory that emerged at lower levels of task demand in aging. Moreover, with increased acoustic challenge, older adults still exhibited costs associated with transient increases in arousal without the corresponding benefits.

Pupil Size and Eye Movements Differently Index Effort in Both Younger and Older Adults

The assessment of mental effort is increasingly relevant in neurocognitive and life span domains. Pupillometry, the measure of the pupil size, is often used to assess effort but has disadvantages. Analysis of eye movements may provide an alternative, but research has been limited to easy and difficult task demands in younger adults. An effort measure must be sensitive to the whole effort profile, including "giving up" effort investment, and capture effort in different age groups. The current study comprised three experiments in which younger (n = 66) and older (n = 44) adults listened to speech masked by background babble at different signal-to-noise ratios associated with easy, difficult, and impossible speech comprehension. We expected individuals to invest little effort for easy and impossible speech (giving up) but to exert effort for difficult speech. Indeed, pupil size was largest for difficult but lower for easy and impossible speech. In contrast, gaze dispersion decreased with increasing speech masking in both age groups. Critically, gaze dispersion during difficult speech returned to levels similar to easy speech after sentence offset, when acoustic stimulation was similar across conditions, whereas gaze dispersion during impossible speech continued to be reduced. These findings show that a reduction in eye movements is not a byproduct of acoustic factors, but instead suggest that neurocognitive processes, different from arousal-related systems regulating the pupil size, drive reduced eye movements during high task demands. The current data thus show that effort in one sensory domain (audition) differentially impacts distinct functional properties in another sensory domain (vision).

Influence of Speech Rate on Auditory Recognition in Cochlear Implant Users

INTRODUCTION

This study aimed to verify the influence of speech stimulus presentation and speed on auditory recognition in cochlear implant (CI) users with poorer performance.

METHODS

The cross-sectional observational study applied auditory speech perception tests to fifteen adults, using three different ways of presenting the stimulus, in the absence of competitive noise: monitored live voice (MLV); recorded speech at typical speed (RSTS); recorded speech at slow speed (RSSS). The scores were assessed using the Percent Sentence Recognition Index (PSRI). The data were inferentially analysed using the Friedman and Wilcoxon tests with a 95% confidence interval and 5% significance level (p < 0.05).

RESULTS

The mean age was 41.1 years, the mean duration of CI use was 11.4 years, and the mean hearing threshold was 29.7 ± 5.9 dBHL. Test performance, as determined by the PSRI, was MLV = 42.4 ± 17.9%; RSTS = 20.3 ± 14.3%; RSSS = 40.6 ± 20.7%. There was a significant difference identified for RSTS compared to MLV and RSSS.

CONCLUSION

The way the stimulus is presented and the speed at which it is presented enable greater auditory speech recognition in CI users, thus favouring comprehension when the tests are applied in the MLV and RSSS modalities.

Evaluating Speaker-Listener Cognitive Effort in Speech Communication Through Brain-to-Brain Synchrony: A Pilot Functional Near-Infrared Spectroscopy Investigation

PURPOSE

We explore a new approach to the study of cognitive effort involved in listening to speech by measuring the brain activity in a listener in relation to the brain activity in a speaker. We hypothesize that the strength of this brain-to-brain synchrony (coupling) reflects the magnitude of cognitive effort involved in verbal communication and includes both listening effort and speaking effort. We investigate whether interbrain synchrony is greater in native-to-native versus native-to-nonnative communication using functional near-infrared spectroscopy (fNIRS).

METHOD

Two speakers participated, a native speaker of American English and a native speaker of Korean who spoke English as a second language. Each speaker was fitted with the fNIRS cap and told short stories. The native English speaker provided the English narratives, and the Korean speaker provided both the nonnative (accented) English and Korean narratives. In separate sessions, fNIRS data were obtained from seven English monolingual participants ages 20-24 years who listened to each speaker's stories. After listening to each story in native and nonnative English, they retold the content, and their transcripts and audio recordings were analyzed for comprehension and discourse fluency, measured in the number of hesitations and articulation rate. No story retellings were obtained for narratives in Korean (an incomprehensible language for English listeners). Utilizing fNIRS technique termed sequential scanning, we quantified the brain-to-brain synchronization in each speaker-listener dyad.

RESULTS

For native-to-native dyads, multiple brain regions associated with various linguistic and executive functions were activated. There was a weaker coupling for native-to-nonnative dyads, and only the brain regions associated with higher order cognitive processes and functions were synchronized. All listeners understood the content of all stories, but they hesitated significantly more when retelling stories told in accented English. The nonnative speaker hesitated significantly more often than the native speaker and had a significantly slower articulation rate. There was no brain-to-brain coupling during listening to Korean, indicating a break in communication when listeners failed to comprehend the speaker.

CONCLUSIONS

We found that effortful speech processing decreased interbrain synchrony and delayed comprehension processes. The obtained brain-based and behavioral patterns are consistent with our proposal that cognitive effort in verbal communication pertains to both the listener and the speaker and that brain-to-brain synchrony can be an indicator of differences in their cumulative communicative effort.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.25452142.

The impact of face coverings on audio-visual contributions to communication with conversational speech

The use of face coverings can make communication more difficult by removing access to visual cues as well as affecting the physical transmission of speech sounds. This study aimed to assess the independent and combined contributions of visual and auditory cues to impaired communication when using face coverings. In an online task, 150 participants rated videos of natural conversation along three dimensions: (1) how much they could follow, (2) how much effort was required, and (3) the clarity of the speech. Visual and audio variables were independently manipulated in each video, so that the same video could be presented with or without a superimposed surgical-style mask, accompanied by one of four audio conditions (either unfiltered audio, or audio-filtered to simulate the attenuation associated with a surgical mask, an FFP3 mask, or a visor). Hypotheses and analyses were pre-registered. Both the audio and visual variables had a statistically significant negative impact across all three dimensions. Whether or not talkers' faces were visible made the largest contribution to participants' ratings. The study identifies a degree of attenuation whose negative effects can be overcome by the restoration of visual cues. The significant effects observed in this nominally low-demand task (speech in quiet) highlight the importance of the visual and audio cues in everyday life and that their consideration should be included in future face mask designs.

Used to Be a Dime, Now It's a Dollar: Revised Speech Perception in Noise Key Word Predictability Revisited 40 Years On

PURPOSE

Almost 40 years after its development, in this article, we reexamine the relevance and validity of the ubiquitously used Revised Speech Perception in Noise (R-SPiN) sentence corpus. The R-SPiN corpus includes "high-context" and "low-context" sentences and has been widely used in the field of hearing research to examine the benefit derived from semantic context across English-speaking listeners, but research investigating age differences has yielded somewhat inconsistent findings. We assess the appropriateness of the corpus for use today in different English-language cultures (i.e., British and American) as well as for older and younger adults.

METHOD

Two hundred forty participants, including older (60-80 years) and younger (19-31 years) adult groups in the the United Kingdom and United States, completed a cloze task consisting of R-SPiN sentences with the final word removed. Cloze, as a measure of predictability, and entropy, as a measure of response uncertainty, were compared between culture and age groups.

RESULTS

Most critically, of the 200 "high-context" stimuli, only around half were assessed as highly predictable for older adults (United Kingdom: 109; United States: 107); and fewer still, for younger adults (United Kingdom: 75; United States: 81). We also found dominant responses to these "high-context" stimuli varied between cultures, with U.S. responses being more likely to match the original R-SPiN target.

CONCLUSIONS

Our findings highlight the issue of incomplete transferability of corpus items across English-language cultures as well as diminished equivalency for older and younger adults. By identifying relevant items for each population, this work could facilitate the interpretation of inconsistent findings in the literature, particularly relating to age effects.

Note on the Dual-Task Paradigm and its Use to Measure Listening Effort

People regularly communicate in complex environments, requiring them to flexibly shift their attention across multiple sources of sensory information. Increasing recruitment of the executive functions that support successful speech comprehension in these multitasking settings is thought to contribute to the sense of effort that listeners often experience. One common research method employed to quantify listening effort is the dual-task paradigm in which individuals recognize speech and concurrently perform a secondary (often visual) task. Effort is operationalized as performance decrements on the secondary task as speech processing demands increase. However, recent reviews have noted critical inconsistencies in the results of dual-task experiments, likely in part due to how and when the two tasks place demands on a common set of mental resources and how flexibly individuals can allocate their attention to them. We propose that in order to move forward to address this gap, we need to first look backward: better integrating theoretical models of resource capacity and allocation as well as of task-switching that have been historically developed in domains outside of hearing research (viz., cognitive psychology and neuroscience). With this context in mind, we describe how dual-task experiments could be designed and interpreted such that they provide better and more robust insights into the mechanisms that contribute to effortful listening.

Automated Measurement of Speech Recognition, Reaction Time, and Speech Rate and Their Relation to Self-Reported Listening Effort for Normal-Hearing and Hearing-Impaired Listeners Using various Maskers

In speech audiometry, the speech-recognition threshold (SRT) is usually established by adjusting the signal-to-noise ratio (SNR) until 50% of the words or sentences are repeated correctly. However, these conditions are rarely encountered in everyday situations. Therefore, for a group of 15 young participants with normal hearing and a group of 12 older participants with hearing impairment, speech-recognition scores were determined at SRT and at four higher SNRs using several stationary and fluctuating maskers. Participants' verbal responses were recorded, and participants were asked to self-report their listening effort on a categorical scale (self-reported listening effort, SR-LE). The responses were analyzed using an Automatic Speech Recognizer (ASR) and compared to the results of a human examiner. An intraclass correlation coefficient of r = .993 for the agreement between their corresponding speech-recognition scores was observed. As expected, speech-recognition scores increased with increasing SNR and decreased with increasing SR-LE. However, differences between speech-recognition scores for fluctuating and stationary maskers were observed as a function of SNR, but not as a function of SR-LE. The verbal response time (VRT) and the response speech rate (RSR) of the listeners' responses were measured using an ASR. The participants with hearing impairment showed significantly lower RSRs and higher VRTs compared to the participants with normal hearing. These differences may be attributed to differences in age, hearing, or both. With increasing SR-LE, VRT increased and RSR decreased. The results show the possibility of deriving a behavioral measure, VRT, measured directly from participants' verbal responses during speech audiometry, as a proxy for SR-LE.

Quantifying the Impact of Auditory Deafferentation on Speech Perception

The past decade has seen a wealth of research dedicated to determining which and how morphological changes in the auditory periphery contribute to people experiencing hearing difficulties in noise despite having clinically normal audiometric thresholds in quiet. Evidence from animal studies suggests that cochlear synaptopathy in the inner ear might lead to auditory nerve deafferentation, resulting in impoverished signal transmission to the brain. Here, we quantify the likely perceptual consequences of auditory deafferentation in humans via a physiologically inspired encoding-decoding model. The encoding stage simulates the processing of an acoustic input stimulus (e.g., speech) at the auditory periphery, while the decoding stage is trained to optimally regenerate the input stimulus from the simulated auditory nerve firing data. This allowed us to quantify the effect of different degrees of auditory deafferentation by measuring the extent to which the decoded signal supported the identification of speech in quiet and in noise. In a series of experiments, speech perception thresholds in quiet and in noise increased (worsened) significantly as a function of the degree of auditory deafferentation for modeled deafferentation greater than 90%. Importantly, this effect was significantly stronger in a noisy than in a quiet background. The encoding-decoding model thus captured the hallmark symptom of degraded speech perception in noise together with normal speech perception in quiet. As such, the model might function as a quantitative guide to evaluating the degree of auditory deafferentation in human listeners.

Pupillometry reveals differences in cognitive demands of listening to face mask-attenuated speech

Face masks offer essential protection but also interfere with speech communication. Here, audio-only sentences spoken through four types of masks were presented in noise to young adult listeners. Pupil dilation (an index of cognitive demand), intelligibility, and subjective effort and performance ratings were collected. Dilation increased in response to each mask relative to the no-mask condition and differed significantly where acoustic attenuation was most prominent. These results suggest that the acoustic impact of the mask drives not only the intelligibility of speech, but also the cognitive demands of listening. Subjective effort ratings reflected the same trends as the pupil data.

Self-pacing ameliorates recall deficit when listening to vocoded discourse: a cochlear implant simulation

Introduction

In spite of its apparent ease, comprehension of spoken discourse represents a complex linguistic and cognitive operation. The difficulty of such an operation can increase when the speech is degraded, as is the case with cochlear implant users. However, the additional challenges imposed by degraded speech may be mitigated to some extent by the linguistic context and pace of presentation.

Methods

An experiment is reported in which young adults with age-normal hearing recalled discourse passages heard with clear speech or with noise-band vocoding used to simulate the sound of speech produced by a cochlear implant. Passages were varied in inter-word predictability and presented either without interruption or in a self-pacing format that allowed the listener to control the rate at which the information was delivered.

Results

Results showed that discourse heard with clear speech was better recalled than discourse heard with vocoded speech, discourse with a higher average inter-word predictability was better recalled than discourse with a lower average inter-word predictability, and self-paced passages were recalled better than those heard without interruption. Of special interest was the semantic hierarchy effect: the tendency for listeners to show better recall for main ideas than mid-level information or detail from a passage as an index of listeners' ability to understand the meaning of a passage. The data revealed a significant effect of inter-word predictability, in that passages with lower predictability had an attenuated semantic hierarchy effect relative to higher-predictability passages.

Discussion

Results are discussed in terms of broadening cochlear implant outcome measures beyond current clinical measures that focus on single-word and sentence repetition.

Listening effort and fatigue among cochlear implant users: a scoping review

Introduction

In challenging listening situations, speech perception with a cochlear implant (CI) remains demanding and requires high levels of listening effort, which can lead to increased levels of listening-related fatigue. The body of literature on these topics increases as the number of CI users rises. This scoping review aims to provide an overview of the existing literature on listening effort, fatigue, and listening-related fatigue among CI users and the measurement techniques to evaluate them.

Methods

The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statements were used to conduct the scoping review. The search was performed on PubMed, Scopus, and Web of Science to identify all relevant studies.

Results

In total, 24 studies were included and suggests that CI users experience higher levels of listening effort when compared to normal hearing controls using scales, questionnaires and electroencephalogram measurements. However, executing dual-task paradigms did not reveal any difference in listening effort between both groups. Uncertainty exists regarding the difference in listening effort between unilateral, bilateral, and bimodal CI users with bilateral hearing loss due to ambiguous results. Only five studies were eligible for the research on fatigue and listening-related fatigue. Additionally, studies using objective measurement methods were lacking.

Discussion

This scoping review highlights the necessity for additional research on these topics. Moreover, there is a need for guidelines on how listening effort, fatigue, and listening-related fatigue should be measured to allow for study results that are comparable and support optimal rehabilitation strategies.

Phonological discrimination and contrast detection in pupillometry

Introduction

The perception of phonemes is guided by both low-level acoustic cues and high-level linguistic context. However, differentiating between these two types of processing can be challenging. In this study, we explore the utility of pupillometry as a tool to investigate both low- and high-level processing of phonological stimuli, with a particular focus on its ability to capture novelty detection and cognitive processing during speech perception.

Methods

Pupillometric traces were recorded from a sample of 22 Danish-speaking adults, with self-reported normal hearing, while performing two phonological-contrast perception tasks: a nonword discrimination task, which included minimal-pair combinations specific to the Danish language, and a nonword detection task involving the detection of phonologically modified words within sentences. The study explored the perception of contrasts in both unprocessed speech and degraded speech input, processed with a vocoder.

Results

No difference in peak pupil dilation was observed when the contrast occurred between two isolated nonwords in the nonword discrimination task. For unprocessed speech, higher peak pupil dilations were measured when phonologically modified words were detected within a sentence compared to sentences without the nonwords. For vocoded speech, higher peak pupil dilation was observed for sentence stimuli, but not for the isolated nonwords, although performance decreased similarly for both tasks.

Conclusion

Our findings demonstrate the complexity of pupil dynamics in the presence of acoustic and phonological manipulation. Pupil responses seemed to reflect higher-level cognitive and lexical processing related to phonological perception rather than low-level perception of acoustic cues. However, the incorporation of multiple talkers in the stimuli, coupled with the relatively low task complexity, may have affected the pupil dilation.

Auditory, Lexical, and Multitasking Demands Interactively Impact Listening Effort

PURPOSE

This study examined the extent to which acoustic, linguistic, and cognitive task demands interactively impact listening effort.

METHOD

Using a dual-task paradigm, on each trial, participants were instructed to perform either a single task or two tasks. In the primary word recognition task, participants repeated Northwestern University Auditory Test No. 6 words presented in speech-shaped noise at either an easier or a harder signal-to-noise ratio (SNR). The words varied in how commonly they occur in the English language (lexical frequency). In the secondary visual task, participants were instructed to press a specific key as soon as a number appeared on screen (simpler task) or one of two keys to indicate whether the visualized number was even or odd (more complex task).

RESULTS

Manipulation checks revealed that key assumptions of the dual-task design were met. A significant three-way interaction was observed, such that the expected effect of SNR on effort was only observable for words with lower lexical frequency and only when multitasking demands were relatively simpler.

CONCLUSIONS

This work reveals that variability across speech stimuli can influence the sensitivity of the dual-task paradigm for detecting changes in listening effort. In line with previous work, the results of this study also suggest that higher cognitive demands may limit the ability to detect expected effects of SNR on measures of effort. With implications for real-world listening, these findings highlight that even relatively minor changes in lexical and multitasking demands can alter the effort devoted to listening in noise.

The use of lexical semantics for processing face-masked speech in monolinguals and bilinguals

Face masks impede visual and acoustic cues that help make speech processing and language comprehension more efficient. Many studies report this phenomenon, but few examined how listeners utilize semantic information to overcome the challenges posed by face masks. Fewer still investigated this impact on bilinguals' processing of face-masked speech [Smiljanic, Keerstock, Meemann, and Ransom, S. M. (2021). J. Acoust. Soc. Am. 149(6), 4013-4023; Truong, Beck, and Weber (2021). J. Acoust. Soc. Am. 149(1), 142-144]. Therefore, this study aims to determine how monolingual and bilingual listeners use semantic information to compensate for the loss of visual and acoustic information when the speaker is wearing a mask. A lexical priming experiment tested how monolingual listeners and early-acquiring simultaneous bilingual listeners responded to video of English word pairs. The prime-target pairs were either strongly related, weakly related, or unrelated and were both either masked or unmasked. Analyses of reaction time results showed an overall effect of masking in both groups and an effect of semantic association strength on processing masked and unmasked speech. However, speaker groups were not different; subsequent analyses of difference values showed no effect of semantic context. These results illustrate the limited role of word-level semantic information on processing in adverse listening conditions. Results are discussed in light of semantic processing at the sentence level.

Energetic and informational masking place dissociable demands on listening effort: Evidence from simultaneous electroencephalography and pupillometrya)

The task of processing speech masked by concurrent speech/noise can pose a substantial challenge to listeners. However, performance on such tasks may not directly reflect the amount of listening effort they elicit. Changes in pupil size and neural oscillatory power in the alpha range (8-12 Hz) are prominent neurophysiological signals known to reflect listening effort; however, measurements obtained through these two approaches are rarely correlated, suggesting that they may respond differently depending on the specific cognitive demands (and, by extension, the specific type of effort) elicited by specific tasks. This study aimed to compare changes in pupil size and alpha power elicited by different types of auditory maskers (highly confusable intelligible speech maskers, speech-envelope-modulated speech-shaped noise, and unmodulated speech-shaped noise maskers) in young, normal-hearing listeners. Within each condition, the target-to-masker ratio was set at the participant's individually estimated 75% correct point on the psychometric function. The speech masking condition elicited a significantly greater increase in pupil size than either of the noise masking conditions, whereas the unmodulated noise masking condition elicited a significantly greater increase in alpha oscillatory power than the speech masking condition, suggesting that the effort needed to solve these respective tasks may have different neural origins.

The effects of speech masking on neural tracking of acoustic and semantic features of natural speech

Listening environments contain background sounds that mask speech and lead to communication challenges. Sensitivity to slow acoustic fluctuations in speech can help segregate speech from background noise. Semantic context can also facilitate speech perception in noise, for example, by enabling prediction of upcoming words. However, not much is known about how different degrees of background masking affect the neural processing of acoustic and semantic features during naturalistic speech listening. In the current electroencephalography (EEG) study, participants listened to engaging, spoken stories masked at different levels of multi-talker babble to investigate how neural activity in response to acoustic and semantic features changes with acoustic challenges, and how such effects relate to speech intelligibility. The pattern of neural response amplitudes associated with both acoustic and semantic speech features across masking levels was U-shaped, such that amplitudes were largest for moderate masking levels. This U-shape may be due to increased attentional focus when speech comprehension is challenging, but manageable. The latency of the neural responses increased linearly with increasing background masking, and neural latency change associated with acoustic processing most closely mirrored the changes in speech intelligibility. Finally, tracking responses related to semantic dissimilarity remained robust until severe speech masking (-3 dB SNR). The current study reveals that neural responses to acoustic features are highly sensitive to background masking and decreasing speech intelligibility, whereas neural responses to semantic features are relatively robust, suggesting that individuals track the meaning of the story well even in moderate background sound.

Listening efficiency in adult cochlear-implant users compared with normally-hearing controls at ecologically relevant signal-to-noise ratios

Introduction

Due to having to work with an impoverished auditory signal, cochlear-implant (CI) users may experience reduced speech intelligibility and/or increased listening effort in real-world listening situations, compared to their normally-hearing (NH) peers. These two challenges to perception may be usefully integrated in a measure of listening efficiency: conceptually, the amount of accuracy achieved for a certain amount of effort expended.

Methods

We describe a novel approach to quantifying listening efficiency based on the rate of evidence accumulation toward a correct response in a linear ballistic accumulator (LBA) model of choice decision-making. Estimation of this objective measure within a hierarchical Bayesian framework confers further benefits, including full quantification of uncertainty in parameter estimates. We applied this approach to examine the speech-in-noise performance of a group of 24 CI users (M age: 60.3, range: 20-84 years) and a group of 25 approximately age-matched NH controls (M age: 55.8, range: 20-79 years). In a laboratory experiment, participants listened to reverberant target sentences in cafeteria noise at ecologically relevant signal-to-noise ratios (SNRs) of +20, +10, and +4 dB SNR. Individual differences in cognition and self-reported listening experiences were also characterised by means of cognitive tests and hearing questionnaires.

Results

At the group level, the CI group showed much lower listening efficiency than the NH group, even in favourable acoustic conditions. At the individual level, within the CI group (but not the NH group), higher listening efficiency was associated with better cognition (i.e., working-memory and linguistic-closure) and with more positive self-reported listening experiences, both in the laboratory and in daily life.

Discussion

We argue that listening efficiency, measured using the approach described here, is: (i) conceptually well-motivated, in that it is theoretically impervious to differences in how individuals approach the speed-accuracy trade-off that is inherent to all perceptual decision making; and (ii) of practical utility, in that it is sensitive to differences in task demand, and to differences between groups, even when speech intelligibility remains at or near ceiling level. Further research is needed to explore the sensitivity and practical utility of this metric across diverse listening situations.

Speech recognition in noise task among children and young-adults: a pupillometry study

Introduction

Children experience unique challenges when listening to speech in noisy environments. The present study used pupillometry, an established method for quantifying listening and cognitive effort, to detect temporal changes in pupil dilation during a speech-recognition-in-noise task among school-aged children and young adults.

Methods

Thirty school-aged children and 31 young adults listened to sentences amidst four-talker babble noise in two signal-to-noise ratios (SNR) conditions: high accuracy condition (+10 dB and  + 6 dB, for children and adults, respectively) and low accuracy condition (+5 dB and + 2 dB, for children and adults, respectively). They were asked to repeat the sentences while pupil size was measured continuously during the task.

Results

During the auditory processing phase, both groups displayed pupil dilation; however, adults exhibited greater dilation than children, particularly in the low accuracy condition. In the second phase (retention), only children demonstrated increased pupil dilation, whereas adults consistently exhibited a decrease in pupil size. Additionally, the children's group showed increased pupil dilation during the response phase.

Discussion

Although adults and school-aged children produce similar behavioural scores, group differences in dilation patterns point that their underlying auditory processing differs. A second peak of pupil dilation among the children suggests that their cognitive effort during speech recognition in noise lasts longer than in adults, continuing past the first auditory processing peak dilation. These findings support effortful listening among children and highlight the need to identify and alleviate listening difficulties in school-aged children, to provide proper intervention strategies.

Clear speech promotes speaking rate normalization

When speaking in noisy conditions or to a hearing-impaired listener, talkers often use clear speech, which is typically slower than conversational speech. In other research, changes in speaking rate affect speech perception through speaking rate normalization: Slower context sounds encourage perception of subsequent sounds as faster, and vice versa. Here, on each trial, listeners heard a context sentence before the target word (which varied from "deer" to "tier"). Clear and slowed conversational context sentences elicited more "deer" responses than conversational sentences, consistent with rate normalization. Changing speaking styles aids speech intelligibility but might also produce other outcomes that alter sound/word recognition.

Time Scales and Moments of Listening Effort Revealed in Pupillometry

This article offers a collection of observations that highlight the value of time course data in pupillometry and points out ways in which these observations create deeper understanding of listening effort. The main message is that listening effort should be considered on a moment-to-moment basis rather than as a singular amount. A review of various studies and the reanalysis of data reveal distinct signatures of effort before a stimulus, during a stimulus, in the moments after a stimulus, and changes over whole experimental testing sessions. Collectively these observations motivate questions that extend beyond the "amount" of effort, toward understanding how long the effort lasts, and how precisely someone can allocate effort at specific points in time or reduce effort at other times. Apparent disagreements between studies are reconsidered as informative lessons about stimulus selection and the nature of pupil dilation as a reflection of decision making rather than the difficulty of sensory encoding.

The effect of modality onset asynchrony and processing time on the recognition of text-supplemented speech

This study examined the effect of modality onset asynchrony and response processing time for the recognition of text-supplemented speech. Speech and text were periodically interrupted by noise or black bars, respectively, to preserve 50% of the sentence and presented in unimodal and multimodal conditions. Sentence recognition and response errors were assessed for responses made simultaneous with the stimulus or after its presentation. Increased processing time allowed for the cognitive repair of initial response errors in working memory. Text-supplemented speech was best recognized with minimal temporal asynchrony. Overall, text supplementation facilitated the recognition of degraded speech when provided sufficient processing time.

Ordinal Pattern Analysis: A Tutorial on Assessing the Fit of Hypotheses to Individual Repeated Measures Data

PURPOSE

This article provides a tutorial introduction to ordinal pattern analysis, a statistical analysis method designed to quantify the extent to which hypotheses of relative change across experimental conditions match observed data at the level of individuals. This method may be a useful addition to familiar parametric statistical methods including repeated measures analysis of variance and generalized linear mixed-effects models, particularly when analyzing inherently individual characteristics, such as perceptual processes, and where experimental effects are usefully modeled in relative rather than absolute terms.

METHOD

Three analyses of increasing complexity are demonstrated using ordinal pattern analysis. An initial analysis of a very small data set is designed to explicate the simple mathematical calculations that make up ordinal pattern analysis, which can be performed without the aid of a computer. Analyses of slightly larger data sets are used to demonstrate familiar concepts, including comparison of competing hypotheses, handling missing data, group comparisons, and pairwise tests. All analyses can be reproduced using provided code and data.

RESULTS

Ordinal pattern analysis results are presented, along with an analogous linear mixed-effects analysis, to illustrate the similarities and differences in information provided by ordinal pattern analysis in comparison to familiar parametric methods.

CONCLUSION

Although ordinal pattern analysis does not produce familiar numerical effect sizes, it does provide highly interpretable results in terms of the proportion of individuals whose results are consistent with a hypothesis, along with individual and group-level statistics, which quantify hypothesis performance.

The Involvement of Listening Effort in Explaining Bilingual Listening Under Adverse Listening Conditions

The current review examines listening effort to uncover how it is implicated in bilingual performance under adverse listening conditions. Various measures of listening effort, including physiological, behavioral, and subjective measures, have been employed to examine listening effort in bilingual children and adults. Adverse listening conditions, stemming from environmental factors, as well as factors related to the speaker or listener, have been examined. The existing literature, although relatively limited to date, points to increased listening effort among bilinguals in their nondominant second language (L2) compared to their dominant first language (L1) and relative to monolinguals. Interestingly, increased effort is often observed even when speech intelligibility remains unaffected. These findings emphasize the importance of considering listening effort alongside speech intelligibility. Building upon the insights gained from the current review, we propose that various factors may modulate the observed effects. These include the particular measure selected to examine listening effort, the characteristics of the adverse condition, as well as factors related to the particular linguistic background of the bilingual speaker. Critically, further research is needed to better understand the impact of these factors on listening effort. The review outlines avenues for future research that would promote a comprehensive understanding of listening effort in bilingual individuals.

Intelligibility as a measure of speech perception: Current approaches, challenges, and recommendations

Intelligibility measures, which assess the number of words or phonemes a listener correctly transcribes or repeats, are commonly used metrics for speech perception research. While these measures have many benefits for researchers, they also come with a number of limitations. By pointing out the strengths and limitations of this approach, including how it fails to capture aspects of perception such as listening effort, this article argues that the role of intelligibility measures must be reconsidered in fields such as linguistics, communication disorders, and psychology. Recommendations for future work in this area are presented.

Identifying Listeners Whose Speech Intelligibility Depends on a Quiet Extra Moment After a Sentence

PURPOSE

An extra moment after a sentence is spoken may be important for listeners with hearing loss to mentally repair misperceptions during listening. The current audiologic test battery cannot distinguish between a listener who repaired a misperception versus a listener who heard the speech accurately with no need for repair. This study aims to develop a behavioral method to identify individuals who are at risk for relying on a quiet moment after a sentence.

METHOD

Forty-three individuals with hearing loss (32 cochlear implant users, 11 hearing aid users) heard sentences that were followed by either 2 s of silence or 2 s of babble noise. Both high- and low-context sentences were used in the task.

RESULTS

Some individuals showed notable benefit in accuracy scores (particularly for high-context sentences) when given an extra moment of silent time following the sentence. This benefit was highly variable across individuals and sometimes absent altogether. However, the group-level patterns of results were mainly explained by the use of context and successful perception of the words preceding sentence-final words.

CONCLUSIONS

These results suggest that some but not all individuals improve their speech recognition score by relying on a quiet moment after a sentence, and that this fragility of speech recognition cannot be assessed using one isolated utterance at a time. Reliance on a quiet moment to repair perceptions would potentially impede the perception of an upcoming utterance, making continuous communication in real-world scenarios difficult especially for individuals with hearing loss. The methods used in this study-along with some simple modifications if necessary-could potentially identify patients with hearing loss who retroactively repair mistakes by using clinically feasible methods that can ultimately lead to better patient-centered hearing health care.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.21644801.

Interaural speech asymmetry predicts bilateral speech intelligibility but not listening effort in adults with bilateral cochlear implants

Introduction

Bilateral cochlear implants (BiCIs) can facilitate improved speech intelligibility in noise and sound localization abilities compared to a unilateral implant in individuals with bilateral severe to profound hearing loss. Still, many individuals with BiCIs do not benefit from binaural hearing to the same extent that normal hearing (NH) listeners do. For example, binaural redundancy, a speech intelligibility benefit derived from having access to duplicate copies of a signal, is highly variable among BiCI users. Additionally, patients with hearing loss commonly report elevated listening effort compared to NH listeners. There is some evidence to suggest that BiCIs may reduce listening effort compared to a unilateral CI, but the limited existing literature has not shown this consistently. Critically, no studies to date have investigated this question using pupillometry to quantify listening effort, where large pupil sizes indicate high effort and small pupil sizes indicate low effort. Thus, the present study aimed to build on existing literature by investigating the potential benefits of BiCIs for both speech intelligibility and listening effort.

Methods

Twelve BiCI adults were tested in three listening conditions: Better Ear, Poorer Ear, and Bilateral. Stimuli were IEEE sentences presented from a loudspeaker at 0° azimuth in quiet. Participants were asked to repeat back the sentences, and responses were scored by an experimenter while changes in pupil dilation were measured.

Results

On average, participants demonstrated similar speech intelligibility in the Better Ear and Bilateral conditions, and significantly worse speech intelligibility in the Poorer Ear condition. Despite similar speech intelligibility in the Better Ear and Bilateral conditions, pupil dilation was significantly larger in the Bilateral condition.

Discussion

These results suggest that the BiCI users tested in this study did not demonstrate binaural redundancy in quiet. The large interaural speech asymmetries demonstrated by participants may have precluded them from obtaining binaural redundancy, as shown by the inverse relationship between the two variables. Further, participants did not obtain a release from effort when listening with two ears versus their better ear only. Instead, results indicate that bilateral listening elicited increased effort compared to better ear listening, which may be due to poor integration of asymmetric inputs.

Interactions between acoustic challenges and processing depth in speech perception as measured by task-evoked pupil response

Speech perception under adverse conditions is a multistage process involving a dynamic interplay among acoustic, cognitive, and linguistic factors. Nevertheless, prior research has primarily focused on factors within this complex system in isolation. The primary goal of the present study was to examine the interaction between processing depth and the acoustic challenge of noise and its effect on processing effort during speech perception in noise. Two tasks were used to represent different depths of processing. The speech recognition task involved repeating back a sentence after auditory presentation (higher-level processing), while the tiredness judgment task entailed a subjective judgment of whether the speaker sounded tired (lower-level processing). The secondary goal of the study was to investigate whether pupil response to alteration of dynamic pitch cues stems from difficult linguistic processing of speech content in noise or a perceptual novelty effect due to the unnatural pitch contours. Task-evoked peak pupil response from two groups of younger adult participants with typical hearing was measured in two experiments. Both tasks (speech recognition and tiredness judgment) were implemented in both experiments, and stimuli were presented with background noise in Experiment 1 and without noise in Experiment 2. Increased peak pupil dilation was associated with deeper processing (i.e., the speech recognition task), particularly in the presence of background noise. Importantly, there is a non-additive interaction between noise and task, as demonstrated by the heightened peak pupil dilation to noise in the speech recognition task as compared to in the tiredness judgment task. Additionally, peak pupil dilation data suggest dynamic pitch alteration induced an increased perceptual novelty effect rather than reflecting effortful linguistic processing of the speech content in noise. These findings extend current theories of speech perception under adverse conditions by demonstrating that the level of processing effort expended by a listener is influenced by the interaction between acoustic challenges and depth of linguistic processing. The study also provides a foundation for future work to investigate the effects of this complex interaction in clinical populations who experience both hearing and cognitive challenges.