Effects of hearing aid use and background noise on listening effort in children who are hard of hearing

Margaret E. Dallapiazza, Elizabeth A. Walker, Caitlin Sapp, Bailey R. Tatge

Department of Communication Sciences and Disorders, The University of Iowa
Background Methods Results, cont.
 Listening effort is defined as the allocation of mental resources to overcome  An unaided SNR-70 was obtained using an adaptive procedure from the Hearing  In the dual-task paradigm, Dual-task secondary RTs
obstacles in goal pursuit during listening tasks (Pichora-Fuller et al., 2016). in Noise Test (HINT). Participants repeated 20 HINT sentences in speech-shaped there was a significant
 In adverse listening conditions such as background noise, children expend noise with varying SNRs to determine the SNR at which participants are 70% effect for HA status (p =
increased listening effort (Hicks & Tharpe, 2002). accurate. .05). CHH showed faster RTs
 Increased listening effort results in greater stress, fatigue, and frustration in  Participants practiced rating effort using visual supports (ex: lifting a feather vs. on the secondary task in
children who are hard of hearing (CHH) relative to hearing peers (Hornsby et al., a table). the aided conditions. There
2014). Additionally, increased fatigue has a negative impact on language and  Dual-task procedure: was no effect of noise
academic outcomes (Werfel & Hendricks, 2016). 1) Primary task: participants repeated 20 HINT sentences condition and no
 Although hearing aids (HAs) are the primary approach for habilitation for CHH, 2) Secondary task: Reaction time (RT) task required participants to press space interaction.
HAs may not be worn consistently (Walker et al., 2013, 2015; Gustafson et al., bar in response to seeing a color word appear on monitor (Wu et al., 2016)
2015).  Participants completed 4 dual-task conditions,
 HAs are thought to reduce listening effort by increasing access to the speech 4 primary task conditions, and 1 secondary Self-report ratings
 For self-report ratings of
spectrum, thus reducing cognitive load. HAs can reduce listening effort in adults
(Downs, 1982; Hornsby, 2013); however, McGarrigle et al. (2018) reported that
task condition.
 Dual-Task at SNR-70 (Aided & Unaided)
YELLOW perceived effort, there was a
significant effect for HA status (p
HA use did not reduce listening effort in CHH.  Dual-Task in Quiet (Aided & Unaided) Red Yellow
= .01) and noise condition (p =
 The purpose of this research study is to determine the effects of HA use and  Speech only at SNR-70 (Aided & Unaided) Blue Green
.03). CHH reported less effort on
background noise on listening effort in CHH.  Speech only in Quiet (Aided & Unaided) the primary task in the aided
 After each condition participants rated their condition and in quiet. There
Research Questions effort for both tasks using the subjective rating was no significant interaction.
scale.
1. How does listening with HAs impact listening effort in CHH relative to listening
 Dependent variables: 1) primary task (speech
without HAs?
recognition); 2) change in secondary task RT
2. How does listening in background noise impact listening effort in CHH relative to
listening in quiet?
from baseline (RTE-RTB); 3) primary task Discussion
subjective ratings  Using both a dual-task paradigm and subjective ratings, the current findings
Participants Results indicate that amplification reduces listening effort in children with mild to
 32 CHH with bilateral hearing loss and binaural HAs participated Mean SNR-70 Standard Deviation Range
moderately severe hearing loss.
 These results are consistent with findings in the adult listening effort literature
Demographic Characteristics M SD Degree of HL % n +16.56 18.63 -2 to 58
(Downs, 1982), but inconsistent with a study by McGarrigle et al. (2018). The
Chronological Age (yrs) 10.2 1.2 Slight or Mild 56.25 18 Primary Task Percentage Correct inconsistency in the two studies may be due to a narrower age range in the
Dual Task Speech Only current research (8-11 year olds compared to 6-13 year olds), use of sentence-
Age at Confirmation of HL (mos) 18.0 27.4 Moderate 37.5 12
Aided Aided Unaided Unaided Aided Aided Unaided Unaided level stimuli instead of word-level, and/or use of equated-performance SNRs
Age at HA Fitting (mos) 19.7 27.9 Mod-Severe 6.25 2 Quiet SNR-70 Quiet SNR-70 Quiet SNR-70 Quiet SNR-70 instead of equated-level SNRs.
Better-Ear PTA (dB HL) 42.6 11.4 Mean  Future directions include examining additional underlying factors that may
98.24% 88.24% 84.17% 78.16% 97.96% 89.94% 81.37% 76.23%
Sex % n reduce listening effort in CHH, including language and working memory skills.
SD
Male 40.6 13
2.03 14.5 24.91 22.55 2.55 11.8 28.51 25.03 Funding Sources and Acknowledgements
For primary task speech recognition scores, there was a significant main effect of HA NIH-NIDCD R21 DC015832 (PI: Elizabeth Walker). The authors would like to thank Wendy Fick and Marlea O’Brien for help
Female 60.4 19 status (p = .004), noise condition (p = .001), and a significant interaction (p = .04) with project coordination , Rick Arenas for help with database management, and Yu-Hsiang Wu for providing dual-task
stimuli, as well as the children and families who participated in this study.