Pichora-Fuller M Kathleen
Department of Psychology, University of Toronto, Mississauga, Ontario, Canada.
Int J Audiol. 2003 Jul;42 Suppl 2:2S26-32.
Over the last decade, much research has been conducted to investigate why older listeners report more difficulty in understanding spoken language than would be expected given their degree of audiometric hearing loss. Of particular relevance to audiological rehabilitation is recent research on older listeners when they are engaged in complex tasks involving the auditory processing of naturalistic signals in realistic social and physical environments Discourse epitomizes such activity. By understanding age-related and individual differences in perceptual and cognitive performance, we gain important insights into how hearing impairments influence activity and participation in context. In this paper, the problems of older adults as communicators in everyday life are illuminated by studies showing that auditory processing problems affect cognitive processing. Age-related problems in understanding spoken language are exacerbated by perceptual stressors such as noise and by cognitive stressors such as memory load. It is argued that the significance of these processing problems during discourse depends on social-emotional factors Therefore, goals for new signal-processing technologies designed for older adults who are hard of hearing can be framed not only in terms of improving signal audibility but also in terms of reducing stress on the listener during information processing. Furthermore, goals for therapeutic interventions can be framed in terms of reducing stress during information processing by modifying behaviors and physical and social environments to achieve the listener's goals.
在过去十年中，人们进行了大量研究，以探究为何老年听众在理解口语方面比根据其听力计听力损失程度预期的更困难。与听力康复特别相关的是最近对老年听众在参与涉及现实社会和物理环境中自然主义信号听觉处理的复杂任务时的研究。语篇就是这种活动的典型代表。通过了解感知和认知表现方面与年龄相关的差异以及个体差异，我们对听力障碍如何影响情境中的活动和参与有了重要认识。在本文中，研究表明听觉处理问题会影响认知处理，从而揭示了老年人在日常生活中作为沟通者所面临的问题。与年龄相关的理解口语的问题会因诸如噪音等感知压力源以及诸如记忆负荷等认知压力源而加剧。有人认为，这些处理问题在语篇过程中的重要性取决于社会情感因素。因此，为听力受损的老年人设计的新信号处理技术的目标不仅可以从提高信号可听度的角度来设定，还可以从减少信息处理过程中听众压力的角度来设定。此外，治疗干预的目标可以从通过改变行为以及物理和社会环境以实现听众目标来减少信息处理过程中的压力的角度来设定。
