Speech-perception training for older adults with hearing loss impacts word recognition and effort.

The current pupillometry study examined the impact of speech-perception training on word recognition and cognitive effort in older adults with hearing loss. Trainees identified more words at the follow-up than at the baseline session. Training also resulted in an overall larger and faster peaking pupillary response, even when controlling for performance and reaction time. Perceptual and cognitive capacities affected the peak amplitude of the pupil response across participants but did not diminish the impact of training on the other pupil metrics. Thus, we demonstrated that pupillometry can be used to characterize training-related and individual differences in effort during a challenging listening task. Importantly, the results indicate that speech-perception training not only affects overall word recognition, but also a physiological metric of cognitive effort, which has the potential to be a biomarker of hearing loss intervention outcome.