Department of Psychology, University of Chester, Parkgate Road, Chester, United Kingdom.
Department of Otolaryngology/Head and Neck Surgery, The University of North Carolina at Chapel Hill, Chapel Hill, NC.
Ear Hear. 2019 Mar/Apr;40(2):381-392. doi: 10.1097/AUD.0000000000000623.
Increased listening effort in school-age children with hearing loss (CHL) could compromise learning and academic achievement. Identifying a sensitive behavioral measure of listening effort for this group could have both clinical and research value. This study examined the effects of signal-to-noise ratio (SNR), hearing loss, and personal amplification on 2 commonly used behavioral measures of listening effort: dual-task visual response times (visual RTs) and verbal response times (verbal RTs).
A total of 82 children (aged 6-13 years) took part in this study; 37 children with normal hearing (CNH) and 45 CHL. All children performed a dual-task paradigm from which both measures of listening effort (dual-task visual RT and verbal RT) were derived. The primary task was word recognition in multi-talker babble in three individually selected SNR conditions: Easy, Moderate, and Hard. The secondary task was a visual monitoring task. Listening effort during the dual-task was quantified as the change in secondary task RT from baseline (single-task visual RT) to the dual-task condition. Listening effort based on verbal RT was quantified as the time elapsed from the onset of the auditory stimulus to the onset of the verbal response when performing the primary (word recognition) task in isolation. CHL completed the task aided and/or unaided to examine the effect of amplification on listening effort.
Verbal RTs were generally slower in the more challenging SNR conditions. However, there was no effect of SNR on dual-task visual RT. Overall, verbal RTs were significantly slower in CHL versus CNH. No group difference in dual-task visual RTs was found between CNH and CHL. No effect of amplification was found on either dual-task visual RTs or verbal RTs.
This study compared dual-task visual RT and verbal RT measures of listening effort in the child population. Overall, verbal RTs appear more sensitive than dual-task visual RTs to the negative effects of SNR and hearing loss. The current findings extend the literature on listening effort in the pediatric population by demonstrating that, even for speech that is accurately recognized, school-age CHL show a greater processing speed decrement than their normal-hearing counterparts, a decrement that could have a negative impact on learning and academic achievement in the classroom.
在校龄期听力损失（CHL）儿童中，增加的听力努力可能会影响学习和学业成绩。为这一群体确定一种敏感的听力努力行为测量方法可能具有临床和研究价值。本研究考察了信噪比（SNR）、听力损失和个人放大对两种常用听力努力行为测量方法的影响：双任务视觉反应时间（视觉 RT）和言语反应时间（言语 RT）。
共有 82 名儿童（年龄 6-13 岁）参加了这项研究；37 名正常听力（CNH）儿童和 45 名 CHL 儿童。所有儿童均完成了一项双任务范式，从中得出两种听力努力测量方法（双任务视觉 RT 和言语 RT）。主要任务是在三个单独选择的 SNR 条件下识别多说话者背景噪声中的单词：容易、中等和困难。次要任务是视觉监测任务。双任务期间的听力努力通过从基线（单一任务视觉 RT）到双任务条件的次要任务 RT 的变化来量化。基于言语 RT 的听力努力通过从听觉刺激开始到单独执行主要任务（单词识别）时言语反应开始时的时间流逝来量化。CHL 完成任务时辅助和/或不辅助，以检查放大对听力努力的影响。
在更具挑战性的 SNR 条件下，言语 RT 通常较慢。然而，SNR 对双任务视觉 RT 没有影响。总体而言，CHL 的言语 RT 明显慢于 CNH。在 CNH 和 CHL 之间，双任务视觉 RT 没有发现组间差异。在双任务视觉 RTs 和言语 RTs 上均未发现放大的影响。
本研究比较了儿童群体中双任务视觉 RT 和言语 RT 听力努力测量方法。总体而言，言语 RT 似乎比双任务视觉 RT 更能反映 SNR 和听力损失的负面影响。当前的研究结果通过证明，即使对于准确识别的言语，在校龄期 CHL 中也会表现出比正常听力同龄人更大的处理速度下降，这可能会对课堂学习和学业成绩产生负面影响，从而扩展了儿科人群听力努力的文献。
