Listening effort and fatigue What are we measuring? Dr Piers Dawes

Transcription

1 Listening effort and fatigue What are we measuring? Dr Piers Dawes

2 I went to a great conference today. It was riveting and I was hooked on pretty much every word. And then I got home and collapsed on the sofa. I m not just tired, I m shattered. I ve had to turn my ears off to rest in silence and my eyes are burning When I was younger, I was a little embarrassed to be so tired all the time. I would force myself to go out and be busy all I wanted to do was crawl under the sofa and nap Adult with hearing loss (Bess & Hornsby, 2014)

3 Audiological measures Audiogram Speech recognition tests Hearing questionnaires Hearing sensitivity; fit hearing aid to compensate for loss of audibility Accuracy of speech recognition Hearing disability & hearing aid benefit Listening effort / fatigue? Optimal fit (based on audiogram) and good speech recognition But listening may still be challenging and tiring.

4 Definitions Listening effort refers to the mental exertion required to attend to and understand an auditory message Listening-related fatigue refers to extreme tiredness resulting from effortful listening McGarrigle, R., Munro, K., Stewart, A. J., Dawes, P., Moore, D. R., Barry, J. G., & Amitay, S. (2014). Listening effort and fatigue: what exactly are we measuring? A British Society of audiology Cognition in Hearing Special interest Group white paper. International Journal of Audiology. International Journal of Audiology.

5 Edwards, B. (2007). The future of hearing aid technology. Trends in Amplification, 11(1),

6 Summary so far Effort/fatigue possibly an important (unmeasured) aspect of hearing disability The mental effort required to listen detracts from other tasks (e.g. comprehension) Measures of effort/fatigue could optimise interventions/technology that reduce effort/fatigue, individualise treatment

7 Measures of effort 1.Self-report 2.Behavioural 3.Physiological

8 1. Self-report NASA task load index (Hart & Staveland) -multi-dimensional effort; 6 work-load related factors based on a model of workload -mental, physical, temporal, performance, effort, frustration X

9 Speech, Spatial and Qualities of Hearing Scale (SSQ) Do you have to concentrate very much when listening to someone or something? Can you easily ignore other sounds when trying to listen to something? Do you have to put in a lot of effort to hear what is being said in conversation with others? Gatehouse, S., & Noble, W. (2004). The Speech, Spatial and Qualities of Hearing Scale (SSQ). International Journal of Audiology 43(2),

10 New & experienced HA users Rate SSQ difference over 3 months Speech (20) Spatial (20) Quality (20) Effort (10) Total (70) Dawes, P., Munro, K., Kalluri, S., & Edwards, B. (2014). Acclimatization to hearing aids. Ear & Hearing, 35(2),

11 1. Self-report Advantages Cheap, quick, easy to administer No special equipment required No particular expertise required to administer or interpret Disadvantages Relies on good introspection (cognitively impaired, or children) Subjective; one person finds effortful may not equate with another person s idea of effort No validated self-report measures about hearing fatigue/effort Sensitivity (?) Influenced by task accuracy(?)

12 2. Behavioral Single or dual-task paradigm Single: respond to target word/sentence Time taken to respond = effort Early studies: Downs (1982), Gatehouse & Gordon (1990)

13 Single task Digit triplet test The digits, three, one, nine 1. Identification: identify the final digit in a triplet 2. Arithmetic: calculate the sum of the initial and the final digits in a triplet Houben, R., van Doorn-Bierman, M., & Dreschler, W. A. (2013). Using response time to speech as a measure for listening effort. International Journal of Audiology, 52(11),

14 Answers: Identification: 6, 3, 5 Arithmatic: 7, 9, 5

15 *Recognition accuracy > 80%

16 Single task Advantages Fast processing rate might be important Use equipment available in audiology clinics Disadvantages Not clear that increased effort = slower responses

17 Dual-task Primary speech recognition task Secondary task; memory or reaction time Limited capacity of cognitive resource Two tasks compete for resources As one task becomes more taxing, resource capacity is exceeded and performance on the secondary task worsens

18 Dual Task Primary: Repeat sentences in noise, eg The boat slid on the smooth rocks Secondary: Visual reaction time Sarampalis, A., Kalluri, S., Edwards, B., & Hafter, E. (2009). Objective measures of listening effort: Effects of background noise and noise reduction. Journal of Speech, Language and Hearing Research, 52,

19 Draw arrows on your note pad:

20 Numbers (1-9) on either left or right of the screen Press the arrow that points toward the even number and away from the odd number

21 4 21

22 3

23 23 4

24 3

25 Repeat target sentences Respond to numbers as fast as possible

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27 Young NH subjects, Simulated effect of NR At low SNR (-6 db), no positive effect of NR on speech, but better performance on secondary tasks Sarampalis, A., Kalluri, S., Edwards, B., & Hafter, E. (2009). Objective measures of listening effort: Effects of background noise and noise reduction. Journal of Speech, Language and Hearing Research, 52,

28 Dual task Advantages Face validity like real life multi-tasking Use equipment available in audiology clinics Disadvantages Assumes i) all cognitive capacity taken by both tasks ii) all remaining resources devoted to the second task, with first task as priority Multi task or task switching?

29 3. Physiological Measures of brain activity or nervous system arousal linked to task difficulty fmri, EEG, skin conductance, heart rate, muscle tension, pupil size, hormone levels (cortisol)

30 Pupil size Pupil dilation reflects listening effort - larger task-evoked pupil size in more challenging listening conditions

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32 Kramer, S. E., Kapteyn, T. S., Festen, J. M., & Kuik, D. J. (1997). Assessing aspects of auditory handicap by means of pupil dilatation. International Journal of Audiology. International Journal of Audiology, 36(3),

33 3. Physiological Advantages Objective measure Could be sensitive (?) to differences between listening conditions and individuals Disadvantages Age differences in physiology Sensitive to stress/emotion Need special expensive equipment Need expertise in analysis and interpretation Need controlled conditions

34 Measures of effort 1.Self-report 2.Behavioural 3.Physiological

35 Unanswered questions How important is effort? Is fatigue more important than effort? How does effort relate to fatigue? Measures do not always agree with each other. Which are the most reliable and valid measures? Which measures are applicable in research vs clinical settings? McGarrigle, R., Munro, K., Stewart, A. J., Dawes, P., Moore, D. R., Barry, J. G., & Amitay, S. (2014). Listening effort and fatigue: what exactly are we measuring? A British Society of Audiology Cognition in Hearing Special interest Group white paper. International Journal of Audiology. International Journal of Audiology.

36 Clinical applications, Future Additional outcome measure Individualise treatment, choose features New treatments; e.g. Cognitively controlled hearing aid

37 Clinical Applications, Now Questionnaire e.g. SSQ effort-related questions or general effort/fatigue one (NASA TLX, or Fatigue Assessment Scale) Michielsen, H. J., De Vries, J., Van Heck, G. L., Van de Vijver, F. J., & Sijtsma, K. (2004). Examination of the Dimensionality of Fatigue: The Construction of the Fatigue Assessment Scale (FAS). European Journal of Psychological Assessment, 20(1), 39.

38 Workshop on listening effort and fatigue BSA special interest group for cognition in hearing University of Manchester April 2015 (date TBC) Limited places Contact Ronan McGarrigle for details

39 Acknowledgements Ronan McGarrigle *, Kevin J. Munro *,, Andrew J. Stewart *, David R. Moore,* Johanna G. Barry & Sygal Amitay * School of Psychological Sciences, the University of Manchester, UK Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK Communication Sciences Research Center, Cincinnati Children s Hospital Medical Center, Cincinnati, Ohio, USA, MRC Institute of Hearing Research, Nottingham, UK Piers.dawes@manchester.ac.uk