Listening Effort Outcome Measures in Adult Populations

Listening effort is being considered clinically as an important indicator of patient success with amplification. Listening effort refers to “the mental exertion required to attend to, and understand, an auditory message”. (McGarrigle et al., 2014) Cognitive ability, age, and degree of hearing impairment all must considered when measuring the effort one is exerting on a specific task. Listening effort can be measured using subjective tools, electrophysiologic measures, or with a dual-task paradigm. Subjective tools include self-reports and questionnaires. Electrophysiologic measures can consist of measuring pupil dilation, heart rate variability, and skin conductance. A dual-task paradigm is set-up with two tasks performed by a person simultaneously. The amount of decline on the secondary task compared to when that task is completed in isolation, indicates the amount of effort that was exerted on the task. Each method has its strengths as well as its limitations. This paper discusses the current research on the various methods to measuring listening effort and provides clinical applications for these outcome measures

Value of Otoacoustic Emissions Testing in Pre-school Hearing Screenings: A Literature Review

Unidentified hearing loss in children can have a potential effect on their speech and language, educational, cognitive, and social development. The goal of early detection is to minimize the effects of hearing loss through the appropriate referral for diagnosis and treatment. Hearing screenings throughout the preschool and school-age years are vital for the detection of a late-onset, late identified, or acquired hearing loss. Three influential organizations known as The American Academy of Audiology (AAA), The American Speech- Language-Hearing Association (ASHA), and The National Center for Hearing Assessment and Management (NCHAM), have considered behavioral pure tone screening as the “gold standard”for hearing screening protocol across a range of age groups. Although ideally this gold standard would be implemented in all cases, there may be some instances in which the recommended protocol is not appropriate. Performing a pure tone hearing screening may not be plausible for large groups of children, or those who are not capable of conditioning to the task. In these cases, the use of Otoacoustic Emissions (OAEs) has been suggested as an alternative. The aim of this literature review is to discuss the purpose of preschool and school-age hearing screenings, which screening tools are effective in identifying hearing loss in children, and what the appropriate protocol should be for those screening tools. If OAEs were to be substituted for pure tone screenings, the selection of the pass/fail criteria and specific protocol should maximize the number of children being correctly identified with a hearing loss

Costs of Hearing Loss Relating to Listening Effort, Fatigue, and Stress

There are many known negative impacts of hearing loss including difficulty communicating, especially in noise, avoidance or withdrawal from social situations, social rejection, strain on relationships with family members and friends, emotional effects, including anxiety, depression, and a decline in self-esteem and confidence. While a large amount of research exists regarding the financial, social, and physical costs of hearing loss, the relationship between hearing loss and listening effort, fatigue, and stress are not as well understood. The aim of this paper is to review research regarding the interrelationship of listening of listening effort, stress, and fatigue, as well as a review of subjective and objective measurements of listening effort, stress, and fatigue. A literature review was conducted using research papers obtained from Pubmed and ComDisDome. It has been inferred that increased mental effort associated with hearing loss can lead to an increase in stress, tension, and fatigue. Although self-report, behavioral, and physiological measurements have shown a relationship between hearing loss and listening effort, stress, and fatigue, there is not a consensus on how best to measure and its clinical implications. It can also be argued that hearing-impaired individuals do not experience increased listening effort, fatigue, and stress, simply because they ignore these types of unfavorable listening environments. Overall, more research is needed to obtain a better understanding of the relationship between hearing loss and listening effort, fatigue, and stress