Communication Under Sharply Degraded Auditory Input and the "2-Sentence" Problem.
Communication Under Sharply Degraded Auditory Input and the "2-Sentence" Problem.
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听觉输入急剧退化和“两句话”问题下的通信。
DOI：
10.1097/aud.0000000000001500
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发表时间：
2024
期刊：
影响因子：
3.7
通讯作者：
Wingfield,Arthur
中科院分区：
文献类型：
--
作者：
Svirsky,MarioA;Neukam,JonathanD;Capach,NicoleHope;Amichetti,NicoleM;Lavender,Annette;Wingfield,Arthur
目的：尽管在言语感知的标准临床评估中表现良好，但许多人工耳蜗（CI）用户报告在现实环境中听力时遇到重大困难。我们推测，这种脱节可能与目前临床和研究实验室中使用的测试的生态有效性有限有关。由CI提供的降级的听觉信息所带来的挑战，再加上听众有限的认知资源，可能会导致在处理比临床测试中使用的单个单词或单个句子更苛刻的语音材料时遇到困难。设计：在这里，我们调查语音识别性能和处理努力是否（通过瞳孔扩张测量指数）受到影响时，CI用户或正常-听力控制受试者被要求重复两个句子顺序呈现，而不是只有一个sentence.Results：响应准确性在正常听力的听众影响最小，但CI用户表现出广泛的结果，从没有变化到递减高达45个百分点。根据CI用户在标准临床测试中的表现，无法预测递减量。在CI组和听力正常组中，瞳孔测量与任务难度密切相关，即使后者在所有条件下的言语感知分数接近上限水平。（但不是所有）CI用户对仅比标准临床测试更具挑战性的输入的响应;具体地，当在请求响应之前顺序呈现两个句子时，而不是一次仅呈现单个句子。这种潜在的“2句问题”代表了最简单的可能情况之一，超越了在大多数言语感知临床测试中使用的单个单词或句子的呈现，它提出了一种可能性，即即使是在单句测试中表现良好的人也可能受到其他生态相关操作的严重损害。目前的研究结果还提出了一种可能性，即临床版本的2句测试可以提供可操作的信息咨询和康复CI用户，并与他们密切互动的人。
Objectives:Despite performing well in standard clinical assessments of speech perception, many cochlear implant (CI) users report experiencing significant difficulties when listening in real-world environments. We hypothesize that this disconnect may be related, in part, to the limited ecological validity of tests that are currently used clinically and in research laboratories. The challenges that arise from degraded auditory information provided by a CI, combined with the listener’s finite cognitive resources, may lead to difficulties when processing speech material that is more demanding than the single words or single sentences that are used in clinical tests.Design:Here, we investigate whether speech identification performance and processing effort (indexed by pupil dilation measures) are affected when CI users or normal-hearing control subjects are asked to repeat two sentences presented sequentially instead of just one sentence.Results:Response accuracy was minimally affected in normal-hearing listeners, but CI users showed a wide range of outcomes, from no change to decrements of up to 45 percentage points. The amount of decrement was not predictable from the CI users’ performance in standard clinical tests. Pupillometry measures tracked closely with task difficulty in both the CI group and the normal-hearing group, even though the latter had speech perception scores near ceiling levels for all conditions.Conclusions:Speech identification performance is significantly degraded in many (but not all) CI users in response to input that is only slightly more challenging than standard clinical tests; specifically, when two sentences are presented sequentially before requesting a response, instead of presenting just a single sentence at a time. This potential “2-sentence problem” represents one of the simplest possible scenarios that go beyond presentation of the single words or sentences used in most clinical tests of speech perception, and it raises the possibility that even good performers in single-sentence tests may be seriously impaired by other ecologically relevant manipulations. The present findings also raise the possibility that a clinical version of a 2-sentence test may provide actionable information for counseling and rehabilitating CI users, and for people who interact with them closely.
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