The impact of extra effort and accumulated fatigue in listeners who wear a cochlear implant

1项目概要/摘要 2听力障碍患者报告听力努力是成功社交的主要障碍 3（Hughes et al. 2018），努力的增加导致焦虑的增加（Morata et al. 2005），提前退休 4（Danermark & Gellerstedt 2004），社会行为和负面自我形象的变化（Hétu et al. 1988），以及 [5]疲劳相关性（Edwards，2007）。研究表明，成年人的生产力较低， 6工作场所，与那些没有遭受疲劳的人相比，工作缺勤，错误和事故增加 7（Ricci et al. 2007;威廉姆森et al. 2011），听力损失工人因投诉休病假的比例更高 8“精神痛苦”（克雷默等人，2006年）。因此，了解沟通的哪些方面至关重要 9是努力为听众与听力障碍，和方式，持续的努力导致积累的心理 10疲劳以前的工作大多是分别研究听力努力和疲劳， 11个实验方法和设计，使努力和疲劳之间的机械联系未知。 12本项目旨在通过扩大以往的工作来解决这一需要，以探讨是否同样的 13有助于倾听努力的机制仅仅是偶发的，或者它们是否直接有助于 14疲劳的积累听力努力的主要机制之一是在心理上修复误解的单词 15当感知语音时;使用上下文来追溯性地修复先前的误解是很费力的（Winn & Teece 16 2021），然而，当预测性地使用相同的上下文时，可以减少工作量（Winn 2016）。该项目的目标是 17到1）确定依赖认知修复来恢复误解如何影响听力努力，以及2）直接 18测量持续努力倾听对累积疲劳的影响。第一个目标是确定 19.修复早期与后期误解单词时的努力时间进程。重要的是，这些结果将 图20显示了在语言处理过程中努力是如何持续的，可能是在句子偏移后的几秒钟。 [21]第二个目标将探索努力的短暂增加是否会累积为疲劳，这将是 22个测量生理（瞳孔测量）和行为（反应时间）。该项目的长期目标是 23提高我们对是什么让CI患者的倾听变得费力的理解， 24有助于倾听努力的相同机制也会导致疲劳，或者仅仅是偶尔的增加 25努力这些目标直接涉及NIDCD的优先事项，即增加我们对疾病机制的了解。 26在更真实的环境中成功沟通所需的认知过程。培训 27计划涉及广泛的指导行为措施，瞳孔测量，和先进的统计分析 28篇与研究相关的文章这项研究将在以下领域的领先专家的指导下进行： 29听力和听力的努力，在一个具有良好的听力损失研究记录的机构， 30个培训赠款，以及临床感觉科学的跨学科合作。

1 Project Summary / Abstract 2 People with hearing impairment report listening effort as a major barrier to successful social communication 3 (Hughes et al. 2018), with increases in effort leading to increases in anxiety (Morata et al. 2005), early retirement 4 (Danermark & Gellerstedt 2004), changes in social behavior and negative self-image (Hétu et al. 1988), and 5 listening-related fatigue (Edwards, 2007). Fatigued adults have been shown to be less productive in the 6 workplace, with increases in work absences, more errors and accidents than those not suffering from fatigue 7 (Ricci et al. 2007; Williamson et al. 2011), and workers with hearing loss taking more sick leave due to complaints 8 of “mental distress” (Kramer et al., 2006). Therefore, it is critical to understand what aspects of communication 9 are effortful for listeners with hearing impairment, and the ways that sustained effort leads to accumulated mental 10 fatigue. Previous work has mostly examined listening effort and fatigue separately, with vastly different 11 experimental methods and designs, leaving the mechanistic connection between effort and fatigue unknown. 12 This project is designed to address that need by expanding on previous work to explore whether the same 13 mechanisms that contribute to listening effort are merely episodic, or whether they directly contribute to 14 accumulated fatigue. One of the primary mechanisms of listening effort is mentally repairing misperceived words 15 when perceiving speech; using context to retroactively repair earlier misperceptions is effortful (Winn & Teece 16 2021), yet the same context when used predictively can reduce effort (Winn 2016). The aims of this project are 17 to 1) identify how reliance on cognitive repair to recover misperceptions affects listening effort, and 2) directly 18 measure the impact of sustained effortful listening on accumulated fatigue. The first aim will result in identifying 19 the time-course of effort when repairing early versus later misperceived words. Importantly, these results will 20 show how effort is sustained during language processing, potentially for several seconds after sentence offset. 21 The second aim will explore whether momentary increases in effort accumulate to fatigue, which will be 22 measured physiologically (pupillometry) and behaviorally (reaction time). The long-term goals of this project are 23 to improve our understanding of what makes listening effortful for people with CIs and to understand whether 24 the same mechanisms that contribute to listening effort also contribute to fatigue or are merely episodic increases 25 in effort. These goals directly address the NIDCD’s priority of increasing our knowledge of the mechanisms of 26 the cognitive processes needed for successful communication in more real-world environments. The training 27 program involves extensive instruction in behavioral measures, pupillometry, and advanced statistical analysis 28 relevant to the proposed research. This research will be conducted under the mentorship of leading experts in 29 hearing and listening effort, at an institution with a strong track record of hearing loss research, a history of 30 training grants, and interdisciplinary collaboration in clinical sensory science.