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

1项目摘要/摘要 2名听力障碍患者表示，听力障碍是成功社交沟通的主要障碍 3(Hughes et al.2018年)，努力的增加导致焦虑的增加(Morata等人)。2005)，提前退休 4(Danermark&Gellerstedt，2004年)，社会行为的改变和负面自我形象(Hétu等人)。1988年)，以及 5与听力相关的疲劳(Edwards，2007)。疲惫的成年人在工作中表现出更低的生产力 6工作场所，缺勤增加，错误和事故比不疲倦的人多 7(Ricci等人2007年；威廉姆森等人。2011)，以及听力损失的工人因投诉而休更多病假 8“精神痛苦”(Kramer等人，2006年)。因此，了解沟通的哪些方面是至关重要的 对于听力受损的听众来说，9个是费力的，以及持续的努力导致积累精神的方式 10疲劳。以前的工作主要是单独研究听力努力和疲劳，两者有很大的不同 11种实验方法和设计，努力和疲劳之间的机制联系尚不清楚。 12该项目旨在通过扩展以前的工作来解决这一需求，以探索是否相同 13有助于倾听努力的机制仅仅是间歇性的，或者它们是否直接有助于 14累积性疲劳。听力努力的主要机制之一是在心理上修复被误解的单词 15当感知言语时；使用语境来追溯修复先前的误解是很费力的(Winn&Teess 16 2021)，然而，当预测性地使用相同的背景时，可以减少努力(Winn 2016)。这个项目的目标是 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。第一个目标将导致确定 19修复早期错误单词与后期错误单词时的努力时间进程。重要的是，这些结果将 20显示如何在语言处理过程中持续努力，可能在句子抵消后持续几秒钟。 21第二个目标将探索瞬间的努力增加是否会累积到疲劳，这将是 22进行生理测量(瞳孔测量)和行为测量(反应时间)。这个项目的长期目标是 23以提高我们对听力障碍的理解，并了解是否 有助于听力努力的相同机制也有助于疲劳或仅仅是间歇性增加 25%的努力。这些目标直接解决了NIDCD的优先事项，即增加我们对 26在更真实的环境中成功沟通所需的认知过程。培训 27课程涉及行为测量、斜视测量和高级统计分析方面的广泛指导 28与拟议的研究有关。这项研究将在一流专家的指导下进行， 29听力和听力努力，在一所在听力损失研究方面有良好记录的机构，有 30个培训补助金，以及临床感官科学的跨学科合作。

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.