Identifying listeners with hearing loss at risk for exerting extra effort in speech perception

项目总结/摘要 全球有超过4.6亿人患有听力损失（HL），这对他们的沟通能力产生了负面影响。 (WHO，2020年）。在临床上，表现是通过倾听者正确重复单词的百分比来衡量的。 然而，这些分数不仅反映了听觉系统的健康状况，还反映了听众的能力 通过使用语言和语境知识在心理上修复误解（"认知修复"）。标准 言语感知的测量无法检测出一个人是否使用了认知修复，或者他们是否准确地听到了 （不需要修理）。检测一个人对认知修复的依赖很重要，因为 在测试室中，依赖额外的时间来使用上下文是有帮助的，但在真实的世界中，它可能会崩溃 因为下一句话将在前一句话完全处理之前听到。我们假设 对认知修复的持续需求是使倾听变得努力的核心，也是最终导致 疲劳（Edwards，2017）、焦虑（Morata等人，2005）和社交退缩（Hughes等人，2018年） 对HL患者来说本研究的目的是（1）识别听者对认知修复的依赖，（2）测量 认知修复的时间轴及其对正在进行的处理的干扰，以及（3）测量 由于预先知道句子的主题而产生的努力。第一个目标将导致临床上 可行的测试，使用行为措施，确定当一个听众使用认知修复。重要的是这 测试将更好地识别在临床测试期间使用认知修复的HL患者;这一发现可能导致 改善以患者为中心的个性化护理。第二个目标将使用双任务范式来更好地识别 一句话后认知修复所需的时间。在此期间，听众将 容易受到现实世界对话中即将到来的句子的干扰。第三个目标将使用 瞳孔测量，以衡量听力努力如何受到主题意识的影响 是为了提高我们对认知修复过程及其时间轴的理解，以及识别听众 他们依靠努力的认知策略来弥补听力不好的问题。这些目标直接针对 NIDCD优先增加我们对更真实世界中听觉感知机制的了解 条件及其与成功沟通的认知过程的相互作用。这些研究将 通过检查使用人工耳蜗（神经假体装置）的人的这些问题来实现这一目标 可以恢复听力）和中度至中度感觉神经性HL患者。培训 该计划涉及广泛的指令，在行为措施，瞳孔测量和先进的统计分析 与拟议的研究有关。这项研究将在以下领域的领先专家的指导下进行： 听力，听力努力，和生理学在一个机构与听力损失研究的良好记录， 在临床感觉科学方面也有培训补助金和跨学科合作的历史。

Project Summary / Abstract Over 460 million people worldwide have hearing loss (HL) that negatively impacts their ability to communicate (WHO, 2020). In the clinic, performance is measured by the percentage of words a listener repeats correctly. However, these scores reflect not only the health of the auditory system but also the listener’s ability to mentally repair misperceptions by using knowledge of the language and context (“cognitive repair”). Standard measures of speech perception cannot detect if a person used cognitive repair or if they accurately heard speech (with no need for repair). Detecting a person’s reliance on cognitive repair is important because while reliance on an extra moment to use context is helpful in the testing booth, it may break down in the real world as the next sentence would be heard before the previous sentence was fully processed. We hypothesize that continual need for cognitive repair is at the heart of what makes listening effortful, and what ultimately leads to increased fatigue (Edwards, 2017), anxiety (Morata et al., 2005), and social withdrawal (Hughes et al., 2018) for people with HL. The aims of this project are to (1) identify listener reliance on cognitive repair, (2) measure the timeline of cognitive repair and its interference with ongoing processing, and (3) measure the relief from effort resulting from advance knowledge of the topic of a sentence. The first aim will result in a clinically feasible test using behavioral measures that identifies when a listener uses cognitive repair. Importantly, this test will better identify patients with HL who use cognitive repair during clinical testing; this finding, can lead to improved individualized patient centered care. The second aim will use a dual-task paradigm to better identify the amount of time needed for cognitive repair after a sentence. During this time the listener would be to susceptible to interference from an upcoming sentence in real-world conversation. The third aim will use pupillometry to measure how listening effort is affected by topic awareness The long-term goals of this project are to improve our understanding of the cognitive repair process and its timeline, as well as to identify listeners who rely on effortful cognitive strategies to compensate for poor hearing. These goals directly address the NIDCD priority of increasing our knowledge of the mechanisms of auditory perception in more real-world conditions and their interaction with cognitive processes for successful communication. These studies will achieve this goal by examining these issues in people who use cochlear implants (neural prosthetic devices that can restore hearing) and people with moderate to moderately severe sensorineural HL. The training program involves extensive instruction in behavioral measures, pupillometry, and advanced statistical analysis relevant to the proposed research. This research will be conducted under the mentorship of leading experts in hearing, listening effort, and physiology at an institution with a strong track record of hearing loss research, where there is also a history of training grants and interdisciplinary collaboration in clinical sensory science.