There is broad consensus that listening effort is an important outcome for measuring hearing performance. However, there remains debate on the best ways to measure listening effort. This study sought to measure neural correlates of listening effort using functional near-infrared spectroscopy (fNIRS) in experienced adult hearing aid users. The study evaluated impacts of amplification and signal-to-noise ratio (SNR) on cerebral blood oxygenation, with the expectation that easier listening conditions would be associated with less oxygenation in the prefrontal cortex. Thirty experienced adult hearing aid users repeated sentence-final words from low-context Revised Speech Perception in Noise Test sentences. Participants repeated words at a hard SNR (individual SNR-50) or easy SNR (individual SNR-50 + 10 dB), while wearing hearing aids fit to prescriptive targets or without wearing hearing aids. In addition to assessing listening accuracy and subjective listening effort, prefrontal blood oxygenation was measured using fNIRS. As expected, easier listening conditions (i.e., easy SNR, with hearing aids) led to better listening accuracy, lower subjective listening effort, and lower oxygenation across the entire prefrontal cortex compared to harder listening conditions. Listening accuracy and subjective listening effort were also significant predictors of oxygenation.

UNASSIGNED: Noise reduction (NR) algorithms have been integrated into modern digital hearing aids to reduce noise annoyance and enhance speech intelligibility. This study aimed to evaluate the influences of a novel hearing aid NR algorithm on individuals with severe-to-profound hearing loss.
UNASSIGNED: Twenty-five participants with severe-to-profound bilateral sensorineural hearing loss underwent three tests (speech intelligibility, listening effort, and subjective sound quality in noise) to investigate the influences of NR. All three tests were performed under three NR strength levels (Off, Moderate, and Strong) for both speech in noise program (SpiN) and speech in loud noise program (SpiLN), comprising six different hearing aid conditions.
UNASSIGNED: NR activation significantly reduced listening effort. Subjective sound quality assessments also exhibited benefits of activated NR in terms of noise suppression, listening comfort, satisfaction, and speech clarity.
UNASSIGNED: Individuals with severe-to-profound hearing loss still experienced advantages from NR technology in both listening effort measure and subjective sound quality assessments. Importantly, these benefits did not adversely affect speech intelligibility.

Participation in complex listening situations such as group conversations in noisy environments sets high demands on the auditory system and on cognitive processing. Reports of hearing-impaired people indicate that strenuous listening situations occurring throughout the day lead to feelings of fatigue at the end of the day. The aim of the present study was to develop a suitable test sequence to evoke and measure listening effort (LE) and listening-related fatigue (LRF), and, to evaluate the influence of hearing aid use on both dimensions in mild to moderately hearing-impaired participants. The chosen approach aims to reconstruct a representative acoustic day (Time Compressed Acoustic Day [TCAD]) by means of an eight-part hearing-test sequence with a total duration of approximately 2½ h. For this purpose, the hearing test sequence combined four different listening tasks with five different acoustic scenarios and was presented to the 20 test subjects using virtual acoustics in an open field measurement in aided and unaided conditions. Besides subjective ratings of LE and LRF, behavioral measures (response accuracy, reaction times), and an attention test (d2-R) were performed prior to and after the TCAD. Furthermore, stress hormones were evaluated by taking salivary samples. Subjective ratings of LRF increased throughout the test sequence. This effect was observed to be higher when testing unaided. In three of the eight listening tests, the aided condition led to significantly faster reaction times/response accuracies than in the unaided condition. In the d2-R test, an interaction in processing speed between time (pre- vs. post-TCAD) and provision (unaided vs. aided) was found suggesting an influence of hearing aid provision on LRF. A comparison of the averaged subjective ratings at the beginning and end of the TCAD shows a significant increase in LRF for both conditions. At the end of the TCAD, subjective fatigue was significantly lower when wearing hearing aids. The analysis of stress hormones did not reveal significant effects.

Introduction  Permanent education in health aims to ensure that professionals are constantly learning in the workplace and in the last few years institutions resorted to the technology-mediated education modality and new teaching possibilities were explored. In Brazil, between 2017 and 2021, only six articles and five monographs were published about listening effort. Objective  The objective of this study was to develop a website with scientific content on the topic listening effort for Speech -Language Therapist and Audiologist with free online access. Methods  The study was carried out in five stages: Analysis, contemplating the search for scientific materials to prepare the material. Design, in which the writing and design of the website was carried out. Development, carrying out the adequacy of the online material. Implementation, a stage in which professionals in the area evaluated the quality of the material after consenting to participation through a free and informed consent term. Review, stage in which the researcher analyzed the evaluators\' responses. Results  The five stages of elaboration of the website were carried out, which was evaluated by professionals in the area. The average of responses to all applied questions rated the website as \"superior\". Conclusion  The website development was validated for online availability.

OBJECTIVE: This study aims to control all hearing thresholds, including extended high frequencies (EHFs), presents stimuli of varying difficulty levels, and measures electroencephalography (EEG) and pupillometry responses to determine whether listening difficulty in tinnitus patients is effort or fatigue-related.
METHODS: Twenty-one chronic tinnitus patients and 26 matched healthy controls having normal pure-tone averages with symmetrical hearing thresholds were included. Subjects were evaluated with 0.125-20 kHz pure-tone audiometry, Montreal Cognitive Assessment Test (MoCA), Tinnitus Handicap Inventory (THI), EEG, and pupillometry.
RESULTS: Pupil dilatation and EEG alpha power during the \"encoding\" phase of the presented sentence in tinnitus patients were less in all listening conditions (p < .05). Also, there was no statistically significant relationship between EEG and pupillometry components for all listening conditions and THI or MoCA (p > .05).
CONCLUSIONS: EEG and pupillometry results under various listening conditions indicate potential listening effort in tinnitus patients even if all frequencies, including EHFs, are controlled. Also, we suggest that pupillometry should be interpreted with caution in autonomic nervous system-related conditions such as tinnitus.

UNASSIGNED: Adverse listening conditions can drive increased mental effort during listening. Neuromagnetic alpha oscillations (8-13 Hz) may index this listening effort, but inconsistencies regarding the direction of the relationship are abundant. We performed source analyses on high-density EEG data collected during a speech-on-speech listening task to address the possibility that opposing alpha power relationships among alpha producing brain sources drive this inconsistency.
UNASSIGNED: Listeners (N=20) heard two simultaneously presented sentences of the form: Ready go to now. They either reported the color/number pair of a \"Baron\" call sign sentence (active: high effort), or ignored the stimuli (passive: low effort). Independent component analysis (ICA) was used to segregate temporally distinct sources in the EEG.
UNASSIGNED: Analysis of independent components (ICs) revealed simultaneous alpha enhancements (e.g., for somatomotor mu ICs) and suppressions (e.g., for left temporal ICs) for different brain sources. The active condition exhibited stronger enhancement for left somatomotor mu rhythm ICs, but stronger suppression for central occipital ICs.
UNASSIGNED: This study shows both alpha enhancement and suppression to be associated with increases in listening effort. Literature inconsistencies could partially relate to some source activities overwhelming others in scalp recordings.

Hearing aids and other hearing devices should provide the user with a benefit, for example, compensate for effects of a hearing loss or cancel undesired sounds. However, wearing hearing devices can also have negative effects on perception, previously demonstrated mostly for spatial hearing, sound quality and the perception of the own voice. When hearing devices are set to transparency, that is, provide no gain and resemble open-ear listening as well as possible, these side effects can be studied in isolation. In the present work, we conducted a series of experiments that are concerned with the effect of transparent hearing devices on speech perception in a collocated speech-in-noise task. In such a situation, listening through a hearing device is not expected to have any negative effect, since both speech and noise undergo identical processing, such that the signal-to-noise ratio at ear is not altered and spatial effects are irrelevant. However, we found a consistent hearing device disadvantage for speech intelligibility and similar trends for rated listening effort. Several hypotheses for the possible origin for this disadvantage were tested by including several different devices, gain settings and stimulus levels. While effects of self-noise and nonlinear distortions were ruled out, the exact reason for a hearing device disadvantage on speech perception is still unclear. However, a significant relation to auditory model predictions demonstrate that the speech intelligibility disadvantage is related to sound quality, and is most probably caused by insufficient equalization, artifacts of frequency-dependent signal processing and processing delays.

Listening to speech in noise can require substantial mental effort, even among younger normal-hearing adults. The task-evoked pupil response (TEPR) has been shown to track the increased effort exerted to recognize words or sentences in increasing noise. However, few studies have examined the trajectory of listening effort across longer, more natural, stretches of speech, or the extent to which expectations about upcoming listening difficulty modulate the TEPR. Seventeen younger normal-hearing adults listened to 60-s-long audiobook passages, repeated three times in a row, at two different signal-to-noise ratios (SNRs) while pupil size was recorded. There was a significant interaction between SNR, repetition, and baseline pupil size on sustained listening effort. At lower baseline pupil sizes, potentially reflecting lower attention mobilization, TEPRs were more sustained in the harder SNR condition, particularly when attention mobilization remained low by the third presentation. At intermediate baseline pupil sizes, differences between conditions were largely absent, suggesting these listeners had optimally mobilized their attention for both SNRs. Lastly, at higher baseline pupil sizes, potentially reflecting overmobilization of attention, the effect of SNR was initially reversed for the second and third presentations: participants initially appeared to disengage in the harder SNR condition, resulting in reduced TEPRs that recovered in the second half of the story. Together, these findings suggest that the unfolding of listening effort over time depends critically on the extent to which individuals have successfully mobilized their attention in anticipation of difficult listening conditions.

In daily life, both acoustic factors and social context can affect listening effort investment. In laboratory settings, information about listening effort has been deduced from pupil and cardiovascular responses independently. The extent to which these measures can jointly predict listening-related factors is unknown. Here we combined pupil and cardiovascular features to predict acoustic and contextual aspects of speech perception. Data were collected from 29 adults (mean  =  64.6 years, SD  =  9.2) with hearing loss. Participants performed a speech perception task at two individualized signal-to-noise ratios (corresponding to 50% and 80% of sentences correct) and in two social contexts (the presence and absence of two observers). Seven features were extracted per trial: baseline pupil size, peak pupil dilation, mean pupil dilation, interbeat interval, blood volume pulse amplitude, pre-ejection period and pulse arrival time. These features were used to train k-nearest neighbor classifiers to predict task demand, social context and sentence accuracy. The k-fold cross validation on the group-level data revealed above-chance classification accuracies: task demand, 64.4%; social context, 78.3%; and sentence accuracy, 55.1%. However, classification accuracies diminished when the classifiers were trained and tested on data from different participants. Individually trained classifiers (one per participant) performed better than group-level classifiers: 71.7% (SD  =  10.2) for task demand, 88.0% (SD  =  7.5) for social context, and 60.0% (SD  =  13.1) for sentence accuracy. We demonstrated that classifiers trained on group-level physiological data to predict aspects of speech perception generalized poorly to novel participants. Individually calibrated classifiers hold more promise for future applications.

This study measured electroencephalographic activity in the alpha band, often associated with task difficulty, to physiologically validate self-reported effort ratings from older hearing-impaired listeners performing the Repeat-Recall Test (RRT)-an integrative multipart assessment of speech-in-noise performance, context use, and auditory working memory. Following a single-blind within-subjects design, 16 older listeners (mean age = 71 years, SD = 13, 9 female) with a moderate-to-severe degree of bilateral sensorineural hearing loss performed the RRT while wearing hearing aids at four fixed signal-to-noise ratios (SNRs) of -5, 0, 5, and 10 dB. Performance and subjective ratings of listening effort were assessed for complementary versions of the RRT materials with high/low availability of semantic context. Listeners were also tested with a version of the RRT that omitted the memory (i.e., recall) component. As expected, results showed alpha power to decrease significantly with increasing SNR from 0 through 10 dB. When tested with high context sentences, alpha was significantly higher in conditions where listeners had to recall the sentence materials compared to conditions where the recall requirement was omitted. When tested with low context sentences, alpha power was relatively high irrespective of the memory component. Within-subjects, alpha power was related to listening effort ratings collected across the different RRT conditions. Overall, these results suggest that the multipart demands of the RRT modulate both neural and behavioral measures of listening effort in directions consistent with the expected/designed difficulty of the RRT conditions.