Effort and Displeasure in People Who Are Hard of Hearing.

Listening effort helps explain why people who are hard of hearing are prone to fatigue and social withdrawal. However, a one-factor model that cites only effort due to hardness of hearing is insufficient as there are many who lead happy lives despite their disability. This article explores other contributory factors, in particular motivational arousal and pleasure. The theory of rational motivational arousal predicts that some people forego listening comprehension because they believe it to be impossible and hence worth no effort at all. This is problematic. Why should the listening task be rated this way, given the availability of aids that reduce its difficulty? Two additional factors narrow the explanatory gap. First, we separate the listening task from the benefit derived as a consequence. The latter is temporally more distant, and is discounted as a result. The second factor is displeasure attributed to the listening task, which increases listening cost. Many who are hard of hearing enjoy social interaction. In such cases, the actual activity of listening is a benefit, not a cost. These people also reap the benefits of listening, but do not have to balance these against the displeasure of the task. It is suggested that if motivational harmony can be induced by training in somebody who is hard of hearing, then the obstacle to motivational arousal would be removed. This suggests a modified goal for health care professionals. Do not just teach those who are hard of hearing how to use hearing assistance devices. Teach them how to do so with pleasure and enjoyment.

Hearing Impairment and Cognitive Energy: The Framework for Understanding Effortful Listening (FUEL).

The Fifth Eriksholm Workshop on "Hearing Impairment and Cognitive Energy" was convened to develop a consensus among interdisciplinary experts about what is known on the topic, gaps in knowledge, the use of terminology, priorities for future research, and implications for practice. The general term cognitive energy was chosen to facilitate the broadest possible discussion of the topic. It goes back to who described the effects of attention on perception; he used the term psychic energy for the notion that limited mental resources can be flexibly allocated among perceptual and mental activities. The workshop focused on three main areas: (1) theories, models, concepts, definitions, and frameworks; (2) methods and measures; and (3) knowledge translation. We defined effort as the deliberate allocation of mental resources to overcome obstacles in goal pursuit when carrying out a task, with listening effort applying more specifically when tasks involve listening. We adapted Kahneman's seminal (1973) Capacity Model of Attention to listening and proposed a heuristically useful Framework for Understanding Effortful Listening (FUEL). Our FUEL incorporates the well-known relationship between cognitive demand and the supply of cognitive capacity that is the foundation of cognitive theories of attention. Our FUEL also incorporates a motivation dimension based on complementary theories of motivational intensity, adaptive gain control, and optimal performance, fatigue, and pleasure. Using a three-dimensional illustration, we highlight how listening effort depends not only on hearing difficulties and task demands but also on the listener's motivation to expend mental effort in the challenging situations of everyday life.