Listening Effort in Quiet and Noisy Environments in the Daily Life of Adults With Hearing Aids: An Extended Version of the Effort Assessment Scale (EEAS).

This study was aimed at assessing listening effort (LE) in quiet and in noisy daily life situations, in 481 adults with hearing aids (HAs) and 62 adults with normal hearing, using an Extended version of the Effort Assessment Scale (EEAS). Participants were invited to self-assess their LE in daily life, on a visual analog scale graded from 0 (no effort) to 10. The EEAS's internal structure identified two separate constructs pertaining to LE in quiet and LE in noise, each with good consistency (Cronbach's α > 0.83). A three-factor model explained 12% of the variance of the EEAS scores, with HA experience the most important one, and better ear hearing threshold (averaged across 0.5-4 kHz) and ear asymmetry as the other two factors. The EEAS subscales differed in behavior, with the LE in noise being the most dependent on HA experience, whereas LE in quiet depended more on better ear hearing threshold. In a subgroup of people with 6 months to less than 24 months HA experience, a significant decrease in LE in noise was observed with increasing HA experience (0.26 points decrease per year of HA experience), whereas in a group of people with at least 24 months of HA experience, a small increase in LE in noise was observed. This effect was not mediated by age, nor hearing threshold. The extended Effort Assessment Scale is therefore offering an assessment of both LE in quiet and LE in noise, with different dependence on HA experience and hearing thresholds.

Comparing methods of analysis in pupillometry: application to the assessment of listening effort in hearing-impaired patients.

Numerous studies showed that task-evoked pupil dilation is an objective marker of cognitive activity and listening effort. However, these studies differ in their experimental and analysis methods. Whereas most studies focus on a single method, the present study sought to compare different pupil-dilation data analysis methods, including different normalization techniques, baseline periods, and baseline durations, in order to assess their influence on the outcomes of pupillometry results obtained in an auditory task. To that purpose, we used pupillometry data recorded in response to words in noise in hearing-impaired individuals. The start-time of the baseline relative to stimulus timing turned out to have a significant influence on conclusions. In particular, a significant interaction in the effects of signal-to-noise ratio and hearing-aid use on pupil dilation was observed when the baseline period used started early relative to the word-an effect likely related to anticipatory, pre-stimulus cognitive processes, such as attention mobilization. This was the case even with only correct-response trials included in analyses, so that any confounding effect of performance in the word-repetition task was eliminated. Different normalization methods and baseline durations showed similar results, however the use of z-score transformation homogenized variability across conditions without affecting the qualitative aspect of the results. The consistency of results regardless of normalization methods, and the fact that differences in pupil dilation and subjective measures of listening effort could be observed despite perfect performance in the task, underlines the relevance of pupillometry as an objective measure of listening effort.