The effect of auditory training on listening effort in hearing-aid users: insights from a pupillometry study.

OBJECTIVE: The study investigated how auditory training affects effort exerted by hearing-impaired listeners in speech-in-noise task. DESIGN: Pupillometry was used to characterise listening effort during a hearing in noise test (HINT) before and after phoneme-in-noise identification training. Half of the study participants completed the training, while the other half formed an active control group. STUDY SAMPLE: Twenty 63-to-79 years old experienced hearing-aid users. RESULTS: Higher peak pupil dilations (PPDs) were obtained at the end of the study compared to the beginning in both groups of the participants. The analysis of pupil dilation in an extended time window revealed, however, that the magnitude of pupillary response increased more in the training than in the control group. The effect of training on effort was observed in pupil responses even when no improvement in HINT was found. CONCLUSION: The results demonstrate that using a listening effort metric adds additional insights into the effectiveness of auditory training compared to the situation when only speech-in-noise performance is considered. Trends observed in pupil responses suggested increased effort-both after the training and the placebo intervention-most likely reflecting the effect of the individual's motivation.

The effect of phoneme-based auditory training on speech intelligibility in hearing-aid users.

OBJECTIVE: Hearing loss commonly causes difficulties in understanding speech in the presence of background noise. The benefits of hearing-aids in terms of speech intelligibility in challenging listening scenarios remain limited. The present study investigated if phoneme-in-noise discrimination training improves phoneme identification and sentence intelligibility in noise in hearing-aid users. DESIGN: Two groups of participants received either a two-week training program or a control intervention. Three phoneme categories were trained: onset consonants (C1), vowels (V) and post-vowel consonants (C2) in C1-V-C2-/i/ logatomes from the Danish nonsense word corpus (DANOK). Phoneme identification test and hearing in noise test (HINT) were administered before and after the respective interventions and, for the training group only, after three months. STUDY SAMPLE: Twenty 63-to-79 years old individuals with a mild-to-moderate sensorineural hearing loss and at least one year of experience using hearing-aids. RESULTS: The training provided an improvement in phoneme identification scores for vowels and post-vowel consonants, which was retained over three months. No significant performance improvement in HINT was found. CONCLUSION: The study demonstrates that the training induced a robust refinement of auditory perception at a phoneme level but provides no evidence for the generalisation to an untrained sentence intelligibility task.