Attention Mobilization as a Modulator of Listening Effort: Evidence From Pupillometry.

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.

Listening Effort, An Overview of App Validation and Testing by the Audiology 4 all Project.

OBJECTIVE: To describe an application's development and validation process that aims to track hearing difficulties in adverse environments (a listening effort application). DESIGN: 71 subjects were evaluated, divided into two groups: 30 subjects aged between 18 and 30, and 41 subjects aged between 40 and 65. All subjects had European Portuguese as their native language; the Montreal Cognitive Assessment (MOCA) scored above 24, and all could read and write. All subjects performed the intelligibility test in noise and the test of listening effort. The two tests were randomly applied in the free field in the audiometric cabin and the application. RESULTS: There were no statistically significant differences between the results of the two methods (p>0.05). For the group aged between 40 and 65 years old, the ROC curve showed that intelligibility inferior to 68.5% and the number of correct answers lower than 1,5 in the listening effort test are the optimal cut-off for referral to further management. Both tests showed low sensitivity and specificity regarding individuals between 18 and 30 years old, indicating that the application is inappropriate for this age group. CONCLUSIONS: The application is valid and can contribute to the screening and self-awareness of listening difficulties in middle age, with a reduction in the prevalence of dementia soon.

Associations Between Auditory Working Memory, Self-Perceived Listening Effort, and Hearing Difficulty in Adults With Mild Traumatic Brain Injury.

OBJECTIVES: Mild traumatic brain injury (TBI) can have persistent effects in the auditory domain (e.g., difficulty listening in noise), despite individuals having normal pure-tone auditory sensitivity. Individuals with a history of mild TBI often perceive hearing difficulty and greater listening effort in complex listening situations. The purpose of the present study was to examine self-perceived hearing difficulty, listening effort, and performance on an auditory processing test battery in adults with a history of mild TBI compared with a control group. DESIGN: Twenty adults ages 20 to 53 years old participated divided into a mild TBI (n = 10) and control group (n = 10). Perceived hearing difficulties were measured using the Adult Auditory Processing Scale and the Hearing Handicap Inventory for Adults. Listening effort was measured using the National Aeronautics and Space Administration-Task Load Index. Listening effort ratings were obtained at baseline, after each auditory processing test, and at the completion of the test battery. The auditory processing test battery included (1) dichotic word recognition, (2) the 500-Hz masking level difference, (3) the Listening in Spatialized Noise-Sentences test, and (4) the Word Auditory Recognition and Recall Measure (WARRM). RESULTS: Results indicated that individuals with a history of mild TBI perceived significantly greater degrees of hearing difficulty and listening effort than the control group. There were no significant group differences on two of the auditory processing tasks (dichotic word recognition or Listening in Spatialized Noise-Sentences). The mild TBI group exhibited significantly poorer performance on the 500-Hz MLD and the WARRM, a measure of auditory working memory, than the control group. Greater degrees of self-perceived hearing difficulty were significantly associated with greater listening effort and poorer auditory working memory. Greater listening effort was also significantly associated with poorer auditory working memory. CONCLUSIONS: Results demonstrate that adults with a history of mild TBI may experience subjective hearing difficulty and listening effort when listening in challenging acoustic environments. Poorer auditory working memory on the WARRM task was observed for the adults with mild TBI and was associated with greater hearing difficulty and listening effort. Taken together, the present study suggests that conventional clinical audiometric battery alone may not provide enough information about auditory processing deficits in individuals with a history of mild TBI. The results support the use of a multifaceted battery of auditory processing tasks and subjective measures when evaluating individuals with a history of mild TBI.

Speech Understanding and Subjective Listening Effort in Noise With Different OTEs and Sound Processing Technologies.

OBJECTIVE: To determine speech reception thresholds (SRTs) in noise and subjective listening effort (LE) in cochlear implant (CI) recipients for application of three sound processing (SP) technologies with two off-the-ear (OTE) CI sound processors, a fixed moderately directional microphone (Standard), an adaptive directional microphone (Beam), and the spatial noise-reduction setting ForwardFocus, with the Kanso 2 (OTE2), and Beam with the Kanso (OTE1). STUDY DESIGN: Prospective repeated measures, within-subject design. SETTING: Single tertiary-referral center. PATIENTS: Twenty CI recipients with bilateral severe-to-profound sensorineural hearing loss. MAIN OUTCOME MEASURES: SRTs were assessed in two spatial configurations with frontal speech and noise from 90-180-270 degrees (S0N90-180-270) or from the CI side (S0NCI). SRTs were obtained for sentences of the Oldenburg sentence test presented in International Collegium of Rehabilitative Audiology (ICRA) noise ICRA5-250. LE for speech understanding in noise was evaluated in S0N90-180-270 and assessed in effort scale categorical units (ESCUs) by using Adaptive Categorical Listening Effort Scaling (ACALES). LEs at 5-dB signal-to-noise ratio (SNR) were calculated from fitted psychometric curves. RESULTS: With OTE2 in S0N90-180-270, SRT with ForwardFocus (-4.28 dB SNR) was better than with Beam (-3.13 dB SNR) and Standard (0.43 dB SNR). ForwardFocus showed lower LE5dB (2.61 ESCU) compared with Beam (4.60 ESCU) and Standard (5.32 ESCU). In a comparison of both OTEs in S0N90-180-270 regarding best-performing SP technology, ForwardFocus with OTE2 yielded a better SRT and better LE5dB than Beam with OTE1 (SRT: -1.70 dB SNR; LE5dB: 4.00 ESCU). With OTE2 in S0NCI, SRT was improved with ForwardFocus (-2.78 dB SNR) compared with Beam (-1.23 dB SNR) and Standard (1.83 dB SNR). CONCLUSION: With respect to SP technology and OTE, CI recipients experience best SRT and lowest LE in S0N90-180-270 when using ForwardFocus with OTE2. ACALES is feasible for assessing subjective LE in CI recipients.

Contributions of listening effort and intelligibility to cortical tracking of speech in adverse listening conditions.

Cortical tracking of speech is vital for speech segmentation and is linked to speech intelligibility. However, there is no clear consensus as to whether reduced intelligibility leads to a decrease or an increase in cortical speech tracking, warranting further investigation of the factors influencing this relationship. One such factor is listening effort, defined as the cognitive resources necessary for speech comprehension, and reported to have a strong negative correlation with speech intelligibility. Yet, no studies have examined the relationship between speech intelligibility, listening effort, and cortical tracking of speech. The aim of the present study was thus to examine these factors in quiet and distinct adverse listening conditions. Forty-nine normal hearing adults listened to sentences produced casually, presented in quiet and two adverse listening conditions: cafeteria noise and reverberant speech. Electrophysiological responses were registered with electroencephalogram, and listening effort was estimated subjectively using self-reported scores and objectively using pupillometry. Results indicated varying impacts of adverse conditions on intelligibility, listening effort, and cortical tracking of speech, depending on the preservation of the speech temporal envelope. The more distorted envelope in the reverberant condition led to higher listening effort, as reflected in higher subjective scores, increased pupil diameter, and stronger cortical tracking of speech in the delta band. These findings suggest that using measures of listening effort in addition to those of intelligibility is useful for interpreting cortical tracking of speech results. Moreover, reading and phonological skills of participants were positively correlated with listening effort in the cafeteria condition, suggesting a special role of expert language skills in processing speech in this noisy condition. Implications for future research and theories linking atypical cortical tracking of speech and reading disorders are further discussed.

Cochlear-Implant Simulated Signal Degradation Exacerbates Listening Effort in Older Listeners.

OBJECTIVES: Individuals with cochlear implants (CIs) often report that listening requires high levels of effort. Listening effort can increase with decreasing spectral resolution, which occurs when listening with a CI, and can also increase with age. What is not clear is whether these factors interact; older CI listeners potentially experience even higher listening effort with greater signal degradation than younger CI listeners. This study used pupillometry as a physiological index of listening effort to examine whether age, spectral resolution, and their interaction affect listening effort in a simulation of CI listening. DESIGN: Fifteen younger normal-hearing listeners (ages 18 to 31 years) and 15 older normal-hearing listeners (ages 65 to 75 years) participated in this experiment; they had normal hearing thresholds from 0.25 to 4 kHz. Participants repeated sentences presented in quiet that were either unprocessed or vocoded, simulating CI listening. Stimuli frequency spectra were limited to below 4 kHz (to control for effects of age-related high-frequency hearing loss), and spectral resolution was decreased by decreasing the number of vocoder channels, with 32-, 16-, and 8-channel conditions. Behavioral speech recognition scores and pupil dilation were recorded during this task. In addition, cognitive measures of working memory and processing speed were obtained to examine if individual differences in these measures predicted changes in pupil dilation. RESULTS: For trials where the sentence was recalled correctly, there was a significant interaction between age and spectral resolution, with significantly greater pupil dilation in the older normal-hearing listeners for the 8- and 32-channel vocoded conditions. Cognitive measures did not predict pupil dilation. CONCLUSIONS: There was a significant interaction between age and spectral resolution, such that older listeners appear to exert relatively higher listening effort than younger listeners when the signal is highly degraded, with the largest effects observed in the eight-channel condition. The clinical implication is that older listeners may be at higher risk for increased listening effort with a CI.

Evaluating Listening Effort in Unilateral, Bimodal, and Bilateral Cochlear Implant Users.

OBJECTIVE: Evaluate listening effort (LE) in unilateral, bilateral, and bimodal cochlear implant (CI) users. Establish an easy-to-implement task of LE that could be useful for clinical decision making. STUDY DESIGN: Prospective cohort study. SETTING: Tertiary neurotology center. METHODS: The Sentence Final Word Identification and Recall Task, an established measure of LE, was modified to include challenging listening conditions (multitalker babble, gender, and emotional variation; test), in addition to single-talker sentences (control). Participants listened to lists of sentences in each condition and recalled the last word of each sentence. LE was quantified by percentage of words correctly recalled and was compared across conditions, across CI groups, and within subjects (best aided vs monaural). RESULTS: A total of 24 adults between the ages of 37 and 82 years enrolled, including 4 unilateral CI users (CI), 10 bilateral CI users (CICI), and 10 bimodal CI users (CIHA). Task condition impacted LE (P < .001), but hearing configuration and listener group did not (P = .90). Working memory capacity and contralateral hearing contributed to individual performance. CONCLUSION: This study adds to the growing body of literature on LE in challenging listening conditions for CI users and demonstrates feasibility of a simple behavioral task that could be implemented clinically to assess LE. This study also highlights the potential benefits of bimodal hearing and individual hearing and cognitive factors in understanding individual differences in performance, which will be evaluated through further research.

Perspective Taking Reflects Beliefs About Partner Sophistication: Modern Computer Partners Versus Basic Computer and Human Partners.

We investigate partner effects on spatial perspective taking behavior in listeners, comparing behavior with a human versus a computer partner (Experiments 1 and 2), and with computer partners of different perceived capabilities (Experiment 3). Participants responded to spoken instructions from their partner which could be interpreted egocentrically (from their own perspective) or othercentrically (from their partner's perspective). In contrast to earlier work, we found that participants were more egocentric with a computer than a human partner. Participants were also more egocentric with a computer partner that appeared more modern and capable, compared to one that appeared outdated and limited in ability. Our results show that perspective taking behavior is sensitive to information about one's partner; in particular, listeners consider their partner's potential ability to collaborate, adjusting their egocentric tendencies accordingly. Moreover, we highlight what appears to be a shift in listeners' expectations regarding computers' collaborative capabilities, leading to greater willingness to push the burden of perspective taking onto a computer partner.

The Involvement of Listening Effort in Explaining Bilingual Listening Under Adverse Listening Conditions.

The current review examines listening effort to uncover how it is implicated in bilingual performance under adverse listening conditions. Various measures of listening effort, including physiological, behavioral, and subjective measures, have been employed to examine listening effort in bilingual children and adults. Adverse listening conditions, stemming from environmental factors, as well as factors related to the speaker or listener, have been examined. The existing literature, although relatively limited to date, points to increased listening effort among bilinguals in their nondominant second language (L2) compared to their dominant first language (L1) and relative to monolinguals. Interestingly, increased effort is often observed even when speech intelligibility remains unaffected. These findings emphasize the importance of considering listening effort alongside speech intelligibility. Building upon the insights gained from the current review, we propose that various factors may modulate the observed effects. These include the particular measure selected to examine listening effort, the characteristics of the adverse condition, as well as factors related to the particular linguistic background of the bilingual speaker. Critically, further research is needed to better understand the impact of these factors on listening effort. The review outlines avenues for future research that would promote a comprehensive understanding of listening effort in bilingual individuals.

Validity and reliability of self-reported and neural measures of listening effort.

Listening effort can be defined as a measure of cognitive resources used by listeners to perform a listening task. Various methods have been proposed to measure this effort, yet their reliability remains unestablished, a crucial step before their application in research or clinical settings. This study encompassed 32 participants undertaking speech-in-noise tasks across two sessions, approximately a week apart. They listened to sentences and word lists at varying signal-to-noise ratios (SNRs) (-9, -6, -3 and 0 dB), then retaining them for roughly 3 s. We evaluated the test-retest reliability of self-reported effort ratings, theta (4-7 Hz) and alpha (8-13 Hz) oscillatory power, suggested previously as neural markers of listening effort. Additionally, we examined the reliability of correct word percentages. Both relative and absolute reliability were assessed using intraclass correlation coefficients (ICC) and Bland-Altman analysis. We also computed the standard error of measurement (SEM) and smallest detectable change (SDC). Our findings indicated heightened frontal midline theta power for word lists compared to sentences during the retention phase under high SNRs (0 dB, -3 dB), likely indicating a greater memory load for word lists. We observed SNR's impact on alpha power in the right central region during the listening phase and frontal theta power during the retention phase in sentences. Overall, the reliability analysis demonstrated satisfactory between-session variability for correct words and effort ratings. However, neural measures (frontal midline theta power and right central alpha power) displayed substantial variability, even though group-level outcomes appeared consistent across sessions.

The effects of temporal cues, point-light displays, and faces on speech identification and listening effort.

Among the most robust findings in speech research is that the presence of a talking face improves the intelligibility of spoken language. Talking faces supplement the auditory signal by providing fine phonetic cues based on the placement of the articulators, as well as temporal cues to when speech is occurring. In this study, we varied the amount of information contained in the visual signal, ranging from temporal information alone to a natural talking face. Participants were presented with spoken sentences in energetic or informational masking in four different visual conditions: audio-only, a modulating circle providing temporal cues to salient features of the speech, a digitally rendered point-light display showing lip movement, and a natural talking face. We assessed both sentence identification accuracy and self-reported listening effort. Audiovisual benefit for intelligibility was observed for the natural face in both informational and energetic masking, but the digitally rendered point-light display only provided benefit in energetic masking. Intelligibility for speech accompanied by the modulating circle did not differ from the audio-only conditions in either masker type. Thus, the temporal cues used here were insufficient to improve speech intelligibility in noise, but some types of digital point-light displays may contain enough phonetic detail to produce modest improvements in speech identification in noise.

The Effect of Breathy Vocal Quality on Speech Intelligibility and Listening Effort in Background Noise.

Speech perception is challenging under adverse conditions. However, there is limited evidence regarding how multiple adverse conditions affect speech perception. The present study investigated two conditions that are frequently encountered in real-life communication: background noise and breathy vocal quality. The study first examined the effects of background noise and breathiness on speech perception as measured by intelligibility. Secondly, the study tested the hypothesis that both noise and breathiness affect listening effort, as indicated by linear and nonlinear changes in pupil dilation. Low-context sentences were resynthesized to create three levels of breathiness (original, mild-moderate, and severe). The sentences were presented in a fluctuating nonspeech noise with two signal-to-noise ratios (SNRs) of -5 dB (favorable) and -9 dB (adverse) SNR. Speech intelligibility and pupil dilation data were collected from young listeners with normal hearing thresholds. The results demonstrated that a breathy vocal quality presented in noise negatively affected speech intelligibility, with the degree of breathiness playing a critical role. Listening effort, as measured by the magnitude of pupil dilation, showed significant effects with both severe and mild-moderate breathy voices that were independent of noise level. The findings contributed to the literature by demonstrating the impact of vocal quality on the perception of speech in noise. They also highlighted the complex dynamics between overall task demand and processing resources in understanding the combined impact of multiple adverse conditions.

Auditory, Lexical, and Multitasking Demands Interactively Impact Listening Effort.

PURPOSE: This study examined the extent to which acoustic, linguistic, and cognitive task demands interactively impact listening effort. METHOD: Using a dual-task paradigm, on each trial, participants were instructed to perform either a single task or two tasks. In the primary word recognition task, participants repeated Northwestern University Auditory Test No. 6 words presented in speech-shaped noise at either an easier or a harder signal-to-noise ratio (SNR). The words varied in how commonly they occur in the English language (lexical frequency). In the secondary visual task, participants were instructed to press a specific key as soon as a number appeared on screen (simpler task) or one of two keys to indicate whether the visualized number was even or odd (more complex task). RESULTS: Manipulation checks revealed that key assumptions of the dual-task design were met. A significant three-way interaction was observed, such that the expected effect of SNR on effort was only observable for words with lower lexical frequency and only when multitasking demands were relatively simpler. CONCLUSIONS: This work reveals that variability across speech stimuli can influence the sensitivity of the dual-task paradigm for detecting changes in listening effort. In line with previous work, the results of this study also suggest that higher cognitive demands may limit the ability to detect expected effects of SNR on measures of effort. With implications for real-world listening, these findings highlight that even relatively minor changes in lexical and multitasking demands can alter the effort devoted to listening in noise.

Distinct brain state dynamics of native and second language processing during narrative listening in late bilinguals.

The process of complex cognition, which includes language processing, is dynamic in nature and involves various network modes or cognitive modes. This dynamic process can be manifested by a set of brain states and transitions between them. Previous neuroimaging studies have shed light on how bilingual brains support native language (L1) and second language (L2) through a shared network. However, the mechanism through which this shared brain network enables L1 and L2 processing remains unknown. This study examined this issue by testing the hypothesis that L1 and L2 processing is associated with distinct brain state dynamics in terms of brain state integration and transition flexibility. A group of late Chinese-English bilinguals was scanned using functional magnetic resonance imaging (fMRI) while listening to eight short narratives in Chinese (L1) and English (L2). Brain state dynamics were modeled using the leading eigenvector dynamic analysis framework. The results show that L1 processing involves more integrated states and frequent transitions between integrated and segregated states, while L2 processing involves more segregated states and fewer transitions. Our work provides insight into the dynamic process of narrative listening comprehension in late bilinguals and sheds new light on the neural representation of language processing and related disorders.

Development of a Sentence Verification Task to Measure Speech Comprehension and Listening Effort in Cochlear Implant Users.

PURPOSE: Tests measuring speech comprehension and listening effort for cochlear implant (CI) users may reflect important aspects of real-world speech communication. In this study, we describe the development of a multiple-talker, English-language sentence verification task (SVT) for use in adult CI users to measure speech comprehension and listening effort. We also examine whether talker differences affect speech comprehension and listening effort. METHOD: Thirteen experienced adult CI users participated in the study and underwent testing using a newly developed multiple-talker SVT. Participants were sequentially presented with audio recordings of unique sentences spoken in English by six different talkers. Participants classified each sentence as either true or false. Accuracy of classification and the response time (RT) for correct responses were used as measures of comprehension and listening effort, respectively. The effect of talker on the results was further analyzed. RESULTS: All 13 participants successfully completed the SVT. The mean verification accuracy for participants was 87.2% ± 8.8%. The mean RT for correct responses across participants was 1,050 ms ± 391 ms. When stratified by talker, verification accuracy ranged from 83.7% to 95.2% and mean RTs across participant ranged from 786 ms to 1,254 ms. Talker did not have a significant effect on sentence classification accuracy, but it did have a significant effect on RTs (p < .001). CONCLUSIONS: The SVT is an easily implemented test that can assess speech comprehension and listening effort simultaneously. CI users may experience increased effort for comprehending certain talkers' speech, despite showing similar levels of comprehension accuracy. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.24126630.

Music in noise recognition: An EEG study of listening effort in cochlear implant users and normal hearing controls.

Despite the plethora of studies investigating listening effort and the amount of research concerning music perception by cochlear implant (CI) users, the investigation of the influence of background noise on music processing has never been performed. Given the typical speech in noise recognition task for the listening effort assessment, the aim of the present study was to investigate the listening effort during an emotional categorization task on musical pieces with different levels of background noise. The listening effort was investigated, in addition to participants' ratings and performances, using EEG features known to be involved in such phenomenon, that is alpha activity in parietal areas and in the left inferior frontal gyrus (IFG), that includes the Broca's area. Results showed that CI users performed worse than normal hearing (NH) controls in the recognition of the emotional content of the stimuli. Furthermore, when considering the alpha activity corresponding to the listening to signal to noise ratio (SNR) 5 and SNR10 conditions subtracted of the activity while listening to the Quiet condition-ideally removing the emotional content of the music and isolating the difficulty level due to the SNRs- CI users reported higher levels of activity in the parietal alpha and in the homologous of the left IFG in the right hemisphere (F8 EEG channel), in comparison to NH. Finally, a novel suggestion of a particular sensitivity of F8 for SNR-related listening effort in music was provided.

Individual characteristics moderate listening effort in noisy classrooms.

Comprehending the teacher's message when other students are chatting is challenging. Even though the sound environment is the same for a whole class, differences in individual performance can be observed, which might depend on a variety of personal factors and their specific interaction with the listening condition. This study was designed to explore the role of individual characteristics (reading comprehension, inhibitory control, noise sensitivity) when primary school children perform a listening comprehension task in the presence of a two-talker masker. The results indicated that this type of noise impairs children's accuracy, effort, and motivation during the task. Its specific impact depended on the level and was modulated by the child's characteristics. In particular, reading comprehension was found to support task accuracy, whereas inhibitory control moderated the effect of listening condition on the two measures of listening effort included in the study (response time and self-ratings), even though with a different pattern of association. A moderation effect of noise sensitivity on perceived listening effort was also observed. Understanding the relationship between individual characteristics and classroom sound environment has practical implications for the acoustic design of spaces promoting students' well-being, and supporting their learning performance.

Energetic and informational masking place dissociable demands on listening effort: Evidence from simultaneous electroencephalography and pupillometrya).

The task of processing speech masked by concurrent speech/noise can pose a substantial challenge to listeners. However, performance on such tasks may not directly reflect the amount of listening effort they elicit. Changes in pupil size and neural oscillatory power in the alpha range (8-12 Hz) are prominent neurophysiological signals known to reflect listening effort; however, measurements obtained through these two approaches are rarely correlated, suggesting that they may respond differently depending on the specific cognitive demands (and, by extension, the specific type of effort) elicited by specific tasks. This study aimed to compare changes in pupil size and alpha power elicited by different types of auditory maskers (highly confusable intelligible speech maskers, speech-envelope-modulated speech-shaped noise, and unmodulated speech-shaped noise maskers) in young, normal-hearing listeners. Within each condition, the target-to-masker ratio was set at the participant's individually estimated 75% correct point on the psychometric function. The speech masking condition elicited a significantly greater increase in pupil size than either of the noise masking conditions, whereas the unmodulated noise masking condition elicited a significantly greater increase in alpha oscillatory power than the speech masking condition, suggesting that the effort needed to solve these respective tasks may have different neural origins.

Objective Measure of Listening Effort in HearingImpaired Individuals With and Without Tinnitus.

BACKGROUND: Tinnitus is a perception of sound in the brain without any external stimulus. Tinnitus patients often complain of more efforts required in listening. They may be ineffective in inhibiting their attention, driven to irrelevant ringing sounds in their ear rather than attending to the relevant target speech stimulus. The study's objective was to evaluate an allocation of cognitive resources among tinnitus patients for concurrent tasks required for understanding speech using an objective dual-task paradigm to assess listening effort. METHODS: We recruited 40 participants with mild to moderately severe sloping sensorineural hearing loss within 60-70 years. They were subgrouped into control and clinical groups. The clinical group had a severe degree of tonal tinnitus bilaterally. The objective listening task used listening effort, and a subjective questionnaire to assess the effort in listening was assessed by each study participant. RESULTS: The results indicated poorer recognition and reduced recall scores in a clinical group than the control group in each signal-to-noise ratio. The recall score in objective listening effort measurement was strongly correlated with subjective questions assessed effort in listening among the clinical group at each signal-to-noise ratio. However, in the control group, the correlation was to a mild degree at 0 dB signal-to-noise ratio only. CONCLUSION: Annoyance caused by tinnitus disrupts attention, thereby limiting the effective use of cognitive resources for concurrent speech processing and recalling reflected in the listening effort task.