Cognition in Hearing Aid Users : Memory for Everyday Speech

Abstract: The thesis investigated the importance of cognition for speech understanding in experienced and new hearing aid users. The aims were 1) to develop a cognitive test (Sentence-final Word Identification and Recall, or SWIR test) to measure the effects of a noise reduction algorithm on processing of highly intelligible speech (everyday sentences); 2) to investigate, using the SWIR test, whether hearing aid signal processing would affect memory for heard speech in experienced hearing aid users; 3) to test whether the effects of signal processing on the ability to recall speech would interact with background noise and individual differences in working memory capacity; 4) to explore the potential clinical application of the SWIR test; and 5) to examine the relationship between cognition and speech recognition in noise in new users over the first six months of hearing aid use. Results showed that, for experienced users, noise reduction freed up cognitive resources and alleviated the negative  impact of noise on memory when speech stimuli were presented in a background of speech babble spoken in the listener’s native language. The possible underlying mechanisms are that noise reduction facilitates auditory stream segregation between target and irrelevant speech and reduces the attention captured by the linguistic information in irrelevant speech. The effects of noise reduction and SWIR performance were modulated by individual differences in working memory capacity. SWIR performance was related to the self-reported outcome of hearing aid use. For new users, working memory capacity played a more important role in speech recognition in noise before acclimatization to hearing aid amplification than after six months. This thesis demonstrates for the first time that hearing aid signal processing can significantly improve the ability of individuals with hearing impairment to recall highly intelligible speech stimuli presented in babble noise. It also adds to the literature showing the key role of working memory capacity in listening with hearing aids, especially for new users. By virtue of its relation to subjective measures of hearing aid outcome, the SWIR test can potentially be used as a tool in assessing hearing aid outcome.