A Tipping Point in Listening Effort: Effects of Linguistic Complexity and Age-Related Hearing Loss on Sentence Comprehension.
Nicole D Ayasse, Arthur Wingfield
PMID 30235973WHAT IT FOUND
Older adults with mild-to-moderate hearing loss understood complex sentences less accurately, especially when the doer and action were far apart.
Their pupil size showed more effort, but effort stopped increasing at the hardest sentences.
Key findings
01All groups understood sentences with the common noun-verb order well, but comprehension was worse when the sentence meaning was expressed in a less common order and when the doer and action were separated by extra words.
02Older adults with hearing loss showed the largest comprehension drop when the less common sentence order also separated the doer from the action.
03Pupil dilation increased with poorer hearing, but older adults did not show a further increase for these hardest sentences.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study tested laboratory sentence comprehension, not everyday communication, hearing aid use, or treatment outcomes. All participants were tested unaided, so the results do not show what happens when hearing aids are used. The hearing-impaired group had mild-to-moderate symmetrical hearing loss, so findings may not apply to severe or asymmetric hearing loss. Eleven older adults needed a louder presentation level to pass the initial audibility check, so the task was not presented at the same level for everyone. Pupil size was used as an index of effort, and older adults have smaller pupil dynamic range, so comparisons across age groups require caution. The sample included 14 young adults and 14 older adults in each older group, a small laboratory sample.
Declared interests
The National Institute on Aging and the National Institute of General Medical Sciences funded the work.
The easy way to misread this
Do not read the plateau in pupil dilation as proof that older adults with hearing loss are not trying. The study only shows that pupil size, an index of effort, stopped increasing at the hardest sentences. The authors could not tell whether this reflected reduced ability or reduced willingness.