Remember Me
Or use your Academic/Social account:


Or use your Academic/Social account:


You have just completed your registration at OpenAire.

Before you can login to the site, you will need to activate your account. An e-mail will be sent to you with the proper instructions.


Please note that this site is currently undergoing Beta testing.
Any new content you create is not guaranteed to be present to the final version of the site upon release.

Thank you for your patience,
OpenAire Dev Team.

Close This Message


Verify Password:
Verify E-mail:
*All Fields Are Required.
Please Verify You Are Human:
fbtwitterlinkedinvimeoflicker grey 14rssslideshare1
Ohlenforst, Barbara; Zekveld, Adriana A.; Jansma, Elise P.; Wang, Yang; Naylor, Graham; Lorens, Artur; Lunner, Thomas; Kramer, Sophia E. (2017)
Publisher: Williams And Wilkins
Journal: Ear and Hearing
Languages: English
Types: Article
Subjects: Listening effort, Behavioral measures, Subjective ratings, Hearing impairment, Speech comprehension, Hearing aid amplification, Systematic Review, Physiologic measures, Quality rating

Classified by OpenAIRE into

mesheuropmc: otorhinolaryngologic diseases
Objectives: To undertake a systematic review of available evidence on the effect of hearing impairment and hearing aid amplification on listening effort. Two research questions were addressed: Q1) does hearing impairment affect listening effort? and Q2) can hearing aid amplification affect listening effort during speech comprehension? Design: English language articles were identified through systematic searches in PubMed, EMBASE, Cinahl, the Cochrane Library, and PsycINFO from inception to August 2014. References of eligible studies were checked. The Population, Intervention, Control, Outcomes, and Study design strategy was used to create inclusion criteria for relevance. It was not feasible to apply a meta-analysis of the results from comparable studies. For the articles identified as relevant, a quality rating, based on the 2011 Grading of Recommendations Assessment, Development, and Evaluation Working Group guidelines, was carried out to judge the reliability and confidence of the estimated effects. Results: The primary search produced 7017 unique hits using the keywords: hearing aids OR hearing impairment AND listening effort OR perceptual effort OR ease of listening. Of these, 41 articles fulfilled the Population, Intervention, Control, Outcomes, and Study design selection criteria of: experimental work on hearing impairment OR hearing aid technologies AND listening effort OR fatigue during speech perception. The methods applied in those articles were categorized into subjective, behavioral, and physiological assessment of listening effort. For each study, the statistical analysis addressing research question Q1 and/or Q2 was extracted. In seven articles more than one measure of listening effort was provided. Evidence relating to Q1 was provided by 21 articles that reported 41 relevant findings. Evidence relating to Q2 was provided by 27 articles that reported 56 relevant findings. The quality of evidence on both research questions (Q1 and Q2) was very low, according to the Grading of Recommendations Assessment, Development, and Evaluation Working Group guidelines. We tested the statistical evidence across studies with nonparametric tests. The testing revealed only one consistent effect across studies, namely that listening effort was higher for hearing-impaired listeners compared with normal-hearing listeners (Q1) as measured by electroencephalographic measures. For all other studies, the evidence across studies failed to reveal consistent effects on listening effort. Conclusion: In summary, we could only identify scientific evidence from physiological measurement methods, suggesting that hearing impairment increases listening effort during speech perception (Q1). There was no scientific, finding across studies indicating that hearing aid amplification decreases listening effort (Q2). In general, there were large differences in the study population, the control groups and conditions, and the outcome measures applied between the studies included in this review. The results of this review indicate that published listening effort studies lack consistency, lack standardization across studies, and have insufficient statistical power. The findings underline the need for a common conceptual framework for listening effort to address the current shortcomings.
  • The results below are discovered through our pilot algorithms. Let us know how we are doing!

    • Ahlstrom, J. B., Horwitz, A. R., Dubno, J. R. (2014). Spatial separation benefit for unaided and aided listening. Ear Hear, 35, 72-85.
    • Armstrong, E. C. (1999). The well-built clinical question: The key to finding the best evidence efficiently. WMJ, 98, 25-28.
    • Baguley, T. (2012). Serious Stats: A Guide to Advanced Statistics for the Behavioral Science. Palgrave Macmillan.
    • Bentler, R. A., & Duve, M. R. (2000). Comparison of hearing aids over the 20th century. Ear Hear, 21, 625-639.
    • Bentler, R., Wu, Y. H., Kettel, J., et al. (2008). Digital noise reduction: Outcomes from laboratory and field studies. Int J Audiol, 47, 447-460.
    • Bernarding, C., Strauss, D. J., Hannemann, R., et al. (2013). Neural correlates of listening effort related factors: Influence of age and hearing impairment. Brain Res Bull, 91, 21-30.
    • Bertoli, S., & Bodmer, D. (2016). Effects of age and task difficulty on ERP responses to novel sounds presented during a speech-perception-in-noise test. Clin Neurophysiol, 127, 360-368.
    • Brons, I., Houben, R., Dreschler, W. A. (2013). Perceptual effects of noise reduction with respect to personal preference, speech intelligibility, and listening effort. Ear Hear, 34, 29-41.
    • Brons, I., Houben, R., Dreschler, W. A. (2014). Effects of noise reduction on speech intelligibility, perceived listening effort, and personal preference in hearing-impaired listeners. Trends hear, 18.
    • Demorest, M. E., & Erdman, S. A. (1986). Scale composition and item analysis of the communication profile for the hearing impaired. J Speech Hear Res, 29, 515-535.
    • Desjardins, J. L., & Doherty, K. A. (2013). Age-related changes in listening effort for various types of masker noises. Ear Hear, 34, 261-272.
    • Desjardins, J. L., & Doherty, K. A. (2014). The effect of hearing aid noise reduction on listening effort in hearing-impaired adults. Ear Hear, 35, 600-610.
    • Dillon, H. (2001). Hearing Aids (1st ed.). Turramurra, Australia: Boomerang Press.
    • Downs, D. W. (1982). Effects of hearing and use on speech discrimination and listening effort. J Speech Hear Disord, 47, 189-193.
    • Dwyer, N. Y., Firszt, J. B., Reeder, R. M. (2014). Effects of unilateral input and mode of hearing in the better ear: Self-reported performance using the speech, spatial and qualities of hearing scale. Ear Hear, 35, 126-136.
    • Ebell, M. (1999). Information at the point of care: Answering clinical questions. J Am Board Fam Pract, 12, 225-235.
    • Edwards, B. (2007). The future of hearing aid technology. Trends Amplif, 11, 31-45.
    • Feuerstein, J. F. (1992). Monaural versus binaural hearing: Ease of listening, word recognition, and attentional effort. Ear Hear, 13, 80-86.
    • Fraser, S., Gagné, J. P., Alepins, M., et al. (2010). Evaluating the effort expended to understand speech in noise using a dual-task paradigm: The effects of providing visual speech cues. J Speech Lang Hear Res, 53, 18-33.
    • Gatehouse, S., & Gordon, J. (1990). Response times to speech stimuli as measures of benefit from amplification. Br J Audiol, 24, 63-68.
    • Gosselin, P. A., & Gagné, J. P. (2010). Use of a dual-task paradigm to measure listening effort. Can J Speech Lang Pathol Audiol, 34, 43-51.
    • Gosselin, P. A., & Gagné, J. P. (2011). Older adults expend more listening effort than young adults recognizing speech in noise. J Speech Lang Hear Res, 54, 944-958.
    • Granholm, E., Asarnow, R. F., Sarkin, A. J., et al. (1996). Pupillary responses index cognitive resource limitations. Psychophysiology, 33, 457-461.
    • Gustafson, S., McCreery, R., Hoover, B., et al. (2014). Listening effort and perceived clarity for normal-hearing children with the use of digital noise reduction. Ear Hear, 35, 183-194.
    • Guyatt, G. H., Oxman, A. D., Kunz, R., et al.; GRADE Working Group. (2008). What is “quality of evidence” and why is it important to clinicians? BMJ, 336, 995-998.
    • Guyatt, G. H., Oxman, A. D., Schünemann, H. J., et al. (2011). GRADE guidelines: A new series of articles in the Journal of Clinical Epidemiology. J Clin Epidemiol, 64, 380-382.
    • Hagerman, B. (1984). Clinical measurements of speech reception threshold in noise. Scand Audiol, 13, 57-63.
    • Hällgren, M., Larsby, B., Lyxell, B., et al. (2005). Speech understanding in quiet and noise, with and without hearing aids. Int J Audiol, 44, 574-583.
    • Harlander, N., Rosenkranz, T., Hohmann, V. (2012). Evaluation of modelbased versus non-parametric monaural noise-reduction approaches for hearing aids. Int J Audiol, 51, 627-639.
    • Hedley-Williams, A., Humes, L. E., Christensen, L. A., Bess, F. H., HedleyWilliams, A. (1997). A comparison of the benefit provided by well-fit linear hearing aids and instruments with automatic reductions of lowfrequency gain. J Speech Lang Hear Res, 40, 666-685.
    • Hick, C. B., & Tharpe, A. M. (2002). Listening effort and fatigue in schoolage children with and without hearing loss. J Speech Lang Hear Res, 45, 573-584.
    • Hopkins, K., Moore Brian, C. J., Stone Michael, A. (2005). Effects of moderate cochlear hearing loss on the ability to benefit from temporal fine structure information in speech. J Acoust Soc Am, 123, 1140-1153.
    • Hornsby, B. W. (2013). The effects of hearing aid use on listening effort and mental fatigue associated with sustained speech processing demands. Ear Hear, 34, 523-534.
    • Howard C. S.., Munro Kevin J., Plack Christopher J. (2010). Listening effort at signal-to-noise ratios that are typical of the school classroom. Int J Audiol, 49, 1708-8186.
    • Humes, L. E. (1999). Dimensions of hearing aid outcome. J Am Acad Audiol, 10, 26-39.
    • Humes, L. E., & Humes, L. E. (2004). Factors affecting long-term hearing aid success. In Seminars in Hearing (Vol. 25, pp. 63-72). New York, NY: Thieme Medical Publishers, Inc.
    • Humes L. E.., & Roberts L. (1990). Speech-recognition difficulties of the hearing impaired elderly: The contributions of audibility. J Speech Hear Res, 33, 726-735.
    • Humes, L. E., Christensen, L. A., Bess, F. H., et al. (1997). A comparison of the benefit provided by well-fit linear hearing aids and instruments with automatic reductions of low-frequency gain. J Speech Lang Hear Res, 40, 666-685.
    • Kahneman, D. (1973). Attention and Effort. New Jersey: Prentice-Hall.
    • Koelewijn T, Zekveld, A., Festen J. M., Kramer S. E. (2012). Pupil dilation uncovers extra listening effort in the presence of a single-talker masker. Ear Hear, 33, 291-300.
    • Korczak, P. A., Kurtzberg, D., Stapells, D. R. (2005). Effects of sensorineural hearing loss and personal hearing AIDS on cortical event-related potential and behavioral measures of speech-sound processing. Ear Hear, 26, 165-185.
    • Kramer S. E., Kapteyn T. S., Festen J. M., Kuik D. J. (1997). Assessing aspects of auditory handicap by means of pupil dilatation. Audiology, 36, 155-164.
    • Kramer, S. E., Kapteyn, T. S., Houtgast, T. (2006). Occupational performance: comparing normally-hearing and hearing-impaired employees using the Amsterdam Checklist for Hearing and Work. Int J Audiol, 45, 503-512.
    • Kuchinsky, S. E., Ahlstrom, J. B., Vaden, K. I. Jr, et al. (2013). Pupil size varies with word listening and response selection difficulty in older adults with hearing loss. Psychophysiology, 50, 23-34.
    • Kulkarni, P. N., Pandey, P. C., Jangamashetti, D. S. (2012). Multi-band frequency compression for improving speech perception by listeners with moderate sensorineural hearing loss. Speech Commun, 54, 341-350.
    • Laeng, B., Sirois, S., Gredebäck, G. (2012). Pupillometry: A window to the preconscious? Perspect Psychol Sci, 7, 18-27.
    • Larsby, B., Hällgren, M., Lyxell, B., et al. (2005). Cognitive performance and perceived effort in speech processing tasks: Effects of different noise backgrounds in normal-hearing and hearing-impaired subjects. Int J Audiol, 44, 131-143.
    • Luts, H., Eneman, K., Wouters, J., et al. (2010). Multicenter evaluation of signal enhancement algorithms for hearing aids. J Acoust Soc Am, 127, 1491-1505.
    • Mackersie, C. L., & Cones, H. (2011). Subjective and psychophysiological indexes of listening effort in a competing-talker task. J Am Acad Audiol, 22, 113-122.
    • Mackersie, C. L., MacPhee, I. X., Heldt, E. W. (2015). Effects of hearing loss on heart rate variability and skin conductance measured during sentence recognition in noise. Ear Hear, 36, 145-154.
    • Martin, B. A., & Stapells, D. R. (2005). Effects of low-pass noise masking on auditory event-related potentials to speech. Ear Hear, 26, 195-213.
    • McCoy, S. L., Tun, P. A., Cox, L. C., et al. (2005). Hearing loss and perceptual effort: Downstream effects on older adults' memory for speech. Q J Exp Psychol A, 58, 22-33.
    • McGarrigle, R., Munro, K. J., Dawes, P., et al. (2014). Listening effort and fatigue: What exactly are we measuring? A British Society of Audiology Cognition in Hearing Special Interest Group 'white paper'. Int J Audiol, 53, 433-440.
    • Moher, D., Liberati, A., Tetzlaff, J., et al.; PRISMA Group. (2009). Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. Ann Intern Med, 151, 264-9, W64.
    • Neher, T., Grimm, G., Hohmann, V., et al. (2014a). Do hearing loss and cognitive function modulate benefit from different binaural noise-reduction settings? Ear Hear, 35, e52-e62.
    • Neher, T., Grimm, G., Hohmann, V. (2014). Perceptual consequences of different signal changes due to binaural noise reduction: Do hearing loss and working memory capacity play a role? Ear Hear, 35, e213-e227.
    • Noble, W., & Gatehouse, S. (2006). Effects of bilateral versus unilateral hearing aid fitting on abilities measured by the speech, spatial, and qualities of hearing scale (SSQ). Int J Audiol, 45, 172-181.
    • Noble, W., Tyler, R., Dunn, C., et al. (2008). Unilateral and bilateral cochlear implants and the implant-plus-hearing-aid profile: Comparing self-assessed and measured abilities. Int J Audiol, 47, 505-514.
    • Oates, P. A., Kurtzberg, D., Stapells, D. R. (2002). Effects of sensorineural hearing loss on cortical event-related potential and behavioral measures of speech-sound processing. Ear Hear, 23, 399-415.
    • Obleser, J., Wöstmann, M., Hellbernd, N., Wilsch, A., Maess, B. (2012). Adverse listening conditions and memory load drive a common alpha oscillatory network. J Neurosci, 32, 12376-12383.
    • Pals, C., Sarampalis, A., Baskent, D. (2013). Listening effort with cochlear implant simulations. J Speech Lang Hear Res, 56, 1075-1084.
    • Petersen E. B., Wöstmann, M., Obleser, J., Stenfelt, S., Lunner, T. (2015). Hearing loss impacts neural alpha oscillations under adverse listening conditions. Front Psychol, 6.
    • Picou, E. M., Ricketts, T. A., Hornsby, B. W. (2013). How hearing aids, background noise, and visual cues influence objective listening effort. Ear Hear, 34, e52-e64.
    • Picou, E. M., Aspell, E., Ricketts, T. A. (2014). Potential benefits and limitations of three types of directional processing in hearing aids. Ear Hear, 35, 339-352.
    • Plomp, R. (1986). A signal-to-noise ratio model for the speech-reception threshold of the hearing impaired. J Speech, Lang Hear Res, 29, 146-154.
    • Rakerd, B., Seitz, P. F., Whearty, M. (1996). Assessing the cognitive demands of speech listening for people with hearing losses. Ear Hear, 17, 97-106.
    • Richardson, W. S., Wilson, M. C., Nishikawa, J., et al. (1995). The well-built clinical question: A key to evidence-based decisions. ACP J Club, 123, A12-A13.
    • Rönnberg, J., Lunner, T., Zekveld, A., et al. (2013). The ease of language understanding (ELU) model: Theoretical, empirical, and clinical advances. Front Syst Neurosci, 7, 31.
    • Sarampalis, A., Kalluri, S., Edwards, B., et al. (2009). Objective measures of listening effort: Effects of background noise and noise reduction. J Speech Lang Hear Res, 52, 1230-1240.
    • Schünemann, H., Brozek, J., Guyatt, G., Oxman, A. (2013). GRADE Handbook: Handbook for Grading the Quality of Evidence and the Strength of Recommendations Using the GRADE Approach. Available at: http://gdt. guidelinedevelopment.org/app/handbook/handbook.html.
    • Shinn-Cunningham, B. G., & Best, V. (2008). Selective attention in normal and impaired hearing. Trends Amplif.
    • Steel, M. M., Papsin, B. C., Gordon, K. A. (2015). Binaural fusion and listening effort in children who use bilateral cochlear implants: A psychoacoustic and pupillometric study. PLoS One, 10, e0117611.
    • Stelmachowicz, P. G., Lewis, D. E., Choi, S., et al. (2007). Effect of stimulus bandwidth on auditory skills in normal-hearing and hearing-impaired children. Ear Hear, 28, 483-494.
    • Stephens, D., & Hétu, R. (1991). Impairment, disability and handicap in audiology: Towards a consensus. Audiology, 30, 185-200.
    • Strawbridge, W., Wallhagen, M. I., Shema, S. J., Kaplan, G. A. (2000). Negative consequences of hearing impairment in old age: A longitudinal analysis. Gerontologist, 40, 320-326.
    • Tun, P. A., McCoy, S. L., Wingfield, A. (2009). Aging, hearing acuity, and the attentional costs of effortful listening. Psychol Aging, 24, 761-766.
    • Weinstein, B. E., & Ventry, I. M. (1982). Hearing impairment and social isolation in the elderly. J Speech Hear Res, 25, 593-599.
    • Wild, C. J., Yusuf, A., Wilson, D. E., et al. (2012). Effortful listening: The processing of degraded speech depends critically on attention. J Neurosci, 32, 14010-14021.
    • Winn, M. B., Edwards, J. R., Litovsky, R. Y. (2015). The impact of auditory spectral resolution on listening effort revealed by pupil dilation. Ear Hear, 36, e153-e165.
    • Wu,Y. H., Aksan, N., Rizzo, M., et al. (2014). Measuring listening effort: Driving simulator versus simple dual-task paradigm. Ear Hear, 35, 623-632.
    • Xia, J., Nooraei, N., Kalluri, S., et al. (2015). Spatial release of cognitive load measured in a dual-task paradigm in normal-hearing and hearingimpaired listeners. J Acoust Soc Am, 137, 1888-1898.
    • Zekveld, A. A., Kramer, S. E., Festen, J. M. (2011). Cognitive load during speech perception in noise: The influence of age, hearing loss, and cognition on the pupil response. Ear Hear, 32, 498-510.
    • Zekveld, A. A., Kramer, S. E., Festen, J. M. (2010). Pupil response as an indication of effortful listening: The influence of sentence intelligibility. Ear Hear, 31, 480-490.
  • Inferred research data

    The results below are discovered through our pilot algorithms. Let us know how we are doing!

    Title Trust
  • No similar publications.

Share - Bookmark

Funded by projects


Cite this article