title: Measuring listening effort: driving simulator versus simple dual-task paradigm.
abstract: OBJECTIVE
  The dual-task paradigm has been widely used to measure listening effort. The primary objectives of the study were to (1) investigate the effect of hearing aid amplification and a hearing aid directional technology on listening effort measured by a complicated, more real world dual-task paradigm and (2) compare the results obtained with this paradigm to a simpler laboratory-style dual-task paradigm.
  
  
  METHODS
  The listening effort of adults with hearing impairment was measured using two dual-task paradigms, wherein participants performed a speech recognition task simultaneously with either a driving task in a simulator or a visual reaction-time task in a sound-treated booth. The speech materials and road noises for the speech recognition task were recorded in a van traveling on the highway in three hearing aid conditions: unaided, aided with omnidirectional processing (OMNI), and aided with directional processing (DIR). The change in the driving task or the visual reaction-time task performance across the conditions quantified the change in listening effort.
  
  
  RESULTS
  Compared to the driving-only condition, driving performance declined significantly with the addition of the speech recognition task. Although the speech recognition score was higher in the OMNI and DIR conditions than in the unaided condition, driving performance was similar across these three conditions, suggesting that listening effort was not affected by amplification and directional processing. Results from the simple dual-task paradigm showed a similar trend: hearing aid technologies improved speech recognition performance, but did not affect performance in the visual reaction-time task (i.e., reduce listening effort). The correlation between listening effort measured using the driving paradigm and the visual reaction-time task paradigm was significant. The finding showing that our older (56 to 85 years old) participants' better speech recognition performance did not result in reduced listening effort was not consistent with literature that evaluated younger (approximately 20 years old), normal hearing adults. Because of this, a follow-up study was conducted. In the follow-up study, the visual reaction-time dual-task experiment using the same speech materials and road noises was repeated on younger adults with normal hearing. Contrary to findings with older participants, the results indicated that the directional technology significantly improved performance in both speech recognition and visual reaction-time tasks.
  
  
  CONCLUSIONS
  Adding a speech listening task to driving undermined driving performance. Hearing aid technologies significantly improved speech recognition while driving, but did not significantly reduce listening effort. Listening effort measured by dual-task experiments using a simulated real-world driving task and a conventional laboratory-style task was generally consistent. For a given listening environment, the benefit of hearing aid technologies on listening effort measured from younger adults with normal hearing may not be fully translated to older listeners with hearing impairment.
authors.affiliation: 1Department of Communication Sciences and Disorders, The University of Iowa, Iowa City, Iowa, USA; and 2Department of Neurology, The University of Iowa, Iowa City, Iowa, USA.
authors.forename: Yu-Hsiang
authors.initials: YH
authors.lastname: Wu
authors.forename: Nazan
authors.initials: N
authors.lastname: Aksan
authors.forename: Matthew
authors.initials: M
authors.lastname: Rizzo
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Stangl
authors.forename: Xuyang
authors.initials: X
authors.lastname: Zhang
authors.forename: Ruth
authors.initials: R
authors.lastname: Bentler
mesh_terms: D000161:Acoustic Stimulation / Q000379:methods; D000368:Aged; D000369:Aged, 80 and over; D001334:Automobile Driving; D005260:Female; D006310:Hearing Aids; D006319:Hearing Loss, Sensorineural / Q000503:physiopathology / Q000523:psychology* / Q000534:rehabilitation; D006801:Humans; D008297:Male; D008875:Middle Aged; D013067:Speech Perception; D013647:Task Performance and Analysis; D014584:User-Computer Interface
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