Assessment of Listening Effort Experience in Normal and Hearing Impaired Adult Population

Abstract Background Hearing impaired patients often report difficulties on attending to auditory message. These difficulties are not only exclusive to understanding the auditory message, rather, the process itself become effortful and induce tiredness or fatigue. While conventional Puretone audiometry and speech audiometry are efficient tools to access hearing impaired individuals, they do not address the perceived Listening Effort (LE) that the patient faces on daily basis. Accordingly, LE assessment tools represent a relatively new dimension in evaluating hearing impaired population. These tools include a subjective self-report questionnaires as the Speech, Spatial, Qualities of hearing scale (SSQ), a behavioral tool such as the dual task paradigms, and an objective physiological tool such as pupillometry, skin conductance, heart rate, Electroencephalography (EEG), functional magnetic resonance imaging(fMRI). This study has used subjective self-rating Arabic version of SSQ scale, and an objective physiological tool which is pupillometry to measure LE for adult hearing aid users. Aim of the Work To standardize LE assessment tools namely the Arabic version of SSQ, and Pupillometry in normal hearing adults. To assess LE in adult Hearing aids (HA) users to investigate whether they still suffer even after being optimally fitted with HA. Patients and Methods The study consisted of one hundred and eleven adult individuals divided into two groups; a normal hearing group (sixty normal individuals) with mean age 40 years and a study group (fifty-one HA users with bilateral symmetrical sensorineural hearing loss of variable degrees) with mean age 35 years and hearing loss duration ranging from 2-49 years. Patients were recruited from Audiology Unit, ORL department, Ain Shams University. Listening effort was measured by a subjective self-report scale (Arabic version of Speech, Spatial, and Qualities of Hearing scale (SSQ)), and a physiological objective tool (Pupillometry) to measure pupil dilation quotient. Results Hearing aid users group revealed statistically significant increased listening effort for both subjective and objective methods referenced to age matched normal group. Conclusions Listening effort test battery is clinically feasible in audiology practice and could help understand the challenges the hearing impaired faces. HA algorithms and technology have not resolved LE for the majority of HA users.