Listening Requires More Effort for Children with Hearing Loss

Noisy Classrooms Add to Learning Difficulties for Students with Hearing Problems

(ROCKVILLE, MD) Children with hearing loss expend more effort in listening than their normally hearing counterparts, which may lead to difficulties in classroom work such as note-taking for those with hearing loss, according to a study reported in the June issue of the American Speech-Language-Hearing Association's (ASHA) Journal of Speech, Language, and Hearing Research.

Parents, audiologists and educators have long speculated that children with hearing loss must expend more effort, and therefore fatigue more easily, than their peers when listening in adverse acoustic conditions. Recognizing that classroom acoustic factors such as signal-to-noise ratio and reverberation time are often poorer than what is recommended for optimal listening, researchers compared the levels of fatigue and listening effort required by children with hearing loss to those of children with normal hearing. Even though they found little evidence of differences in the fatigue levels of the two groups, the researchers observed that children with hearing loss, even those who used personal amplification systems, expended greater listening effort in both easy and difficult listening conditions than children with normal hearing.

The researchers asked 14 children with hearing loss and 14 children with normal hearing to perform a primary task of listening in varying levels of background noise simultaneously with a secondary task of pushing a button in response to random presentations of a probe. The researchers observed poorer reaction times in the secondary task by the children with hearing loss than in their peers, indicating increased effort in the primary listening task. Interestingly, all of the listening conditions in current study incorporated better signal-to-noise levels than those typically found in classroom environments.

"This study is an important step in looking at the effects of hearing loss in children," says study author Candace Bourland Hicks of the Texas Tech University Health Sciences Center. "Although we have observed over the years that children with hearing loss appear to have less energy at the end of a school day than children with normal hearing, this study provides the first evidence that children with hearing loss actually expend more energy listening than their normal hearing counterparts."

While the researchers did find that the average salivary cortisol levels they used to measure fatigue significantly decreased throughout the school day in all children, they did not observe significant differences in the levels of the two groups. Among the possible explanations offered by researchers relating to the outcome of the fatigue experiment were:

that the stress of listening in less than optimal conditions may not accumulate to a point resulting in fatigue;

that the inability to attend to speech in the classroom setting has been misinterpreted as fatigue when in fact children are bored or not paying attention;

that adequate amplification such as that worn by a majority of the children with hearing loss in the current study may reduce stress or fatigue related to listening, or

that cortisol levels were not sensitive enough to capture changes in fatigue or stress related to listening.

Article: "Listening Effort and Fatigue in School-Age Children With and Without Hearing Loss," Candace Bourland Hicks, Texas Tech University Health Sciences Center, and Anne Marie Tharpe, Vanderbilt Bill Wilkerson Center for Otolaryngology and Communication Sciences; Journal of Speech, Language, and Hearing Research, Vol. 45, June 2002.
For the full text of this article, contact Mike Rick at 301-897-7351 or mrick@asha.org, or Mona Thomas at 301-897-0156 or mthomas@asha.org. An abstract of the article and additional information on hearing loss in children can be found on ASHA's consumer website at www.asha.org.

ASHA also offers a free consumer brochure entitled "Hearing, Noise, and School-Age Children," which examines the effects of noise in the classroom as well as several other issues related to children's hearing, including the types and signs of hearing loss, the relationship between noise and hearing loss, and how parents can get services for their child. Consumers can receive a copy of the brochure by calling ASHA's toll-free HELPLINE at 1-800-638-8255 (TALK).

The American Speech-Language-Hearing Association is the national professional, scientific, and credentialing association for more than 105,000 audiologists, speech-language pathologists, and speech, language, and hearing scientists. Audiologists specialize in preventing and assessing hearing disorders as well as providing audiologic treatment including hearing aids. Speech-language pathologists identify, assess, and treat speech and language problems including swallowing disorders.