Cognition and hearing aids

The perceptual information transmitted from a damaged cochlea to the brain is more poorly specified than information from an intact cochlea and requires more processing in working memory before language content can be decoded. In addition to making sounds audible, current hearing aids include several technologies that are intended to facilitate language understanding for persons with hearing impairment in challenging listening situations. These include directional microphones, noise reduction, and fast-acting amplitude compression systems. However, the processed signal itself may challenge listening to the extent that with specific types of technology, and in certain listening situations, individual differences in cognitive processing resources may determine listening success. Here, current and developing digital hearing aid signal processing schemes are reviewed in the light of individual working memory (WM) differences. It is argued that signal processing designed to improve speech understanding may have both positive and negative consequences, and that these may depend on individual WM capacity.     

Cognition and aided speech recognition in noise: Specific role for cognitive factors following nine-week experience with adjusted compression settings in hearing aids

The working memory model for Ease of Language Understanding (ELU) proposes that language understanding under taxing conditions is related to explicit cognitive capacity. We refer to this as the mismatch hypothesis, since phonological representations based on the processing of speech under established conditions may not be accessed so readily when input conditions change and a match becomes problematic. Then, cognitive capacity requirements may differ from those used for processing speech hitherto. In the present study, we tested this hypothesis by investigating the relationship between aided speech recognition in noise and cognitive capacity in experienced hearing aid users when there was either a match or mismatch between processed speech input and established phonological representations. The settings in the existing digital hearing aids of the participants were adjusted to one of two different compression settings which processed the speech signal in qualitatively different ways ("fast" or "slow"). Testing took place after a 9-week period of experience with the new setting. Speech recognition was tested under different noise conditions and with match or mismatch (i.e. alternative compression setting) manipulations of the input signal. Individual cognitive capacity was measured using a reading span test and a letter monitoring test. Reading span, a reliable measure of explicit cognitive capacity, predicted speech recognition performance under mismatch conditions when processed input was incongruent with recently established phonological representations, due to the specific hearing aid setting. Cognitive measures were not main predictors of performance under match conditions. These findings are in line with the ELU model.