No AccessJournal of Speech, Language, and Hearing ResearchResearch Article18 Dec 2019

Listening Effort Among Adults With and Without Attention-Deficit/Hyperactivity Disorder

    Purpose

    Few studies have assessed listening effort (LE)—the cognitive resources required to perceive speech—among populations with intact hearing but reduced availability of cognitive resources. Attention/deficit/hyperactivity disorder (ADHD) is theorized to restrict attention span, possibly making speech perception in adverse conditions more challenging. This study examined the effect of ADHD on LE among adults using a behavioral dual-task paradigm (DTP).

    Method

    Thirty-nine normal-hearing adults (aged 21–27 years) participated: 19 with ADHD (ADHD group) and 20 without ADHD (control group). Baseline group differences were measured in visual and auditory attention as well as speech perception. LE using DTP was assessed as the performance difference on a visual–motor task versus a simultaneous auditory and visual–motor task.

    Results

    Group differences in attention were confirmed by differences in visual attention (larger reaction times between congruent and incongruent conditions) and auditory attention (lower accuracy in the presence of distractors) among the ADHD group, compared to the controls. LE was greater among the ADHD group than the control group. Nevertheless, no group differences were found in speech perception.

    Conclusions

    LE is increased among those with ADHD. As a DTP assumes limited cognitive capacity to allocate attentional resources, LE among those with ADHD may be increased because higher level cognitive processes are more taxed in this population. Studies on LE using a DTP should take into consideration mechanisms of selective and divided attention. Among young adults who need to continuously process great volumes of auditory and visual information, much more effort may be expended by those with ADHD than those without it. As a result, those with ADHD may be more prone to fatigue and irritability, similar to those who are engaged in more outwardly demanding tasks.

    References

    • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders: DSM-5. Washington, DC: Author.
    • Arlinger, S., Lunner, T., Lyxell, B., & Pichora-Fuller, M. K. (2009). The emergence of cognitive hearing science.Scandinavian Journal of Psychology, 50(5), 371–384.
    • Biehl, S. C., Gschwendtner, K. M., Guhn, A., Müller, L. D., Reichert, S., Heupel, J., … Jacob, C. P. (2015). Does adult ADHD interact with COMT val (158) met genotype to influence working memory performance.ADHD Attention Deficit and Hyperactivity Disorders, 7(1), 19–25.
    • Blomberg, R., Danielsson, H., Rudner, M., Söderlund, G. B., & Rönnberg, J. (2019). Speech processing difficulties in attention deficit hyperactivity disorder (ADHD).Frontiers in Psychology, 10, 1536.
    • Boothroyd, A. (1968). Statistical theory of the speech discrimination score.The Journal of the Acoustical Society of America, 43(2), 362–367.
    • Broadbent, D. E. (1958). The effects of noise on behavior.In D. E. Broadbent (Ed.), Perception and communication (pp. 81–107). Elmsford, NY: Pergamon.
    • Brown, V. A., & Strand, J. F. (2019). Noise increases listening effort in normal-hearing young adults, regardless of working memory capacity.Language, Cognition and Neuroscience, 34(5), 628–640.
    • Childress, A. C. (2016). Methylphenidate HCl for the treatment of ADHD in children and adolescents.Expert Opinion on Pharmacotherapy, 17(8), 1171–1178.
    • Corbett, B., & Stanczak, D. E. (1999). Neuropsychological performance of adults evidencing attention-deficit hyperactivity disorder.Archives of Clinical Neuropsychology, 14(4), 373–387.
    • Desjardins, J. L., & Doherty, K. A. (2014). The effect of hearing aid noise reduction on listening effort in hearing-impaired adults.Ear and Hearing, 35(6), 600–610.
    • Downs, D. W. (1982). Effects of hearing aid use on speech discrimination and listening effort.Journal of Speech and Hearing Disorders, 47(2), 189–193.
    • Downs, D. W., & Crum, M. A. (1978). Processing demands during auditory learning under degraded listening conditions.Journal of Speech and Hearing Research, 21(4), 702–714.
    • Fostick, L. (2017). The effect of attention-deficit/hyperactivity disorder and methylphenidate treatment on the adult auditory temporal order judgment threshold.Journal of Speech, Language, and Hearing Research, 60(7), 2124–2128.
    • Fraser, S., Gagné, J. P., Alepins, M., & Dubois, P. (2010). Evaluating the effort expended to understand speech in noise using a dual-task paradigm: The effects of providing visual speech cues.Journal of Speech, Language, and Hearing Research, 53, 18–33.
    • Freyaldenhoven, M. C., Thelin, J. W., Plyler, P. N., Nabelek, A. K., & Burchfield, S. B. (2005). Effect of stimulant medication on the acceptance of background noise in individuals with attention deficit/hyperactivity disorder.Journal of the American Academy of Audiology, 16(9), 677–686.
    • Gagné, J. P., Besser, J., & Lemke, U. (2017). Behavioral assessment of listening effort using a dual-task paradigm: A review.Trends in Hearing, 21, 2331216516687287.
    • Gallun, F. J., Mason, C. R., & Kidd, G. (2007). Task-dependent costs in processing two simultaneous auditory stimuli.Perception & Psychophysics, 69(5), 757–771.
    • Geffner, D., Lucker, J. R., & Koch, W. (1996). Evaluation of auditory discrimination in children with ADD and without ADD.Child Psychiatry and Human Development, 26(3), 169–180.
    • Goldman, R. (1970). Goldman-Fristoe-Woodcock Test of Auditory Discrimination. Circle Pines, MN: AGS.
    • Goodman, D. W., Mitchell, S., Rhodewalt, L., & Surman, C. B. (2016). Clinical presentation, diagnosis and treatment of attention-deficit hyperactivity disorder (ADHD) in older adults: A review of the evidence and its implications for clinical care.Drugs and Aging, 33(1), 27–36.
    • Gosselin, P. A., & Gagné, J. P. (2010). Use of a dual-task paradigm to measure listening effort.Canadian Journal of Speech-Language Pathology and Audiology, 34, 43–51.
    • Gosselin, P. A., & Gagné, J. P. (2011). Older adults expend more listening effort than young adults recognizing speech in noise.Journal of Speech, Language, and Hearing Research, 54(3), 944–958.
    • Hornsby, B. W. (2013). The effects of hearing aid use on listening effort and mental fatigue associated with sustained speech processing demands.Ear and Hearing, 34(5), 523–534.
    • Hughes, K. C., & Galvin, K. L. (2013). Measuring listening effort expended by adolescents and young adults with unilateral or bilateral cochlear implants or normal hearing.Cochlear Implants International, 14(3), 121–129.
    • Hughes, S. E., Hutchings, H. A., Rapport, F. L., McMahon, C. M., & Boisvert, I. (2018). Social connectedness and perceived listening effort in adult cochlear implant users: A grounded theory to establish content validity for a new patient-reported outcome measure.Ear and Hearing, 39(5), 922–934.
    • Jaśkowski, P. (1993). Selective attention and temporal-order judgment.Perception, 22(6), 681–689.
    • Kieffer, M. J., Vukovic, R. K., & Berry, D. (2013). Roles of attention shifting and inhibitory control in fourth-grade reading comprehension.Reading Research Quarterly, 48(4), 333–348.
    • Kiessling, J., Pichora-Fuller, K., Gatehouse, S., Stephens, D., Arlinger, S., Chisolm, T., … von Wedel, H. (2003). Candidature for and delivery of audiological services: Special needs of older people.International Journal of Audiology, 42(2), S92–S101.
    • Koelewijn, T., de Kluiver, H., Shinn-Cunningham, B. G., Zekveld, A. A., & Kramer, S. E. (2015). The pupil response reveals increased listening effort when it is difficult to focus attention.Hearing Research, 323, 81–90.
    • Koelewijn, T., Zekveld, A. A., Lunner, T., & Kramer, S. E. (2018). The effect of reward on listening effort as reflected by the pupil dilation response.Hearing Research, 367, 106–112.
    • Lam, C. M., & Beale, I. L. (1991). Relations among sustained attention, reading performance, and teachers' ratings of behavior problems.Remedial and Special Education, 12(2), 40–47.
    • Lucker, J. R., Geffner, D., & Koch, W. (1996). Perception of loudness in children with ADD and without ADD.Child Psychiatry and Human Development, 26(3), 181–190.
    • McGarrigle, R., Munro, K. J., Dawes, P., Stewart, A. J., Moore, D. R., Barry, J. G., & Amitay, S. (2014). Listening effort and fatigue: What exactly are we measuring? A British Society of Audiology Cognition in Hearing Special Interest Group ‘white paper.International Journal of Audiology, 53(7), 433–445.
    • McInnes, A., Humphries, T., Hogg-Johnson, S., & Tannock, R. (2003). Listening comprehension and working memory are impaired in children with ADHD irrespective of language development.Journal of Abnormal Child Psychology, 31, 427–433.
    • Michalek, A. M., Watson, S. M., Ash, I., Ringleb, S., & Raymer, A. (2014). Effects of noise and audiovisual cues on speech processing in adults with and without ADHD.International Journal of Audiology, 53(3), 145–152.
    • Mishra, S., Lunner, T., Stenfelt, S., Rönnberg, J., & Rudner, M. (2013). Visual information can hinder working memory processing of speech.Journal of Speech, Language, and Hearing Research, 56(4), 1120–1132.
    • Mor, B., Yitzhaki-Amsalem, S., & Prior, A. (2015). The joint effect of bilingualism and ADHD on executive functions.Journal of Attention Disorders, 19(6), 527–541.
    • Navon, D., & Gopher, D. (1979). On the economy of the human-processing system.Psychological Review, 86(3), 214–255.
    • Ng, E. H. N., Rudner, M., Lunner, T., Pedersen, M. S., & Rönnberg, J. (2013). Effects of noise and working memory capacity on memory processing of speech for hearing-aid users.International Journal of Audiology, 52(7), 433–441.
    • Norman, D. A., & Bobrow, D. G. (1975). On data-limited and resource-limited processes.Cognitive Psychology, 7(1), 44–64.
    • Pals, C., Sarampalis, A., & Başkent, D. (2013). Listening effort with cochlear implant simulations.Journal of Speech, Language, and Hearing Research, 56(4), 1075–1084.
    • Pichora-Fuller, M. K., Kramer, S. E., Eckert, M. A., Edwards, B., Hornsby, B. W. Y., Humes, L. E., … Wingfield, A. (2016). Hearing impairment and cognitive energy: The framework for understanding effortful listening (FUEL).Ear and Hearing, 37(Suppl. 1), 5S–27S.
    • Pichora-Fuller, M. K., Schneider, B. A., & Daneman, M. (1995). How young and old adults listen to and remember speech in noise.The Journal of the Acoustical Society of America, 97(1), 593–608.
    • Picou, E. M., & Ricketts, T. A. (2014). The effect of changing the secondary task in dual-task paradigms for measuring listening effort.Ear and Hearing, 35(6), 611–622.
    • Polanczyk, G., de Lima, M. S., Horta, B. L., Biederman, J., & Rohde, L. A. (2007). The worldwide prevalence of ADHD: A systematic review and metaregression analysis.The American Journal of Psychiatry, 164, 942–948.
    • Rabbitt, P. (1991). Mild hearing loss can cause apparent memory failures which increase with age and reduce with IQ.Acta Oto-Laryngologica, 111(sup476), 167–176.
    • Rönnberg, J. (2003). Cognition in the hearing impaired and deaf as a bridge between signal and dialogue: A framework and a model.International Journal of Audiology, 42, S68–S76.
    • Rönnberg, J., Lunner, T., Zekveld, A., Sörqvist, P., Danielsson, H., Lyxell, B., … Rudner, M. (2013). The ease of language understanding (ELU) model: Theoretical, empirical, and clinical advances.Frontiers in Systems Neuroscience, 7, 31.
    • Rudner, M. (2016). Cognitive spare capacity as an index of listening effort.Ear and Hearing, 37, 69S–76S.
    • Rudner, M., Lunner, T., Behrens, T., Thorén, E. S., & Rönnberg, J. (2012). Working memory capacity may influence perceived effort during aided speech recognition in noise.Journal of the American Academy of Audiology, 23(8), 577–589.
    • Sarampalis, A., Kalluri, S., Edwards, B., & Hafter, E. (2009). Objective measures of listening effort: Effects of background noise and noise reduction.Journal of Speech, Language, and Hearing Research, 52(5), 1230–1240.
    • Seeman, S., & Sims, R. (2015). Comparison of psychophysiological and dual-task measures of listening effort.Journal of Speech, Language, and Hearing Research, 58(6), 1781–1792.
    • Silva, K. L., Guimarães-da-Silva, P. O., Grevet, E. H., Victor, M. M., Salgado, C. A., Vitola, E. S., … Karam, R. G. (2013). Cognitive deficits in adults with ADHD go beyond comorbidity effects.Journal of Attention Disorders, 17(6), 483–488.
    • Söderlund, G., Sikström, S., & Smart, A. (2007). Listen to the noise: Noise is beneficial for cognitive performance in ADHD.The Journal of Child Psychology and Psychiatry, 48(8), 840–847.
    • Söderlund, G. B., & Jobs, E. N. (2016). Differences in speech recognition between children with attention deficits and typically developed children disappear when exposed to 65 dB of auditory noise.Frontiers in Psychology, 7, 34.
    • Soutschek, A., Schwarzkopf, W., Finke, K., Hennig-Fast, K., Müller, H. J., Riedel, M., … Schubert, T. (2013). Interference control in adult ADHD: No evidence for interference control deficits if response speed is controlled by delta plots.Acta Psychologica, 143(1), 71–78.
    • Strauss, D. J., & Francis, A. L. (2017). Toward a taxonomic model of attention in effortful listening.Cognitive, Affective, & Behavioral Neuroscience, 17(4), 809–825.
    • Stroop, J. R. (1935). Studies of interference in serial verbal reactions.Journal of Experimental Psychology, 18(6), 643–662.
    • Taitelbaum-Swead, R., & Fostick, L. (2016). The effect of age and type of noise on speech perception under conditions of changing context and noise levels.Folia Phoniatrica et Logopaedica, 68(1), 16–21.
    • Tarver, J., Daley, D., & Sayal, K. (2014). Attention-deficit hyperactivity disorder (ADHD): An updated review of the essential facts.Child: Care, Health and Development, 40(6), 762–774.
    • Thomas, R., Sanders, S., Doust, J., Beller, E., & Glasziou, P. (2015). Prevalence of attention-deficit/hyperactivity disorder: A systematic review and meta-analysis.Pediatrics, 135(4), e994–e1001.
    • Tun, P. A., McCoy, S., & Wingfield, A. (2009). Aging, hearing acuity, and the attentional costs of effortful listening.Psychology and Aging, 24(3), 761–766.
    • Vakil, E., Mass, M., & Schiff, R. (2016). Eye movement performance on the Stroop test in adults with ADHD.Journal of Attention Disorders, 23, 1160–1169.
    • Van Engen, K. J., & Peelle, J. E. (2014). Listening effort and accented speech.Frontiers in Human Neuroscience, 8, 577.
    • van Mourik, R., Sergeant, J. A., Heslenfeld, D., Konig, C., & Oosterlaan, J. (2011). Auditory conflict processing in ADHD.The Journal of Child Psychology and Psychiatry, 52(3), 265–274.
    • Wassenberg, R., Hendriksen, J. G., Hurks, P. P., Feron, F. J., Vles, J. S., & Jolles, J. (2010). Speed of language comprehension is impaired in ADHD.Journal of Attention Disorders, 13(4), 374–385.
    • Wechsler, D. (1997). WAIS-III, Wechsler Adult Intelligence Scale: Administration and scoring manual. San Antonio, TX: The Psychological Corporation.
    • Wendt, D., Koelewijn, T., Książek, P., Kramer, S. E., & Lunner, T. (2018). Toward a more comprehensive understanding of the impact of masker type and signal-to-noise ratio on the pupillary response while performing a speech-in-noise test.Hearing Research, 369, 67–78.
    • Wu, Y. H., Aksan, N., Rizzo, M., Stangl, E., Zhang, X., & Bentler, R. (2014). Measuring listening effort: Driving simulator versus simple dual-task paradigm.Ear and Hearing, 35(6), 623–632.
    • Zekveld, A. A., Koelewijn, T., & Kramer, S. E. (2018). The pupil dilation response to auditory stimuli: Current state of knowledge.Trends in Hearing, 22, 2331216518777174.

    Additional Resources