|Title:||Fatigue and Listening Effort in School-Age Children with Hearing Loss|
|Principal Investigator:||Bess, Fred||Awardee:||Vanderbilt University Medical Center|
|Program:||Cognition and Student Learning in Special Education [Program Details]|
|Award Period:||7/1/2011–6/30/2015||Award Amount:||$1,495,212|
Previous Institution: Vanderbilt University
Purpose: Although research has demonstrated that children with hearing loss (CHL) experience difficulties with speech recognition under noisy conditions, less is known about the listening effort expended and its effects on hearing-related fatigue. The purpose of this study is to investigate whether school-aged children with mild to moderate hearing loss experience greater fatigue caused by listening effort in noisy school classrooms than children without hearing loss. The researchers will compare CHL to students without hearing loss on fatigue and subsequent stress, assessed with biochemical markers, during the course of a full day. In addition, they will compare CHL to typically hearing students on cognitive effort used during listening tasks; fatigue due to listening effort on these tasks; and the impact of such listening-related fatigue on basic learning (phonological processing) skills. The anticipated results of this study are expected to inform the development of school-based interventions aimed at helping CHL manage the challenges of attention and cognitive resources in the classroom, such as the provision of small group instruction, seating arrangements that minimize distraction, utilization of breaks, and scheduling more demanding listening tasks earlier in the day.
Project Activities: After screening children for eligibility (e.g., hearing assessment), the research team will obtain data on diurnal variations in salivary cortisol, collected multiple times over two separate days. Parents will assist by collecting salivary samples at home and completing a demographic survey. The children will also engage in a laboratory dual-task paradigm to examine cognitive effort needed to perform speech recognition with background noise, with event-related potentials measured prior to and following this task as a psychophysiologic indicator of fatigue. The same children will also take a test of phonological processing both on a weekend morning (pretest) and after school (posttest), and complete a questionnaire on their perception of fatigue, to determine the effect of listening-related fatigue on learning skills.
Products: Products from this project will include published reports and presentations on the comparison of children with and without hearing loss on cognitive effort in listening, fatigue and subsequent stress, and the effect of listening-related fatigue on phonological processing skills.
Setting: Data will be collected in a variety of settings—university laboratory, children's schools, and children's homes—in Tennessee.
Population: The population will consist of 90 students, 6–12 years of age, attending general education classrooms for at least part of the school day. Half of the sample will be children with mild to moderate bilateral sensorineural hearing loss and half will be children without such hearing loss.
Intervention: There is no intervention.
Research Design and Methods: This is a mixed methods approach to investigate listening-related fatigue in school-aged CHL. Researchers (and parents) will take samples of salivary cortisol throughout a full day, on two separate days, for children with and without mild to moderate hearing loss to examine diurnal variations in stress response. The children will also engage in a laboratory dual-task paradigm to examine cognitive effort needed to perform speech recognition with background noise, with data collected on event-related potentials prior to and following this task (as a psychophysiologic indicator of fatigue). The same children will also take a test of phonological processing both on a weekend morning (pretest) and after school (posttest), as well as complete a questionnaire on fatigue, to determine the effect of listening-related fatigue on learning skills.
Control Condition: The control group will be school-aged children without sensorineural hearing loss.
Key Measures: Assessments include a parental demographic questionnaire, audiologic measures (e.g., hearing assessment), Test of Non-verbal Intelligence, PedsQL Multidimensional Fatigue scale, salivary cortisol samples, dual-task paradigm, event-related potentials, Comprehensive Test of Phonological Processing, and Child Fatigue Scale–R.
Data Analytic Strategy: The main analytical approach for addressing the study hypotheses will be mixed effects or hierarchical linear modeling. For the cortisol data, there will also be an exploratory analysis of change over time using a longitudinal mixture model.
Journal article, monograph, or newsletter
Bess, F.H., and Hornsby, B.W. (2014). The Complexities of Fatigue in Children With Hearing Loss. Perspectives on Hearing and Hearing Disorders in Childhood, 24(2): 25–39. doi:10.1044/hhdc24.2.25
Bess, F.H., and Hornsby, B.Y. (2014). Commentary: Listening can be Exhausting—Fatigue in Children and Adults With Hearing Loss. Ear and Hearing, 35(6): 592–599. doi:10.1097/AUD.0000000000000099
Bess, F.H., Gustafson, S.J., and Hornsby, B.W. (2014). How Hard can it be to Listen? Fatigue in School-Age Children With Hearing Loss. Journal of Educational Audiology, 20: 1–14. Full text
Hornsby, B. W., Naylor, G., and Bess, F. H. (2016). A Taxonomy of Fatigue Concepts and Their Relation to Hearing Loss. Ear and Hearing, 37: Suppl 1, 136S-144S. doi:10.1097/AUD.0000000000000289
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. doi:10.1097/AUD.0b013e31828003d8
Hornsby, B.W.Y., Werfel, K., Camarata, S., and Bess, F.H. (2014). Subjective Fatigue in Children With Hearing Loss: Some Preliminary Findings. American Journal of Audiology, 23: 129–134. doi:10.1044/1059–0889(2013/13–0017)
Porter, H.L., Sladen, D.P. Rothpletz, A.M., Ampah, S.B., and Bess, F.H. (2013). Developmental Outcomes in Early School-Aged Children With Minimal Hearing Loss. American Journal of Audiology, 22: 263–270. doi:10.1044/1059–0889