Gitte Keidser

Measuring communication difficulty through effortful speech production during conversation

Abstract This study describes the use of a novel conversation elicitation framework to collect fluent, dynamic conversational speech in simulated realistic acoustic environments of varying complexities. Our aim is to quantify speech modifications during conversation, which characterize effortful speech, as a function of the difficulty of the acoustic environment. We report speech production data at the acoustic-phonetic level (vocal level, mid-frequency emphasis, formant frequencies and formant bandwidths), as well as at higher levels of analysis including utterance duration and turn overlap durations. The sensitivity and test-retest reliability of different speech production measures to changes in acoustic environment are reported. We propose a multi-dimensional view of effortful speech modifications. Considering speech modifications across different linguistic levels provides a richer view of the effects of the acoustic environment on communication as compared with consideration of low-level acoustic-phonetic markers alone. Finally, we describe how consideration of speech modification data may form the basis of a measure of communication effort with scope for the assessment of the impacts of hearing impairment and amplification upon ease of spoken communication.

Predictors of hearing loss self-management in older adults

Abstract Purpose: To determine the factor structure of a clinical tool for the assessment of hearing loss self-management, and to identify predictors of the total score on the assessment and the extracted factor scores. Materials and methods: Hearing loss self-management assessments were conducted with 62 older adults. The factor structure of the assessment was determined by exploratory factor analysis. Multiple linear regression analyses identified significant contributors to the total score and to each of the extracted factors. Results: Three factors were identified, each representing a distinct domain of hearing loss self-management: Actions, Psychosocial Behaviours, and Knowledge. The most common significant predictor was hearing health care experience, which predicted self-management overall and in the Actions and Knowledge domains. Health literacy predicted hearing loss self-management overall and in the Psychosocial Behaviours domain. Actions were additionally predicted by hearing aid self-efficacy and gender, Psychosocial Behaviours by health locus of control, and Knowledge by age. Conclusions: The results of the factor analysis suggested that hearing loss self-management is a multidimensional construct. Each domain of hearing loss self-management was influenced by different contextual factors. Subsequent interventions to improve hearing loss self-management should therefore be domain-specific and tailored to relevant contextual factors. Implications for rehabilitation Hearing loss is a chronic health condition that requires on-going self-management of its effects on everyday life. Hearing loss self-management is multidimensional and encompasses the domains of Actions, Psychosocial Behaviours, and Knowledge. Different contextual factors influence each hearing loss self-management domain, including previous experience receiving hearing health care services, health literacy, hearing aid self-efficacy, health locus of control, age, and gender. Audiological rehabilitation programs should thus ensure that interventions to improve hearing loss self-management are domain- and context-specific.