Listening Effort Is Difficult to Detect in a Person’s Voice: Implications for Audiology Evaluations and Conversation Partners.

Purpose: Listening can be effortful for a variety of reasons, including when a person misperceives a word in a sentence and then mentally repairs it using later context. The current study explored whether an external observer (in the role of a tester/clinician) could detect that effort by hearing the listener’s voice as they repeat the sentence. Method: Stimuli were audio recordings of 13 adults with cochlear implants repeating sentences that were either intact or with a masked word that could be inferred/repaired using context (the latter of which were previously documented to elicit greater effort). Participants (n = 171, including 28 audiologists) used a continuous visual analog scale to judge whether the talker heard one type of stimulus or the other. Participants were also surveyed for experiences related to detecting effort or confusion in a talker’s voice. Results: Participant judges were unable to discern when the CI users were forced to effortfully infer words from context when repeating a sentence. Ratings indicated a general bias toward assuming the listener heard the original sentence correctly without any need for repair. Acoustic properties of the CI users’ voices (hypothesized higher voice pitch and delayed verbal reaction time for stimuli involving repair) did not reliably correlate with ratings of uncertainty. There were also no statistically detectable advantages for audiologists or for people who reported experience or skill in discerning uncertainty in a talker’s voice. Conclusions: Despite clear evidence that mental repair incurs extra effort, the process of mental repair gives no reliably perceptible signature in a talker’s voice, even for audiologists and others who profess to have experience and skill in conversing with people who have hearing loss. Listening effort is at risk of going unnoticed by conversation partners and by audiologists who might underestimate a patient’s effort when listening to speech. [ABSTRACT FROM AUTHOR]