Identifying Listeners Whose Speech Intelligibility Depends on a Quiet Extra Moment After a Sentence

Abstract

Purpose: An extra moment after a sentence is spoken may be important for listeners with hearing loss to mentally repair misperceptions during listening. The current audiologic test battery cannot distinguish between a listener who repaired a misperception versus a listener who heard the speech accurately with no need for repair. This study aims to develop a behavioral method to identify individuals who are at risk for relying on a quiet moment after a sentence. Method: Forty-three individuals with hearing loss (32 cochlear implant users, 11 hearing aid users) heard sentences that were followed by either 2 s of silence or 2 s of babble noise. Both high- and low-context sentences were used in the task. Results: Some individuals showed notable benefit in accuracy scores (particularly for high-context sentences) when given an extra moment of silent time following the sentence. This benefit was highly variable across individuals and sometimes absent altogether. However, the group-level patterns of results were mainly explained by the use of context and successful perception of the words preceding sentence-final words. Conclusions: These results suggest that some but not all individuals improve their speech recognition score by relying on a quiet moment after a sentence, and that this fragility of speech recognition cannot be assessed using one isolated utterance at a time. Reliance on a quiet moment to repair perceptions would potentially impede the perception of an upcoming utterance, making continuous communication in real-world scenarios difficult especially for individuals with hearing loss. The methods used in this study—along with some simple modifications if necessary—could potentially identify patients with hearing loss who retroactively repair mistakes by using clinically feasible methods that can ultimately lead to better patient-centered hearing health care. Supplemental Material: https://doi.org/10.23641/asha.21644801