NCT06053190 · University of Utah
Effects of Clear Speech on Listening Effort and Memory in Sentence Processing
What this study is about
Sensorineural hearing loss (SNHL) is among the most prevalent chronic conditions in aging and has a profoundly negative effect on speech comprehension, leading to increased social isolation, reduced quality of life, and increased risk for the development of dementia in older adulthood.
View original scientific description
Sensorineural hearing loss (SNHL) is among the most prevalent chronic conditions in aging and has a profoundly negative effect on speech comprehension, leading to increased social isolation, reduced quality of life, and increased risk for the development of dementia in older adulthood. Typical audiological tests and interventions, which focus on measuring and restoring audibility, do not explain the full range of cognitive difficulties that adults with hearing loss experience in speech comprehension. For example, adults with SNHL have to work disproportionally harder to decode acoustically degraded speech. That additional effort is thought to diminish shared executive and attentional resources for higher-level language processes, impacting subsequent comprehension and memory, even when speech is completely intelligible. This phenomenon has been referred to as listening effort (LE). There is a growing understanding that these cognitive factors are a critical and often "hidden effect" of hearing loss. At the same time, the effects of LE on the neural mechanisms of language processing and memory in SNHL are currently not well understood. In order to develop evidence-based assessments and interventions to improve comprehension and memory in SNHL, it is critical that the cognitive and neural mechanisms of LE and its consequences for speech comprehension are elucidated. In this project, the investigators adopt a multi-method approach, combining methods from clinical audiology, psycholinguistics, and cognitive neuroscience to address this gap of knowledge. Specifically, the investigators adopt a novel and innovative method of co-registering pupillometry (a reliable physiological measure of LE) and language-related event-related brain potential (ERP) measures during real-time speech processing to characterize the effects of clear speech (i.e., a listener-oriented speaking style that is spontaneously adopted to improve intelligibility when speakers are aware of a perception difficulty on behalf of the listener) on high-level language processes (e.g., semantic retrieval, syntactic integration) and subsequent speech memory in older adults with SNHL. This innovative work addresses a time-sensitive gap in the literature regarding the identification of objective and reliable markers of specific neurocognitive processes impacted by speech clarity and LE in age-related SNHL.
Interventions
BEHAVIORAL
Sentence stimulus
The sentences are designed such that a specific target word is either (a) Plausible (normal), (b) a semantic pragmatic violation, or (c) a morpho-syntactic violation. Example: e.g., "Every morning at breakfast, the boys would (A: EAT)/ (B.PLANT )/ (C. EATS ) eggs..."
BEHAVIORAL
Speaking style
The sentences will be presented either in A. conversational speaking style, or B. hyper-articulated clear speech style. Clear and conversational speech samples will be elicited from a single male talker. In the conversational speech condition, which will be recorded first, the talker will be instructed to read the sentences as they would in everyday conversation. In the clear speech condition, the talker will be instructed to produce the sentences as if they would if they were talking to a person with hearing loss.
Primary outcome measures
N400 amplitude
Time frame: During the speech listening portion of the experiment, up to 4 hours.
The N400 mean amplitude will be measured from the ERP waveform for each condition, using standard procedures for ERP research.
N400 latency
Time frame: During the speech listening portion of the experiment, up to 4 hours.
The N400 onset latency will be measured from the ERP waveform for each condition, using standard procedures for ERP research.
P600 amplitude
Time frame: During the speech listening portion of the experiment, up to 4 hours.
The P600 mean amplitude will be measured from the ERP waveform for each condition, using standard procedures.
P600 latency
Time frame: During the speech listening portion of the experiment, up to 4 hours.
The P600 onset latency will be measured from the ERP waveform for each condition, using standard procedures.
pupil dilation
Time frame: During the speech listening portion of the experiment, up to 4 hours.
The pupil dilation response (average proportion change from baseline) will be measured from the continuous pupillometry time series, measured prior to target word onset, and compared between speech samples presented in clear and conversational speech.
Delayed Recognition Memory
Time frame: Immediately after the speech listening portion of the experiment, up to 30 minutes.
Recognition memory will be measured using both standard accuracy and signal detection measures from the recognition memory task
Who can participate
This study lists these criteria on ClinicalTrials.gov. A study coordinator reviews eligibility during screening — this page does not determine whether you qualify.
Inclusion criteria
- Right-handed
- Native English speaker
- Scores in the normal range (\> or = 25 points) on Montreal Cognitive Assessment (MoCA)
- For adults with hearing loss, a pure-tone average score of \> 25 dB HL (between 1 - 4kHz)
Exclusion criteria
- Left-handed (language-related electrophysiological responses of left-handed subjects differ from those of right-handed subjects)
- History of psychiatric or neurological illnesses (including skull fractures, as this is known to alter electrophysiological response at the scalp)
- Score of \< 25 points on the MOCA
- Use of certain prescription and non-prescription drugs known to alter brain function and the autonomic nervous system, including pupil dilation (e.g., anti-depressants, attention deficit hyperactivity disorder drugs)
- Any eye disease that would impair the ability to measure pupil dilation (e.g., cataracts, nystagmus, amblyopia)
- Scores on speech shadowing audibility control task below 50%, suggesting poor intelligibility
- A display of behavior that would significantly interfere with the validity of data collection or safety during the study;
Where
- Salt Lake City, Utah
Related conditions & keywords
Frequently asked questions
What is a clinical trial?
A clinical trial is a research study that tests new medical treatments, drugs, devices, or procedures to determine their safety and effectiveness. Trials are carefully designed and monitored to protect participants while advancing medical knowledge.
Is it safe to participate?
Clinical trials follow strict safety guidelines and ethical standards. Trials must be reviewed and approved, and participants are closely monitored by medical professionals throughout the study. You can withdraw at any time if you choose.
Will I be compensated?
Many clinical trials offer compensation for your time, travel expenses, and inconvenience. The specific compensation varies by study and will be discussed during the screening process. All study-related medical care is typically provided at no cost to participants.
Will I receive a placebo instead of treatment?
When effective treatment exists, participants typically receive either the standard treatment plus the study intervention, or the standard treatment plus placebo. You would not be denied effective care. Placebos are primarily used when no proven treatment is available, or in addition to standard care. Your trial consent form will clearly explain what treatments you may receive.
Can I leave a trial if I change my mind?
Absolutely. Participation in clinical trials is completely voluntary. You have the right to withdraw from the study at any time, for any reason, without penalty or loss of benefits to which you are otherwise entitled.
How long does a clinical trial last?
Trial duration varies widely depending on the study design and purpose. Some trials last just a few weeks, while others may continue for months or years. The study coordinator will provide specific timeline information during your screening call.
Data: ClinicalTrials.gov · synced Jan 13, 2025 · Source of record for eligibility and locations