Executive Function Associations With Audibility-Adjusted Speech Perception in Noise

Mark A Eckert; Lois J Matthews; Kenneth I Vaden Jr; Judy R Dubno

doi:10.1044/2024_JSLHR-24-00333

Executive Function Associations With Audibility-Adjusted Speech Perception in Noise

J Speech Lang Hear Res. 2024 Dec 9;67(12):4811-4828. doi: 10.1044/2024_JSLHR-24-00333. Epub 2024 Oct 30.

Authors

Mark A Eckert^{1

2}, Lois J Matthews¹, Kenneth I Vaden Jr¹, Judy R Dubno¹

Affiliations

¹ Hearing Research Program, Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston.
² Department of Otolaryngology-Head and Neck Surgery, Columbia University, New York, NY.

PMID: 39475684
PMCID: PMC11666980 (available on 2025-06-01)
DOI: 10.1044/2024_JSLHR-24-00333

Abstract

Purpose: Speech recognition in noise is challenging for listeners and appears to require support from executive functions to focus attention on rapidly unfolding target speech, track misunderstanding, and sustain attention. The current study was designed to test the hypothesis that lower executive function abilities explain poorer speech recognition in noise, including among older participants with hearing loss who often exhibit diminished speech recognition in noise and cognitive abilities.

Method: A cross-sectional sample of 400 younger-to-older adult participants (19 to < 90 years of age) from the community-based Medical University of South CarolinaLongitudinal Cohort Study of Age-related Hearing Loss were administered tasks with executive control demands to assess individual variability in a card-sorting measure of set-shifting/performance monitoring, a dichotic listening measure of selective attention/working memory, sustained attention, and processing speed. Key word recognition in the high- and low-context speech perception-in-noise (SPIN) tests provided measures of speech recognition in noise. The SPIN scores were adjusted for audibility using the Articulation Index to characterize the impact of varied hearing sensitivity unrelated to reduced audibility on cognitive and speech recognition associations.

Results: Set-shifting, dichotic listening, and processing speed each explained unique and significant variance in audibility-adjusted, low-context SPIN scores (ps < .001), including after controlling for age, pure-tone threshold average (PTA), sex, and education level. The dichotic listening and processing speed effect sizes were significantly diminished when controlling for PTA, indicating that participants with poorer hearing sensitivity were also likely to have lower executive function and lower audibility-adjusted speech recognition.

Conclusions: Poor set-shifting/performance monitoring, slow processing speed, and poor selective attention/working memory appeared to partially explain difficulties with speech recognition in noise after accounting for audibility. These results are consistent with the premise that distinct executive functions support speech recognition in noise.

MeSH terms

Adult
Aged
Aged, 80 and over
Attention
Cross-Sectional Studies
Executive Function* / physiology
Female
Humans
Male
Middle Aged
Noise*
Speech Perception*
Young Adult

Grants and funding

This work was supported (in part) by National Institute on Deafness and Other Communication Disorders Grant P50 DC 000422 (awarded to Dubno and Eckert), Medical University of South Carolina Center for Biomedical Imaging, South Carolina Clinical and Translational Research Institute, and National Institutes of Health/National Center for Research Resources Grant UL1 TR001450 (awarded to Dubno and Eckert). This investigation was conducted in a facility constructed with support from Research Facilities Improvement Program Grant C06 RR14516 (awarded to Dubno and Eckert) from the National Center for Research Resources.