Listen up! ADHD slows spoken-word processing in adverse listening conditions: Evidence from eye movements.

BACKGROUND: Cognitive skills such as sustained attention, inhibition and working memory are essential for speech processing, yet are often impaired in people with ADHD. Offline measures have indicated difficulties in speech recognition on multi-talker babble (MTB) background for young adults with ADHD (yaADHD). However, to-date no study has directly tested online speech processing in adverse conditions for yaADHD. AIMS: Gauging the effects of ADHD on segregating the spoken target-word from its sound-sharing competitor, in MTB and working-memory (WM) load. METHODS AND PROCEDURES: Twenty-four yaADHD and 22 matched controls that differ in sustained attention (SA) but not in WM were asked to follow spoken instructions presented on MTB to touch a named object, while retaining one (low-load) or four (high-load) digit/s for later recall. Their eye fixations were tracked. OUTCOMES AND RESULTS: In the high-load condition, speech processing was less accurate and slowed by 140ms for yaADHD. In the low-load condition, the processing advantage shifted from early perceptual to later cognitive stages. Fixation transitions (hesitations) were inflated for yaADHD. CONCLUSIONS AND IMPLICATIONS: ADHD slows speech processing in adverse listening conditions and increases hesitation, as speech unfolds in time. These effects, detected only by online eyetracking, relate to attentional difficulties. We suggest online speech processing as a novel purview on ADHD. WHAT THIS PAPER ADDS?: We suggest speech processing in adverse listening conditions as a novel vantage point on ADHD. Successful speech recognition in noise is essential for performance across daily settings: academic, employment and social interactions. It involves several executive functions, such as inhibition and sustained attention. Impaired performance in these functions is characteristic of ADHD. However, to date there is only scant research on speech processing in ADHD. The current study is the first to investigate online speech processing as the word unfolds in time using eyetracking for young adults with ADHD (yaADHD). This method uncovered slower speech processing in multi-talker babble noise for yaADHD compared to matched controls. The performance of yaADHD indicated increased hesitation between the spoken word and sound-sharing alternatives (e.g., CANdle-CANdy). These delays and hesitations, on the single word level, could accumulate in continuous speech to significantly impair communication in ADHD, with severe implications on their quality of life and academic success. Interestingly, whereas yaADHD and controls were matched on WM standardized tests, WM load appears to affect speech processing for yaADHD more than for controls. This suggests that ADHD may lead to inefficient deployment of WM resources that may not be detected when WM is tested alone. Note that these intricate differences could not be detected using traditional offline accuracy measures, further supporting the use of eyetracking in speech tasks. Finally, communication is vital for active living and wellbeing. We suggest paying attention to speech processing in ADHD in treatment and when considering accessibility and inclusion.

Speech Processing as a Far-Transfer Gauge of Serious Games for Cognitive Training in Aging: Randomized Controlled Trial of Web-Based Effectivate Training.

BACKGROUND: The number of serious games for cognitive training in aging (SGCTAs) is proliferating in the market and attempting to combat one of the most feared aspects of aging-cognitive decline. However, the efficacy of many SGCTAs is still questionable. Even the measures used to validate SGCTAs are up for debate, with most studies using cognitive measures that gauge improvement in trained tasks, also known as near transfer. This study takes a different approach, testing the efficacy of the SGCTA-Effectivate-in generating tangible far-transfer improvements in a nontrained task-the Eye tracking of Word Identification in Noise Under Memory Increased Load (E-WINDMIL)-which tests speech processing in adverse conditions. OBJECTIVE: This study aimed to validate the use of a real-time measure of speech processing as a gauge of the far-transfer efficacy of an SGCTA designed to train executive functions. METHODS: In a randomized controlled trial that included 40 participants, we tested 20 (50%) older adults before and after self-administering the SGCTA Effectivate training and compared their performance with that of the control group of 20 (50%) older adults. The E-WINDMIL eye-tracking task was administered to all participants by blinded experimenters in 2 sessions separated by 2 to 8 weeks. RESULTS: Specifically, we tested the change between sessions in the efficiency of segregating the spoken target word from its sound-sharing alternative, as the word unfolds in time. We found that training with the SGCTA Effectivate improved both early and late speech processing in adverse conditions, with higher discrimination scores in the training group than in the control group (early processing: F1,38=7.371; P=.01; ηp2=0.162 and late processing: F1,38=9.003; P=.005; ηp2=0.192). CONCLUSIONS: This study found the E-WINDMIL measure of speech processing to be a valid gauge for the far-transfer effects of executive function training. As the SGCTA Effectivate does not train any auditory task or language processing, our results provide preliminary support for the ability of Effectivate to create a generalized cognitive improvement. Given the crucial role of speech processing in healthy and successful aging, we encourage researchers and developers to use speech processing measures, the E-WINDMIL in particular, to gauge the efficacy of SGCTAs. We advocate for increased industry-wide adoption of far-transfer metrics to gauge SGCTAs.

One Size Does Not Fit All: Examining the Effects of Working Memory Capacity on Spoken Word Recognition in Older Adults Using Eye Tracking.

Difficulties understanding speech form one of the most prevalent complaints among older adults. Successful speech perception depends on top-down linguistic and cognitive processes that interact with the bottom-up sensory processing of the incoming acoustic information. The relative roles of these processes in age-related difficulties in speech perception, especially when listening conditions are not ideal, are still unclear. In the current study, we asked whether older adults with a larger working memory capacity process speech more efficiently than peers with lower capacity when speech is presented in noise, with another task performed in tandem. Using the Eye-tracking of Word Identification in Noise Under Memory Increased Load (E-WINDMIL) an adapted version of the "visual world" paradigm, 36 older listeners were asked to follow spoken instructions presented in background noise, while retaining digits for later recall under low (single-digit) or high (four-digits) memory load. In critical trials, instructions (e.g., "point at the candle") directed listeners' gaze to pictures of objects whose names shared onset or offset sounds with the name of a competitor that was displayed on the screen at the same time (e.g., candy or sandal). We compared listeners with different memory capacities on the time course for spoken word recognition under the two memory loads by testing eye-fixations on a named object, relative to fixations on an object whose name shared phonology with the named object. Results indicated two trends. (1) For older adults with lower working memory capacity, increased memory load did not affect online speech processing, however, it impaired offline word recognition accuracy. (2) The reverse pattern was observed for older adults with higher working memory capacity: increased task difficulty significantly decreases online speech processing efficiency but had no effect on offline word recognition accuracy. Results suggest that in older adults, adaptation to adverse listening conditions is at least partially supported by cognitive reserve. Therefore, additional cognitive capacity may lead to greater resilience of older listeners to adverse listening conditions. The differential effects documented by eye movements and accuracy highlight the importance of using both online and offline measures of speech processing to explore age-related changes in speech perception.

Safe and Sound: The Effects of Experimentally Priming the Sense of Attachment Security on Pure-Tone Audiometric Thresholds Among Young and Older Adults.

Attachment security has consistently been found to correlate with relaxed exploration, openness, and mindful attention to incoming information. The present studies explored whether contextually infusing a sense of attachment security (security priming) can improve hearing in young and older adults. In Study 1, participants (29 young, 30 older) performed a standardized pure-tone audiometric-thresholds test twice. In the security-priming condition, a picture of a participant's security-enhancing figure was presented throughout the task. In the control condition, a picture of an unknown person (matched in sex, age, and facial expression) was used as a neutral prime. Study 2 (14 young, 14 older) was almost identical, except that it was preregistered and the neutral prime was a circle. In both studies, participants performed better (had lower hearing thresholds) in the security-priming condition. The current study is the first to show that attachment security improves sensory perception, and these results have meaningful implications for theory and clinical hearing tests.

Differences in Working Memory Capacity Affect Online Spoken Word Recognition: Evidence From Eye Movements.

Individual differences in working memory capacity have been gaining recognition as playing an important role in speech comprehension, especially in noisy environments. Using the visual world eye-tracking paradigm, a recent study by Hadar and coworkers found that online spoken word recognition was slowed when listeners were required to retain in memory a list of four spoken digits (high load) compared with only one (low load). In the current study, we recognized that the influence of a digit preload might be greater for individuals who have a more limited memory span. We compared participants with higher and lower memory spans on the time course for spoken word recognition by testing eye-fixations on a named object, relative to fixations on an object whose name shared phonology with the named object. Results show that when a low load was imposed, differences in memory span had no effect on the time course of preferential fixations. However, with a high load, listeners with lower span were delayed by ∼550 ms in discriminating target from sound-sharing competitors, relative to higher span listeners. This follows an assumption that the interference effect of a memory preload is not a fixed value, but rather, its effect is greater for individuals with a smaller memory span. Interestingly, span differences affected the timeline for spoken word recognition in noise, but not offline accuracy. This highlights the significance of using eye-tracking as a measure for online speech processing. Results further emphasize the importance of considering differences in cognitive capacity, even when testing normal hearing young adults.