Participant-selected music listening during pulmonary rehabilitation in people with chronic obstructive pulmonary disease: A randomised controlled trial.

To evaluate the impact of participant-selected music listening as an adjunct to pulmonary rehabilitation (PR) in people with COPD. Adults with COPD referred to PR were randomly assigned to participant-selected music listening (intervention group, [IG]) or usual care (control group [CG]) during an 8-weeks PR program. Prior to training, the IG completed an interview with a registered music therapist to identify music preferences. IG participants listened to an individualised playlist; CG participants had usual care. Primary outcomes included end-6-min walk test symptoms (dyspnoea and exertion) and dyspnoea (Multidimensional Dyspnoea Profile [MDP]), measured pre and post PR and 6-months follow-up. 58 participants, FEV1 52.4 (25.9)% pd) were recruited. There were no between-group differences following the intervention (p > .05 for all outcomes at all time points). Within-group differences following PR were significant for MDP sensory quality: IG mean difference [95% CI] -2.2 [-3.3 to -1.2]; CG -1.5 [-2.5 to -0.5] points; MDP emotional response: IG -3.2 [-4.2 to -2.3]; CG -2.2 [-3.2 to -1.3] points). Participant-selected music listening during PR offered no greater benefit to symptoms of dyspnoea or exertion compared to usual care. With the study limited by COVID-19 restrictions, the role of this adjunct remains to be clarified.

Top-down modulation of dichotic listening affects interhemispheric connectivity: an electroencephalography study.

Introduction: Dichotic listening (DL) has been extensively used as a task to investigate auditory processing and hemispheric lateralisation in humans. According to the "callosal relay model," the typical finding of a right ear advantage (REA) occurs because the information coming from the right ear has direct access to the left dominant hemisphere while the information coming from the left ear has to cross via the corpus callosum. The underlying neuroanatomical correlates and neurophysiological mechanisms have been described using diffusion tensor imaging (DTI) and lagged phase synchronization (LPS) of the interhemispheric auditory pathway. During the non-forced condition of DL, functional connectivity (LPS) of interhemispheric gamma-band coupling has been described as a relevant mechanism related to auditory perception in DL. In this study, we aimed to extend the previous results by exploring the effects of top-down modulation of DL (forced-attention condition) on interhemispheric gamma-band LPS. Methods: Right-handed healthy participants (n = 31; 17 females) performed three blocks of DL with different attention instructions (no-attention, left-ear attention, right-ear attention) during simultaneous EEG recording with 64 channels. Source analysis was done with exact low-resolution brain electromagnetic tomography (eLORETA) and functional connectivity between bilateral auditory areas was assessed as LPS in the gamma-band frequency range. Results: Twenty-four participants (77%) exhibited a right-ear advantage in the no-attention block. The left- and right-attention conditions significantly decreased and increased right-ear reports, respectively. Similar to the previous studies, functional connectivity analysis (gamma-band LPS) showed significantly increased connectivity between left and right Brodmann areas (BAs) 41 and 42 during left ear reports in contrast with right ear reports. Our new findings notably indicated that the right-attention condition exhibited significantly higher connectivity between BAs 42 compared with the no-attention condition. This enhancement of connectivity was more pronounced during the perception of right ear reports. Discussion: Our results are in line with previous reports describing gamma-band synchronization as a relevant neurophysiological mechanism involved in the interhemispheric connectivity according to the callosal relay model. Moreover, we newly added some evidence of attentional effects on this interhemispheric connectivity, consistent with the attention-executive model. Our results suggest that reciprocal inhibition could be involved in hemispheric lateralization processes.

Tracking Listening Skill Development in Infants and Children with Hearing Loss: A Normative Dataset for the Functional Listening Index-Paediatric (FLI-P®).

BACKGROUND: Longitudinal studies highlight the importance of early intervention and timely device fitting for language development in children with congenital or early acquired hearing loss. Due to the variability in hearing loss, comorbidities, family circumstances, and service access, individualised monitoring of listening development is essential to inform decision-making. The Functional Listening Index-Paediatric (FLI-P), a 64-item hierarchical checklist of listening skills, has been validated for children with hearing loss aged 0-6 years. This study aimed to develop benchmarks for the FLI-P in typically hearing children, allowing for comparison with individual children with hearing loss. METHODS: FLI-P scores were obtained from parents/caregivers of 561 typically hearing children aged 0-72 months. Each child's FLI-P score was categorised into a 6-month age block, with a minimum of 36 data points per block. Quantile regression was employed to establish percentiles of FLI-P scores by age. RESULTS: FLI-P scores were successfully recorded for all 561 children. Regression analysis determined that the 16th and 84th percentiles of FLI-P scores corresponded to approximately ±1 standard deviation from the median score for each age group. A graphical representation of these percentile trajectories was created to facilitate comparison between children with hearing loss and the normative data. CONCLUSION: A normative dataset of FLI-P scores from typically hearing children has been established, allowing for comparisons with the scores and developmental trajectories of individual children with hearing loss. The study demonstrates how FLI-P can guide early intervention decisions and effectively monitor progress.

Brain Laterality in Dyslexia Seen during Literacy Development and Early Training.

During the period in which children learn to read and write, a gradual shift from right to left hemisphere dominance for language is typically seen. However, in children with dyslexia, a deviant pattern is described in the literature. As part of a larger longitudinal study (The Bergen Longitudinal Dyslexia Study), the present study aimed to assess this development from an early age before children learn to read and write. Dichotic listening (DL), which is a non-invasive test, was used to assess the development of brain laterality in a Typical group and a Dyslexia group. The participants received yearly sessions of evidence-based literacy training at ages 5 to 7. The Typical group showed increasing ear scores and a shift from no ear advantage in the Pre-literacy stage (age 6), indicative of no hemisphere dominance, to a right ear advantage, indicative of a left hemisphere dominance, in the Emergent literacy stage (age 8) and the Literacy stage (age 11). The Dyslexia group showed a different pattern, with a significant right ear advantage at age 6, indicative of a right hemisphere dominance, and increasing ear scores at ages 8 and 11; however, no ear dominance was observed in the Literacy stage. The results point to an effect of relevant, evidence-based training affecting both right and left hemispheres in dyslexia, which should form a basis for further research.

Effects of mindfulness-based music listening on conflict control in young adults with insomnia disorder: behavioral and event-related potential evidence.

Introduction: Insomnia Disorder (ID) has become the second most prevalent mental disorder, with significant negative effects on daytime cognitive functions. Previous studies suggested that mindfulness-based music listening (MBML) can effectively improve conflict control and attentional processing in healthy adults. However, the behavioral and neurophysiological characteristics of MBML in young adults with ID remain unclear. Methods: To explore the behavioral and neurophysiological characteristics of MBML in regulating negative emotions among young Chinese adults with ID, 60 young adults with ID were asked to complete an emotion-word Stroop task under three mood states while recording event-related potentials (ERPs). Results: Task and questionnaire results showed that (1) negative emotion induced by the negative simulated video significantly suppressed the attentional processing of emotional faces and words in the conflict control task among young people with ID, (2) MBML reduced cognitive and physical arousal levels, enhanced positive mood, and improved attentional control abilities in young adults with ID. The ERP results showed that a greater N3 effect and the smaller P3 and late positive component (LPC) effects reflected that MBML effectively regulated negative emotions induced by the negative simulated video and attentional processing abilities for conflict control in young adults with ID. Discussion: Maintaining mindfulness while listening to music may enhance positive emotional experiences and improve cognitive ability, and exhibit larger N3 effects and smaller P3 and LPC effects in the electrophysiology mechanism, with a reduction in the hyperarousal level in young adults with insomnia disorders.

Disparities between objectively measured hearing loss and subjectively perceived aided hearing loss: A scoping review.

Objectives: This scoping review aims to summarize and synthesize research findings on the disparities between audiometrically diagnosed and aided hearing loss versus the individual's own experience of hearing loss. Methods: A systematic search strategy was employed across multiple databases to identify studies published between 1990 and October 2023 focusing on the experiences of hearing problems among individuals with aided hearing loss. The selected studies underwent screening based on predetermined inclusion and exclusion criteria. These criteria revolved around including papers featuring a population of adult (+18) individuals with audiometrically measured hearing loss who had undergone technological rehabilitation. Data charting was employed to provide an overview of the studies and was additionally utilized to identify key themes. Narrative analysis was used to identify subthemes within the data set. Results: A total of 11 articles met the inclusion criteria. The analysis identified five themes: "disability experience and discrepancy between measured and self-perceived hearing loss"; "listening effort"; "mental burden/psychological consequences"; "factors that alleviate the consequences of HL"; and "sociodemographic factors." Conclusions: The scoping review shows that, despite the proliferation of technological options, there is a pressing need for a more concentrated effort to identify and scrutinize the supplementary facets of hearing loss that remain inadequately addressed by current hearing technology. This includes subjective experiences associated with hearing loss that may not be effectively treated solely with hearing aids.

Engagement of the speech motor system in challenging speech perception: Activation likelihood estimation meta-analyses.

The relationship between speech production and perception is a topic of ongoing debate. Some argue that there is little interaction between the two, while others claim they share representations and processes. One perspective suggests increased recruitment of the speech motor system in demanding listening situations to facilitate perception. However, uncertainties persist regarding the specific regions involved and the listening conditions influencing its engagement. This study used activation likelihood estimation in coordinate-based meta-analyses to investigate the neural overlap between speech production and three speech perception conditions: speech-in-noise, spectrally degraded speech and linguistically complex speech. Neural overlap was observed in the left frontal, insular and temporal regions. Key nodes included the left frontal operculum (FOC), left posterior lateral part of the inferior frontal gyrus (IFG), left planum temporale (PT), and left pre-supplementary motor area (pre-SMA). The left IFG activation was consistently observed during linguistic processing, suggesting sensitivity to the linguistic content of speech. In comparison, the left pre-SMA activation was observed when processing degraded and noisy signals, indicating sensitivity to signal quality. Activations of the left PT and FOC activation were noted in all conditions, with the posterior FOC area overlapping in all conditions. Our meta-analysis reveals context-independent (FOC, PT) and context-dependent (pre-SMA, posterior lateral IFG) regions within the speech motor system during challenging speech perception. These regions could contribute to sensorimotor integration and executive cognitive control for perception and production.

EXPRESS: Pure-tone audiometry and dichotic listening in primary progressive aphasia and Alzheimer's disease.

Hearing is multifaceted and the relative contributions of peripheral and central hearing loss are rarely considered together in the context of dementia. Here, we assessed peripheral (as measured with pure-tone audiometry) and central (as measured with dichotic listening) hearing in 19 patients with typical amnestic Alzheimer's disease (tAD), 10 patients with logopenic variant primary progressive aphasia (lvPPA), 11 patients with nonfluent/agrammatic variant PPA (nfvPPA), 15 patients with semantic variant PPA (svPPA), and 28 healthy age-matched individuals. Participants also underwent neuropsychological assessment and magnetic resonance image scanning, allowing us to use voxel-based morphometry to assess associations between hearing scores and grey matter volume. Dichotic listening was impaired in all patient groups relative to healthy controls. In the combined patient (but not healthy control) cohort, dichotic listening scores were significantly correlated with measures of global cognitive functioning and speech-based neuropsychological tasks. Pure-tone audiometry scores were not significantly elevated in any patient group relative to the healthy control group, and no significant correlations were observed between peripheral hearing and neuropsychological task performance in either the combined patient or healthy control cohorts. Neuroanatomically, dichotic listening performance was associated with grey matter volume in a bilateral fronto-temporo-parietal network over the combined patient cohort, but no correlates were identified for pure-tone audiometry. Our findings highlight the importance of speech parsing mechanisms beyond elementary sound detection in driving cognitive test performance, underline the importance of assessing central hearing alongside peripheral hearing in people with dementia, and further delineate the complex auditory profiles of neurodegenerative dementias.

Using the online version of the Trier Social Stress Test to investigate the effect of acute stress on functional lateralization.

How stress affects functional hemispheric asymmetries is relevant because stress represents a risk factor for the development of mental disorders and various mental disorders are associated with atypical lateralization. Using three lateralization tasks, we investigated whether functional hemispheric asymmetries in the form of hemispheric dominance for language (verbal dichotic listening task), emotion processing (emotional dichotic listening task), and visuo-spatial attention (line bisection task) were affected by acute stress in healthy adults. One hundred twenty right-handed men and women performed these lateralization tasks in randomized order after exposure to a mild online stressor (i.e., an online variant of the Trier Social Stress Test (TSST), TSST-OL) and a non-stressful online control task (friendly TSST-OL, fTSST-OL) in a within-subjects design. Importantly, the verbal and the emotional dichotic listening tasks were presented online whereas the line bisection task was completed in paper-pencil form. During these tasks, we found the expected hemispheric asymmetries, indicating that online versions of both the verbal and the emotional dichotic listening task can be used to measure functional hemispheric asymmetries in language and emotion processing remotely. Even though subjective and physiological markers confirmed the success of the online stress manipulation, replicating previous studies, we found no stress-induced effect on functional hemispheric asymmetries. Thus, in healthy participants, functional hemispheric asymmetries do not seem to change flexibly in response to acute stress.

The Effect of Metacognitive Intervention on the Listening Performance and Metacognitive Awareness of High- and Low-Working Memory Capacity EFL Learners.

EFL listening comprehension has been a stark challenge for language learners, but little is known about the combined effect of individual differences, such as working memory capacity, and metacognitive intervention. Thus, the present experimental study investigates the effect of metacognitive intervention on the listening performance and metacognitive awareness of high- and low-WMC EFL learners. For this purpose, Oxford Placement Tests were distributed among 120 male Iranian EFL learners, of which 94 were identified as intermediate. Then, backward visual digit span tests were administered to measure their working memory capacity. Based on the median of all scores, 80 learners were selected and randomly assigned to two experimental groups and two control groups each with 20 participants. Next, their performance on the International English Language Testing System and the Metacognitive Awareness Listening Questionnaire was measured before and after the 8-session metacognitive intervention. Results showed that high-WMC experimental learners had a higher gain with a large effect size in terms of listening performance compared with all the other groups. In addition, the experimental group learners reported the significantly higher use of the metacognitive strategies with a moderate effect size. Interestingly, low-WMC learners' listening performance and metacognitive awareness also improved as a result of the intervention. Our findings bear pedagogical significance in that individual differences in WMC should be considered more in both EFL language classes and the future line of research involving the metacognitive intervention.

[The therapeutic stay, a rewarding experience both professionally and personally]. / Le séjour thérapeutique, une expérience enrichissante sur le plan professionnel et personnel.

The organization of a therapeutic stay by four mental health caregivers was a rich learning experience. This experience, a first for them, enabled them to expand their knowledge and adapt their professional posture over the long term. It also helped them to get to know themselves better on a personal level, to be more attuned to their emotions and aware of their limits. Here's a testimonial.

Automated Measurement of Speech Recognition, Reaction Time, and Speech Rate and Their Relation to Self-Reported Listening Effort for Normal-Hearing and Hearing-Impaired Listeners Using various Maskers.

In speech audiometry, the speech-recognition threshold (SRT) is usually established by adjusting the signal-to-noise ratio (SNR) until 50% of the words or sentences are repeated correctly. However, these conditions are rarely encountered in everyday situations. Therefore, for a group of 15 young participants with normal hearing and a group of 12 older participants with hearing impairment, speech-recognition scores were determined at SRT and at four higher SNRs using several stationary and fluctuating maskers. Participants' verbal responses were recorded, and participants were asked to self-report their listening effort on a categorical scale (self-reported listening effort, SR-LE). The responses were analyzed using an Automatic Speech Recognizer (ASR) and compared to the results of a human examiner. An intraclass correlation coefficient of r = .993 for the agreement between their corresponding speech-recognition scores was observed. As expected, speech-recognition scores increased with increasing SNR and decreased with increasing SR-LE. However, differences between speech-recognition scores for fluctuating and stationary maskers were observed as a function of SNR, but not as a function of SR-LE. The verbal response time (VRT) and the response speech rate (RSR) of the listeners' responses were measured using an ASR. The participants with hearing impairment showed significantly lower RSRs and higher VRTs compared to the participants with normal hearing. These differences may be attributed to differences in age, hearing, or both. With increasing SR-LE, VRT increased and RSR decreased. The results show the possibility of deriving a behavioral measure, VRT, measured directly from participants' verbal responses during speech audiometry, as a proxy for SR-LE.

Culturally and linguistically diverse children's retention of spoken narratives encoded in quiet and in babble noise.

Multi-talker noise impedes children's speech processing and may affect children listening to their second language more than children listening to their first language. Evidence suggests that multi-talker noise also may impede children's memory retention and learning. A total of 80 culturally and linguistically diverse children aged 7 to 9 years listened to narratives in two listening conditions: quiet and multi-talker noise (signal-to-noise ratio +6 dB). Repeated recall (immediate and delayed recall), was measured with a 1-week retention interval. Retention was calculated as the difference in recall accuracy per question between immediate and delayed recall. Working memory capacity was assessed, and the children's degree of school language (Swedish) exposure was quantified. Immediate narrative recall was lower for the narrative encoded in noise than in quiet. During delayed recall, narrative recall was similar for both listening conditions. Children with higher degrees of school language exposure and higher working memory capacity had better narrative recall overall, but these factors were not associated with an effect of listening condition or retention. Multi-talker babble noise does not impair culturally and linguistically diverse primary school children's retention of spoken narratives as measured by multiple-choice questions. Although a quiet listening condition allows for a superior encoding compared with a noisy listening condition, details are likely lost during memory consolidation and re-consolidation.

The Association between Music Listening at Home and Subjective Well-Being.

This study examines the association between listening to music at home and subjective well-being, using data from 14,162 respondents in the China General Social Surveys conducted in 2015, 2017, and 2021. Among the respondents, the average happiness score was 3.958. Regression analyzes indicate that frequent music listening is significantly associated with higher happiness levels, with coefficients of 0.384 in the baseline model and 0.570 in the model with control variables. Robustness checks performed across different models support these findings. Instrumental variable analysis, using Mandarin proficiency, yielded a coefficient of 0.212, indicating a robust association despite a slight reduction in magnitude. Heterogeneity analyzes showed consistent associations across genders, religious beliefs, and regions, with slightly stronger associations observed for females and non-religious individuals. Mediation analysis identified mental health and class identity as significant mediators, contributing to a total association of 0.146. These results highlight the positive correlation between music listening and well-being, suggesting the potential value of integrating music resources into well-being strategies.

[The computerized medical record. From lost illusions to the hope of renewal]. / Le dossier médical informatisé. Des illusions perdues à l'espoir d'un renouveau.

Although the principle of recording and transmitting patient data is not new, the computerized medical record used in today's practice of care still does not meet the needs. We can easily - and often rightly - cast shame on the designers of those medical records and on administrators of our care institutions, but we as caregivers do need to share responsibility. If we really intend to use multiple sources of data wisely, in order to increase global health status at the individual level or for a population, we need to understand clearly the multiple dimensions of data and therefore acquire a real data culture. The revival of the medical record, for too long a source of disillusionment and burnout, is within reach especially as technical solutions appear to automate and facilitate our work of recording data in the field.

Si le principe de la récolte de données concernant les patients ne date pas d'hier, force est de constater que le dossier médical informatisé d'aujourd'hui ne répond toujours pas aux besoins. On peut, bien entendu, par facilité - et souvent à juste titre - jeter l'opprobre sur les concepteurs et les administratifs, mais le monde des soignants a aussi une part de responsabilité. Si nous avons vraiment l'intention d'utiliser à bon escient les multiples sources de données, que ce soit en matière de gestion de la santé individuelle et/ou populationnelle, il nous faut d'abord insister sur la meilleure compréhension par les soignants des multiples dimensions de ces données et donc acquérir une réelle culture en la matière. Le renouveau du dossier médical informatisé, trop longtemps source de désillusions et de burnout, est à portée de main, d'autant plus que des solutions techniques apparaissent, automatisant et facilitant le travail sur le terrain.

Scale of self-perceived listening, empathy, and presence (LEP) abilities in associate degree nursing students for aging care.

This cross-sectional study involved 341 fifth-year associate degree nursing students who completed an online questionnaire survey from May 1 to July 31, 2020. Out of these, 196 effective responses were received, with participants' ages ranging from 19 to 29 years. Most were female, the eldest in their families, and had experience living with grandparents. They had also completed long-term care or elderly nursing courses, and had experience in practicing, volunteering, and caring for elders. The average scores for all listening and empathy items were above 4.0. The LEP self-perception abilities scale demonstrated expert content validity with a score of .94 and an internal consistency Cronbach's α of .96. Construct validity was confirmed with factor loadings ranging from .73 to .92, explaining 67.03% of the variance, indicating strong construct validity.

The Benefit of Hearing Aids as Measured by Listening Accuracy, Subjective Listening Effort, and Functional Near Infrared Spectroscopy.

There is broad consensus that listening effort is an important outcome for measuring hearing performance. However, there remains debate on the best ways to measure listening effort. This study sought to measure neural correlates of listening effort using functional near-infrared spectroscopy (fNIRS) in experienced adult hearing aid users. The study evaluated impacts of amplification and signal-to-noise ratio (SNR) on cerebral blood oxygenation, with the expectation that easier listening conditions would be associated with less oxygenation in the prefrontal cortex. Thirty experienced adult hearing aid users repeated sentence-final words from low-context Revised Speech Perception in Noise Test sentences. Participants repeated words at a hard SNR (individual SNR-50) or easy SNR (individual SNR-50 + 10 dB), while wearing hearing aids fit to prescriptive targets or without wearing hearing aids. In addition to assessing listening accuracy and subjective listening effort, prefrontal blood oxygenation was measured using fNIRS. As expected, easier listening conditions (i.e., easy SNR, with hearing aids) led to better listening accuracy, lower subjective listening effort, and lower oxygenation across the entire prefrontal cortex compared to harder listening conditions. Listening accuracy and subjective listening effort were also significant predictors of oxygenation.

Effectiveness of Noise Cancelling Earbuds in Reducing Hearing and Auditory Attention Deficits in Children with Autism.

Background/Objectives: Autism spectrum disorder (ASD) is a lifelong neurodevelopmental condition characterised by impairments in social communication, sensory abnormalities, and attentional deficits. Children with ASD often face significant challenges with speech perception and auditory attention, particularly in noisy environments. This study aimed to assess the effectiveness of noise cancelling Bluetooth earbuds (Nuheara IQbuds Boost) in improving speech perception and auditory attention in children with ASD. Methods: Thirteen children aged 6-13 years diagnosed with ASD participated. Pure tone audiometry confirmed normal hearing levels. Speech perception in noise was measured using the Consonant-Nucleus-Consonant-Word test, and auditory/visual attention was evaluated via the Integrated Visual and Auditory Continuous Performance Task. Participants completed these assessments both with and without the IQbuds in situ. A two-week device trial evaluated classroom listening and communication improvements using the Listening Inventory for Education-Revised (teacher version) questionnaire. Results: Speech perception in noise was significantly poorer for the ASD group compared to typically developing peers and did not change with the IQbuds. Auditory attention, however, significantly improved when the children were using the earbuds. Additionally, classroom listening and communication improved significantly after the two-week device trial. Conclusions: While the noise cancelling earbuds did not enhance speech perception in noise for children with ASD, they significantly improved auditory attention and classroom listening behaviours. These findings suggest that Bluetooth earbuds could be a viable alternative to remote microphone systems for enhancing auditory attention in children with ASD, offering benefits in classroom settings and potentially minimising the stigma associated with traditional assistive listening devices.

The Cerebellum Is Sensitive to the Lexical Properties of Words During Spoken Language Comprehension.

Over the past few decades, research into the function of the cerebellum has expanded far beyond the motor domain. A growing number of studies are probing the role of specific cerebellar subregions, such as Crus I and Crus II, in higher-order cognitive functions including receptive language processing. In the current fMRI study, we show evidence for the cerebellum's sensitivity to variation in two well-studied psycholinguistic properties of words-lexical frequency and phonological neighborhood density-during passive, continuous listening of a podcast. To determine whether, and how, activity in the cerebellum correlates with these lexical properties, we modeled each word separately using an amplitude-modulated regressor, time-locked to the onset of each word. At the group level, significant effects of both lexical properties landed in expected cerebellar subregions: Crus I and Crus II. The BOLD signal correlated with variation in each lexical property, consistent with both language-specific and domain-general mechanisms. Activation patterns at the individual level also showed that effects of phonological neighborhood and lexical frequency landed in Crus I and Crus II as the most probable sites, though there was activation seen in other lobules (especially for frequency). Although the exact cerebellar mechanisms used during speech and language processing are not yet evident, these findings highlight the cerebellum's role in word-level processing during continuous listening.

Functional benefits of continuous vs. categorical listening strategies on the neural encoding and perception of noise-degraded speech.

Acoustic information in speech changes continuously, yet listeners form discrete perceptual categories to ease the demands of perception. Being a more continuous/gradient as opposed to a more discrete/categorical listener may be further advantageous for understanding speech in noise by increasing perceptual flexibility and resolving ambiguity. The degree to which a listener's responses to a continuum of speech sounds are categorical versus continuous can be quantified using visual analog scaling (VAS) during speech labeling tasks. Here, we recorded event-related brain potentials (ERPs) to vowels along an acoustic-phonetic continuum (/u/ to /a/) while listeners categorized phonemes in both clean and noise conditions. Behavior was assessed using standard two alternative forced choice (2AFC) and VAS paradigms to evaluate categorization under task structures that promote discrete vs. continuous hearing, respectively. Behaviorally, identification curves were steeper under 2AFC vs. VAS categorization but were relatively immune to noise, suggesting robust access to abstract, phonetic categories even under signal degradation. Behavioral slopes were correlated with listeners' QuickSIN scores; shallower slopes corresponded with better speech in noise performance, suggesting a perceptual advantage to noise degraded speech comprehension conferred by a more gradient listening strategy. At the neural level, P2 amplitudes and latencies of the ERPs were modulated by task and noise; VAS responses were larger and showed greater noise-related latency delays than 2AFC responses. More gradient responders had smaller shifts in ERP latency with noise, suggesting their neural encoding of speech was more resilient to noise degradation. Interestingly, source-resolved ERPs showed that more gradient listening was also correlated with stronger neural responses in left superior temporal gyrus. Our results demonstrate that listening strategy modulates the categorical organization of speech and behavioral success, with more continuous/gradient listening being advantageous to sentential speech in noise perception.