Listening effort of DHH students in mainstream primary education under normal, adverse, and facilitating conditions

It can sometimes be very strenuous to understand what the other person is saying to you. For example, when there is a lot of background noise in the classroom or at a party. That effort you then have to make is called ‘listening effort’. Many children who are deaf or hard-of-hearing (DHH) have to make this listening effort very often and for long periods of time. For example, DHH children who attend regular schools where a spoken language is used all day long. 
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Prolonged and excessive listening effort can be harmful to children. It can lead to chronic mental fatigue and chronic stress. Consequently, recent research shows that DHH children in regular schools are on average more fatigued than their hearing classmates. It is very possible that this is related to prolonged and excessive listening effort.  

In this project, we investigated the degree of listening effort of DHH children as well as hearing children in regular schools in two experiments. Two groups participated in both experiments, one group with hearing children (n = 30 / 32) and one group with DHH (n = 30 / 27) between 8 and 12 years old. The project also investigated the impact of both unfavourable listening conditions (background noise) and facilitating factors (the use of speech reading or supportive signs) on listening effort. We examined listening effort in two experimental paradigms (a word recognition task and a dual task). After the first experiment, we decided to no longer include the dual task in the current study.

Two measures of listening effort were used in the experiments: the child's perception of the task (measured by a questionnaire after each task) and children's reaction times in the task. In addition, children in both experiments also completed a questionnaire for listening effort and fatigue in daily life.

The results of the word recognition task showed that:

• DHH children exert more listening effort than their hearing peers.
• DHH and hearing children exert more listening effort in unfavourable listening conditions (when there is a lot of background noise).
• DHH and hearing children exert less listening effort when the speaker's mouth is visible.
• DHH children exert less listening effort when the speaker makes a supporting gesture.
   

Based on the two experiments conducted, we can make the following practical recommendations:

• Encourage the correct use of hearing aids (hearing aid, CI, solo devices) for DHH children to reduce listening effort and remove teachers' objections to working with these devices through coaching and guidance.
• Improve the acoustics of, for example, classrooms or sports halls
• Provide face-focusing for professionals working with DHH children (as well as hearing children) to reduce listening effort, especially in noisy environments. 
• Encourage the use of signs/gestures in professionals working with DHH children to reduce listening effort, especially in noisy environments.
• Provide adequate rest periods at home, in care and at school to reduce the impact of increased listening effort (fatigue).
   

Results from the two experiments will be disseminated through a webinar, two publications and one animation for parents and children.