Listening Effort in School-Aged Children With Limited Useable Hearing Unilaterally: Examining the Effects of a Personal, Digital Remote Microphone System and a Contralateral Routing of Signal System

Technology options for children with limited hearing unilaterally that improve the signal-to-noise ratio are expected to improve speech recognition and also reduce listening effort in challenging listening situations, although previous studies have not confirmed this. Employing behavioral and subjective indices of listening effort, this study aimed to evaluate the effects of two intervention options, remote microphone system (RMS) and contralateral routing of signal (CROS) system, in school-aged children with limited hearing unilaterally. Nineteen children (aged 7–12 years) with limited hearing unilaterally completed a digit triplet recognition task in three loudspeaker conditions: midline, monaural direct, and monaural indirect with three intervention options: unaided, RMS, and CROS system. Verbal response times were interpreted as a behavioral measure of listening effort. Participants provided subjective ratings immediately following behavioral measures. The RMS significantly improved digit triplet recognition across loudspeaker conditions and reduced verbal response times in the midline and indirect conditions. The CROS system improved speech recognition and listening effort only in the indirect condition. Subjective ratings analyses revealed that significantly more participants indicated that the remote microphone made it easier for them to listen and to stay motivated. Behavioral and subjective indices of listening effort indicated that an RMS provided the most consistent benefit for speech recognition and listening effort for children with limited unilateral hearing. RMSs could therefore be a beneficial technology option in classrooms for children with limited hearing unilaterally.