Randomised Study of Web-Based Auditory Training With Varying Perceptual and Cognitive Demands on Training Gains and Generalised Speech, Cognitive, and Communication Outcomes

NCT07506408 | Recruiting

• 1 other identifier: FMHS 245-0925
• Study Type: interventional
• Target: 120
• Locations: 1 country
• Sites: 1

Brief Summary

WP1: PLUS-Auditory Training The goal of this experimental study is to better understand how task difficulty affects on-task learning thresholds and generalised benefits in two PLUS auditory training tasks involving perceptual and cognitive learning in adults aged 18+ (no upper age limit) with listening difficulties. The main question it aims to answer is:

• Does adjusting task difficulty in PLUS, by manipulating the perceptual and cognitive demands of the phonemic discrimination and competing speech tasks, affect on-task learning thresholds and off-task performance in adults with listening difficulties? Researchers will compare the two experimental arms (easy/hard) to see whether adjusting task difficulty influences on-task learning thresholds and off-task performance. Participants will:
• Be randomly assigned to one of two training programs (phonemic discrimination or competing speech) within the two experimental arms (easy/hard);
• Perform training for a minimum of 30 minutes per day, 5 days per week, for two weeks (total 10 training sessions, 5 hours of training);
• Complete pre- and post- training assessments to measure on-task learning performance and change in performance for untrained measures of speech perception, cognition and self-reported outcomes. WP2: Post-Training Focus Groups The goal of this observational study is to gain in-depth qualitative insights into participants' motivations, experiences of task difficulty, and perceived benefits across the PLUS-AT training groups in adults aged 18+ (no upper age limit) with listening difficulties. The main question it aims to answer is:
• How do participants describe their experiences and perceptions of PLUS-AT, particularly regarding task difficulty and self-perceived changes in listening, hearing, thinking, and quality of life? Researchers will explore participant experiences across the two experimental arms (easy/hard) to determine whether motivations for seeking auditory training, knowledge and beliefs about auditory training, attitudes toward PLUS-AT difficulty, and self-perceived changes in listening, hearing, thinking, and quality of life differ. A subset of participants (n = 20) will:
• Be invited from WP1 to join one of four online focus groups (60-90 minutes via Microsoft Teams);
• Attend the focus group corresponding to their assigned training program (phonemic discrimination or competing-speech) within the two experimental arms (easy/hard);
• Share their experiences of completing PLUS-AT.

Conditions

Hearing Loss

Keywords

Auditory Training; Speech Perception; Cognition; Hearing Loss; Listening Difficulties; Intervention

Outcome Measures

Primary Outcomes (1)

• (Adapted) Coordinate Response Measure (CRM)

  This test measures how well participants understand target speech when another talker is present. Two sentences are played at the same time: a female talker (target) and a male talker (distracter). Sentences follow the format 'show the \[animal\] where the \[colour\] \[number\] is', using a fixed target animal (dog) and limited sets of colours and numbers. The distractor never says 'dog' and always names a different animal. Participants identify the colour and number spoken by the female talker while ignoring the male talker, responding via computer or touchscreen. Task difficulty is varied by adjusting the signal to noise ratio (SNR) between target and distracter using an adaptive one up/one down staircase to estimate the speech reception threshold (50% correct). Each run ends after a set number of reversals or trials. Participants complete four runs, with the first as practice. Lower thresholds indicate better performance.

  Week 1, Week 3

Secondary Outcomes (9)

• Practice Listening and Understanding Speech (PLUS) Auditory Training

  Week 1, Week 2

• Letter N-back

  Week 1, Week 3

• Flanker Task

  Week 1, Week 3

• Dual-task of Listening and Memory

  Week 1, Week 3

• Wisconsin Card Sorting Test (WCST)

  Week 1, Week 3

Study Arms (2)

Lower perceptual and cognitive demands (Easier)

EXPERIMENTAL

Trainees are asked to train for a minimum of 30 min/day, 5 days/week over a 2-week period (300 minutes in total) and randomly assigned to one of two adaptive tasks, either: PLUS Phonemic Discrimination (0-back) A 3-interval, 3-alternate forced choice (oddball paradigm) task using eleven phoneme continua (/a/-/uh/, /b/-/d/, /d/-/g/, /e/-/a/, /er/-/or/, /i/-/e/, /l/-/r/, /m/-/n/, /s/-/sh/, /s/-/th/, and /v/-/w/), embedded within syllables, and synthesised from endpoints of real voice recordings. Trainees are asked to respond with the 'odd' sound immediately after presentation of the three stimuli. Or: PLUS Competing Speech: (male, female) Based on the Coordinate Response Measure (CRM), based on the Coordinate Response Measure (CRM), real world sentences are spoken by a target and masker that differ in gender. Trainees are asked to report two keywords spoken by the target talker from a list of all options, whilst ignoring the masker talker.

Behavioral: Practice Listening and Understand Speech (PLUS)

Higher perceptual and cognitive demands (Harder)

EXPERIMENTAL

Trainees are asked to train for a minimum of 30 min/day, 5 days/week over a 2-week period (300 minutes in total) and randomly assigned to one of two adaptive tasks, either: PLUS Phonemic Discrimination (1-back) A 3-interval, 3-alternate forced choice (oddball paradigm) task using eleven phoneme continua (/a/-/uh/, /b/-/d/, /d/-/g/, /e/-/a/, /er/-/or/, /i/-/e/, /l/-/r/, /m/-/n/, /s/-/sh/, /s/-/th/, and /v/-/w/), embedded within syllables, and synthesised from endpoints of real voice recordings. Trainees are asked to respond with the 'odd' sound for the three stimuli presented in the prior trial, while holding the 'odd' sound for the current trial in memory. Or: PLUS Competing Speech: (female, female) Based on the Coordinate Response Measure (CRM), real world sentences are spoken by a target and masker of the same gender. Trainees are asked to report two keywords spoken by the target talker from a list of all options, whilst ignoring the masker talker.

Behavioral: Practice Listening and Understand Speech (PLUS)

Interventions

Practice Listening and Understand Speech (PLUS) BEHAVIORAL

PLUS is a web-based auditory training platform with two adaptive auditory-cognitive training tasks designed to improve listening and communication. Phonemic Discrimination: Phonemes are sounds (e.g. /ba/ vs /da/) that make words different (e.g. "bad" vs "dad"). Participants hear three sounds (e.g., /ba/, /ba/, /da/) from sound pairs (e.g. /ba/ and /da/), and must identify the sound that's different (/da/). Competing Speech: Two talkers produce similar sentences that differ by keywords. Participants are asked to focus on one talker (cued by a target visible on screen) while ignoring a second talker and report two keywords from a list of all possible options.

Also known as: PLUS Phonemic Discrimination, PLUS Competing Speech

Higher perceptual and cognitive demands (Harder); Lower perceptual and cognitive demands (Easier)

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Adults (aged 18+ years, no upper age limit);
• Poorer performance on the DTT (SRT of -5.5 dB SNR or higher, as defined by Dawes, 2013) completed without hearing aid(s) for those who typically use them;
• Non-hearing device users or hearing aid(s) owner;
• Ability to read and understand English;
• Ability to provide informed consent;
• Access to the internet;
• Access to functional built-in speakers, external speakers, or headphones.

You may not qualify if:

• Having previous auditory training experience;
• Cochlear implant users.

Sponsors & Collaborators

• University of Nottingham: lead
• National Institute for Health Research, United Kingdom: collaborator

Study Sites (1)

NIHR Nottingham Biomedical Research Centre

Nottingham, Nottinghamshire, NG1 5DU, United Kingdom

RECRUITING

Related Publications (27)

• Tsimpida D, Rajasingam S, Panagioti M, Henshaw H. The leaky pipeline of hearing care: primary to secondary care evidence from the English Longitudinal Study of Ageing (ELSA). Int J Audiol. 2024 May;63(5):349-357. doi: 10.1080/14992027.2023.2186814. Epub 2023 Mar 23.

  PMID: 36951175 BACKGROUND

• Oosthuizen I,Manchaiah V,Launer S,Swanepoel W

  BACKGROUND

• Ferguson MA,Henshaw H,Clark DP,Moore DR

  BACKGROUND

• Henshaw H, McCormack A, Ferguson MA. Intrinsic and extrinsic motivation is associated with computer-based auditory training uptake, engagement, and adherence for people with hearing loss. Front Psychol. 2015 Aug 6;6:1067. doi: 10.3389/fpsyg.2015.01067. eCollection 2015.

  PMID: 26300796 BACKGROUND

• Boothroyd A. Adult aural rehabilitation: what is it and does it work? Trends Amplif. 2007 Jun;11(2):63-71. doi: 10.1177/1084713807301073.

  PMID: 17494873 BACKGROUND

• Van Wilderode, M. (2019). The implementation and evaluation of different scenarios for a Dutch auditory-cognitive training scheme [Unpublished doctoral thesis]. KU Leuven.

  BACKGROUND

• Stropahl M, Besser J, Launer S. Auditory Training Supports Auditory Rehabilitation: A State-of-the-Art Review. Ear Hear. 2020 Jul/Aug;41(4):697-704. doi: 10.1097/AUD.0000000000000806.

  PMID: 31613823 BACKGROUND

• Helfer KS, Merchant GR, Wasiuk PA. Age-Related Changes in Objective and Subjective Speech Perception in Complex Listening Environments. J Speech Lang Hear Res. 2017 Oct 17;60(10):3009-3018. doi: 10.1044/2017_JSLHR-H-17-0030.

  PMID: 29049601 BACKGROUND

• Wright, B. A., & Zhang, Y. (2009). Insights into human auditory processing gained from perceptual learning. In M. S. Gazzaniga, E. Bizzi, L. M. Chalupa, S. T. Grafton, T. F. Heatherton, C. Koch, J. E. LeDoux, S. J. Luck, G. R. Mangan, J. A. Movshon, H. Neville, E. A. Phelps, P. Rakic, D. L. Schacter, M. Sur, & B. A. Wandell (Eds.), The cognitive neurosciences (4th ed., pp. 353-365). Massachusetts Institute of Technology. https://doi.org/10.7551/mitpress/8029.003.0034

  BACKGROUND

• Bennett RJ, Laplante-Levesque A, Meyer CJ, Eikelboom RH. Exploring Hearing Aid Problems: Perspectives of Hearing Aid Owners and Clinicians. Ear Hear. 2018 Jan/Feb;39(1):172-187. doi: 10.1097/AUD.0000000000000477.

  PMID: 28787315 BACKGROUND

• Ferguson MA, Kitterick PT, Chong LY, Edmondson-Jones M, Barker F, Hoare DJ. Hearing aids for mild to moderate hearing loss in adults. Cochrane Database Syst Rev. 2017 Sep 25;9(9):CD012023. doi: 10.1002/14651858.CD012023.pub2.

  PMID: 28944461 BACKGROUND

• Office for National Statistics. (2019). Population estimates for the UK, England and Wales, Scotland and Northern Ireland: mid-2018. https://www.ons.gov.uk/peoplepopulationandcommunity/populationandmigration/populationestimates/bulletins/annualmidyearpopulationestimates/mid2019estimates

  BACKGROUND

• GBD 2019 Hearing Loss Collaborators. (2021). Hearing loss prevalence and years lived with disability, 1990-2019: findings from the Global Burden of Disease Study 2019. The Lancet, 397(10278), 996-1009. https://doi.org/10.1016/S0140-6736(21)00516-X

  BACKGROUND

• WHO. (2021) World report on hearing. World Health Organization. https://www.who.int/publications/i/item/9789240020481

  BACKGROUND

• Henshaw H, Heinrich A, Tittle A, Ferguson M. Cogmed Training Does Not Generalize to Real-World Benefits for Adult Hearing Aid Users: Results of a Blinded, Active-Controlled Randomized Trial. Ear Hear. 2022 May/Jun;43(3):741-763. doi: 10.1097/AUD.0000000000001096.

  PMID: 34524150 BACKGROUND

• Lawrence BJ, Jayakody DMP, Henshaw H, Ferguson MA, Eikelboom RH, Loftus AM, Friedland PL. Auditory and Cognitive Training for Cognition in Adults With Hearing Loss: A Systematic Review and Meta-Analysis. Trends Hear. 2018 Jan-Dec;22:2331216518792096. doi: 10.1177/2331216518792096.

  PMID: 30092719 BACKGROUND

• Henshaw, H., & Ferguson, M. (2014). Assessing the benefits of auditory training to real-world listening: identifying appropriate and sensitive outcomes. Proceedings of the International Symposium on Auditory and Audiological Research, 4, 45-52. Retrieved from https://proceedings.isaar.eu/index.php/isaarproc/article/view/2013-05

  BACKGROUND

• Akeroyd MA, Munro KJ. Population estimates of the number of adults in the UK with a hearing loss updated using 2021 and 2022 census data. Int J Audiol. 2024 Sep;63(9):659-660. doi: 10.1080/14992027.2024.2341956. Epub 2024 May 15. No abstract available.

  PMID: 38747510 BACKGROUND

• Gatehouse, S. (1999). Glasgow Hearing Aid Benefit Profile: Derivation and Validation of a Client-centered Outcome Measure for Hearing Aid Services. Journal of the American Academy of Audiology, 10(2), 80-103. https://doi.org/10.1055/s-0042-1748460

  BACKGROUND

• Eriksen, B. A., & Eriksen, C. W. (1974). Effects of noise letters upon identification of a target letter in a non- search task. Perception and Psychophysics,16, 143-149. https://doi.org/10.3758/bf03203267

  BACKGROUND

• Heffernan E, Coulson NS, Ferguson MA. Development of the Social Participation Restrictions Questionnaire (SPaRQ) through consultation with adults with hearing loss, researchers, and clinicians: a content evaluation study. Int J Audiol. 2018 Oct;57(10):791-799. doi: 10.1080/14992027.2018.1483585. Epub 2018 Jul 2.

  PMID: 29966457 BACKGROUND

• Cassarly C, Matthews LJ, Simpson AN, Dubno JR. The Revised Hearing Handicap Inventory and Screening Tool Based on Psychometric Reevaluation of the Hearing Handicap Inventories for the Elderly and Adults. Ear Hear. 2020 Jan/Feb;41(1):95-105. doi: 10.1097/AUD.0000000000000746.

  PMID: 31124792 BACKGROUND

• GRANT DA, BERG EA. A behavioral analysis of degree of reinforcement and ease of shifting to new responses in a Weigl-type card-sorting problem. J Exp Psychol. 1948 Aug;38(4):404-11. doi: 10.1037/h0059831. No abstract available.

  PMID: 18874598 BACKGROUND

• Howard CS, Munro KJ, Plack CJ. Listening effort at signal-to-noise ratios that are typical of the school classroom. Int J Audiol. 2010 Dec;49(12):928-32. doi: 10.3109/14992027.2010.520036. Epub 2010 Nov 4.

  PMID: 21047295 BACKGROUND

• KIRCHNER WK. Age differences in short-term retention of rapidly changing information. J Exp Psychol. 1958 Apr;55(4):352-8. doi: 10.1037/h0043688. No abstract available.

  PMID: 13539317 BACKGROUND

• Bianco R, Mills G, de Kerangal M, Rosen S, Chait M. Reward Enhances Online Participants' Engagement With a Demanding Auditory Task. Trends Hear. 2021 Jan-Dec;25:23312165211025941. doi: 10.1177/23312165211025941.

  PMID: 34170748 BACKGROUND

• Cullington HE, Aidi T. Is the digit triplet test an effective and acceptable way to assess speech recognition in adults using cochlear implants in a home environment? Cochlear Implants Int. 2017 Mar;18(2):97-105. doi: 10.1080/14670100.2016.1273435. Epub 2017 Jan 25.

  PMID: 28120703 BACKGROUND

MeSH Terms

Conditions

Hearing Loss

Condition Hierarchy (Ancestors)

Hearing Disorders; Ear Diseases; Otorhinolaryngologic Diseases; Sensation Disorders; Neurologic Manifestations; Nervous System Diseases; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Study Officials

• Helen Henshaw, PhD

  University of Nottingham

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Natalie Lerigo-Smith, MSc

CONTACT

+44 (0)115 8232600; natalie.lerigo-smith1@nottingham.ac.uk

Helen Henshaw, PhD

CONTACT

+44 (0) 115 8232606; helen.henshaw@nottingham.ac.uk

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Masking Details: Participants will not be informed of the individual experimental arms or their allocation
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Model Details: Participants are assigned to one of two or more groups in parallel for the duration of the study

Study Record Dates

• First Submitted: March 19, 2026
• First Posted: April 1, 2026
• Study Start: March 13, 2026
• Primary Completion (Estimated): January 1, 2027
• Study Completion (Estimated): February 1, 2027
• Last Updated: April 1, 2026

Record last verified: 2026-03

Locations

GB (1)