J Am Acad Audiol 2020; 31(10): 771-780
DOI: 10.1055/s-0040-1719136
Research Article

Using the Repeat-Recall Test to Examine Factors Affecting Context Use

Francis Kuk
1   WS Audiology, Widex Office of Research in Clinical Amplification (ORCA-USA), Lisle, Illinois
Christopher Slugocki
1   WS Audiology, Widex Office of Research in Clinical Amplification (ORCA-USA), Lisle, Illinois
Petri Korhonen
1   WS Audiology, Widex Office of Research in Clinical Amplification (ORCA-USA), Lisle, Illinois
› Author Affiliations


Background The effect of context on speech processing has been studied using different speech materials and response criteria. The Repeat-Recall Test (RRT) evaluates listener performance using high context (HC) and low context (LC) sentences; this may offer another platform for studying context use (CU).

Objective This article aims to evaluate if the RRT may be used to study how different signal-to-noise ratios (SNRs), hearing aid technologies (directional microphone and noise reduction), and listener working memory capacities (WMCs) interact to affect CU on the different measures of the RRT.

Design Double-blind, within-subject repeated measures design.

Study Sample Nineteen listeners with a mild-to-moderately severe hearing loss.

Data Collection The RRT was administered with participants wearing the study hearing aids under two microphone (omnidirectional vs. directional) by two noise reduction (on vs. off) conditions. Speech was presented from 0 degree at 75 dB sound pressure level and a continuous speech-shaped noise from 180 degrees at SNRs of 0, 5, 10, and 15 dB. The order of SNR and hearing aid conditions was counterbalanced across listeners. Each test condition was completed twice in two 2-hour sessions separated by 1 month.

Results CU was calculated as the difference between HC and LC sentence scores for each outcome measure (i.e., repeat, recall, listening effort, and tolerable time). For all outcome measures, repeated measures analyses of variance revealed that CU was significantly affected by the SNR of the test conditions. For repeat, recall, and listening effort measures, these effects were qualified by significant two-way interactions between SNR and microphone mode. In addition, the WMC group significantly affected CU during recall and rating of listening effort, the latter of which was qualified by an interaction between the WMC group and SNR. Listener WMC affected CU on estimates of tolerable time as qualified by significant two-way interactions between SNR and microphone mode.

Conclusion The study supports use of the RRT as a tool for measuring how listeners use sentence context to aid in speech processing. The degree to which context influenced scores on each outcome measure of the RRT was found to depend on complex interactions between the SNR of the listening environment, hearing aid features, and the WMC of the listeners.

Publication History

Received: 13 January 2020

Accepted: 17 April 2020

Article published online:
15 February 2021

© 2021. American Academy of Audiology. This article is published by Thieme.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

  • References

  • 1 Kuk F, Slugocki C, Korhonen P. (published ahead of print). An integrative evaluation of the efficacy of a directional microphone and noise reduction algorithm under realistic signal-to-noise ratios. J Am Acad Audiol 2020; 31 (04) 262-270
  • 2 Daneman M, Carpenter P. Individual differences in working memory and reading. J Verbal Learn Verbal Behav 1980; 19 (04) 450-466
  • 3 McCoy SL, Tun PA, Cox LC, Colangelo M, Stewart RA, Wingfield A. Hearing loss and perceptual effort: downstream effects on older adults' memory for speech. Q J Exp Psychol A 2005; 58 (01) 22-33
  • 4 Zekveld AA, Rudner M, Johnsrude IS, Festen JM, van Beek JH, Rönnberg J. The influence of semantically related and unrelated text cues on the intelligibility of sentences in noise. Ear Hear 2011; 32 (06) e16-e25
  • 5 Pichora-Fuller MK, Schneider BA, Daneman M. How young and old adults listen to and remember speech in noise. J Acoust Soc Am 1995; 97 (01) 593-608
  • 6 Rönnberg J, Rudner M, Foo C, Lunner T. Cognition counts: a working memory system for ease of language understanding (ELU). Int J Audiol 2008; 47 (Suppl. 02) S99-S105
  • 7 Dubno JR, Ahlstrom JB, Horwitz AR. Use of context by young and aged adults with normal hearing. J Acoust Soc Am 2000; 107 (01) 538-546
  • 8 Obleser J, Wise RJ, Dresner MA, Scott SK. Functional integration across brain regions improves speech perception under adverse listening conditions. J Neurosci 2007; 27 (09) 2283-2289
  • 9 Bilger RC, Nuetzel JM, Rabinowitz WM, Rzeczkowski C. Standardization of a test of speech perception in noise. J Speech Hear Res 1984; 27 (01) 32-48
  • 10 Elliott LL. Verbal auditory closure and the Speech Perception in Noise (SPIN) test. J Speech Hear Res 1995; 38 (06) 1363-1376
  • 11 Kalikow DN, Stevens KN, Elliott LL. Development of a test of speech intelligibility in noise using sentence materials with controlled word predictability. J Acoust Soc Am 1977; 61 (05) 1337-1351
  • 12 Boothroyd A, Nittrouer S. Mathematical treatment of context effects in phoneme and word recognition. J Acoust Soc Am 1988; 84 (01) 101-114
  • 13 Helfer KS, Freyman RL. Aging and speech-on-speech masking. Ear Hear 2008; 29 (01) 87-98
  • 14 Guediche S, Salvata C, Blumstein SE. Temporal cortex reflects effects of sentence context on phonetic processing. J Cogn Neurosci 2013; 25 (05) 706-718
  • 15 Bäckman L, Mäntylä T, Erngrund K. Optimal recall in early and late adulthood. Scand J Psychol 1984; 25: 306-314
  • 16 Mäntylä T, Nilsson L. Are my cues better than your cues? Uniqueness and reconstruction as prerequisites for optimal recall of verbal materials. Scand J Psychol 1983; 24: 303-312
  • 17 Sarampalis A, Kalluri S, Edwards B, Hafter E. Objective measures of listening effort: effects of background noise and noise reduction. J Speech Lang Hear Res 2009; 52 (05) 1230-1240
  • 18 Holmes E, Folkeard P, Johnsrude IS, Scollie S. Semantic context improves speech intelligibility and reduces listening effort for listeners with hearing impairment. Int J Audiol 2018; 57 (07) 483-492
  • 19 Cox RM, Alexander GC, Gilmore C. Development of the Connected Speech Test (CST). Ear Hear 1987; 8 (5, Suppl): 119S-126S
  • 20 Winn MB. Rapid release from listening effort resulting from semantic context, and effects of spectral degradation and cochlear implants. Trends Hear 2016; 20: 2331216516669723
  • 21 Ricketts TA. Directional hearing aids. Trends Amplif 2001; 5 (04) 139-176
  • 22 Goldinger S. Auditory lexical decision. Lang Cogn Process 1996; 11: 559-568
  • 23 Moulin A, Richard C. Lexical influences on spoken spondaic word recognition in hearing-impaired patients. Front Neurosci 2015; 9: 476
  • 24 Slugocki C, Kuk F, Korhonen P. Development and clinical applications of the ORCA Repeat and Recall Test (RRT). Hear Rev 2018; 25 (12) 22-26
  • 25 Smeds K, Wolters F, Rung M. Estimation of signal-to-noise ratios in realistic sound scenarios. J Am Acad Audiol 2015; 26 (02) 183-196
  • 26 Wu YH, Stangl E, Chipara O, Hasan SS, Welhaven A, Oleson J. Characteristics of real world signal-to-noise ratios and speech listening situations of older adults with mild to moderate hearing loss. Ear Hear 2018; 39 (02) 293-304
  • 27 Keidser G, Dillon H, Flax M, Ching T, Brewer S. The NAL-NL2 prescription procedure. Audiology Res 2011; 1 (01) e24
  • 28 Oeding K, Valente M. Differences in sensation level between the Widex Soundtracker and two real-ear analyzers. J Am Acad Audiol 2013; 24 (08) 660-670
  • 29 Nasreddine ZS, Phillips NA, Bédirian V. et al. The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc 2005; 53 (04) 695-699
  • 30 Cohen J. Statistical Power Analysis for the Behavioral Sciences. 2nd ed.. Mahwah, NJ: Lawrence Erlbaum Associates Publisher; 1988
  • 31 Matthen M. Effort and displeasure in people who are hard of hearing. Ear Hear 2016; 37 (Suppl. 01) 28S-34S
  • 32 Kochkin S. Customer satisfaction with hearing instruments in the digital age. Hear J 2005; 58 (09) 30-39