Commentary: listening can be exhausting--fatigue in children and adults with hearing loss

Abstract

Anecdotal reports of fatigue after sustained speech-processing demands are common among adults with hearing loss; however, systematic research examining hearing loss-related fatigue is limited, particularly with regard to fatigue among children with hearing loss (CHL). Many audiologists, educators, and parents have long suspected that CHL experience stress and fatigue as a result of the difficult listening demands they encounter throughout the day at school. Recent research in this area provides support for these intuitive suggestions. In this article, the authors provide a framework for understanding the construct of fatigue and its relation to hearing loss, particularly in children. Although empirical evidence is limited, preliminary data from recent studies suggest that some CHL experience significant fatigue-and such fatigue has the potential to compromise a child's performance in the classroom. In this commentary, the authors discuss several aspects of fatigue including its importance, definitions, prevalence, consequences, and potential linkage to increased listening effort in persons with hearing loss. The authors also provide a brief synopsis of subjective and objective methods to quantify listening effort and fatigue. Finally, the authors suggest a common-sense approach for identification of fatigue in CHL; and, the authors briefly comment on the use of amplification as a management strategy for reducing hearing-related fatigue.

Fig. 1

Mean PedQL Multidimensional Fatigue Scale subscale and total fatigue scores from children with hearing loss (CHL) and children with normal hearing (CNH). Lower values depict more fatigue. Error bar = 1 standard error (From Hornsby et al. 2013).

Fig. 2

Mean cortisol levels (standard error bars) at all times of collection for children with normal hearing (open squares) and two children with hearing loss (solid square and triangle). Elevated cortisol awakening response values (solid square) are associated with chronic social stress, perceived stress, and worrying about the burdens of the upcoming day. Blunted values (solid triangle) are associated with an inability to mobilize sufficient energy to cope with the challenges of daily life activities.