Listening effort and fatigue in school-age children with and without hearing loss.

Parents, audiologists, and educators have long speculated that children with hearing loss must expend more effort and, therefore, fatigue more easily than their peers with normal hearing when listening in adverse acoustic conditions. Until now, however, very few studies have been conducted to substantiate these speculations. Two experiments were conducted with school-age children with mild-to-moderate hearing loss and with normal hearing. In the first experiment, salivary cortisol levels and a self-rating measure were used to measure fatigue. Neither cortisol measurements nor self-rated measures of fatigue revealed significant differences between children with hearing loss and their normal-hearing peers. In the second experiment, however, a dual-task paradigm used to study listening effort indicated that children with hearing loss expend more effort in listening than children with normal hearing. Results are discussed in terms of clinical application and future research needs.