Speech Processing Difficulties in Attention Deficit Hyperactivity Disorder

Abstract

The large body of research that forms the ease of language understanding (ELU) model emphasizes the important contribution of cognitive processes when listening to speech in adverse conditions; however, speech-in-noise (SIN) processing is yet to be thoroughly tested in populations with cognitive deficits. The purpose of the current study was to contribute to the field in this regard by assessing SIN performance in a sample of adolescents with attention deficit hyperactivity disorder (ADHD) and comparing results with age-matched controls. This population was chosen because core symptoms of ADHD include developmental deficits in cognitive control and working memory capacity and because these top-down processes are thought to reach maturity during adolescence in individuals with typical development. The study utilized natural language sentence materials under experimental conditions that manipulated the dependency on cognitive mechanisms in varying degrees. In addition, participants were tested on cognitive capacity measures of complex working memory-span, selective attention, and lexical access. Primary findings were in support of the ELU-model. Age was shown to significantly covary with SIN performance, and after controlling for age, ADHD participants demonstrated greater difficulty than controls with the experimental manipulations. In addition, overall SIN performance was strongly predicted by individual differences in cognitive capacity. Taken together, the results highlight the general disadvantage persons with deficient cognitive capacity have when attending to speech in typically noisy listening environments. Furthermore, the consistently poorer performance observed in the ADHD group suggests that auditory processing tasks designed to tax attention and working memory capacity may prove to be beneficial clinical instruments when diagnosing ADHD.

The Effects of Working Memory Load on Auditory Distraction in Adults With Attention Deficit Hyperactivity Disorder

“…We were not expecting aADHD to perform on par with Controls in measures of WM capacity. In a previous study performed by our lab group ( Blomberg et al, 2019 ), adolescents (<18 years) with ADHD demonstrated significantly reduced capacity than matched (age and gender) healthy controls on both the Reading span and the Size-comparison span tasks. This finding, in combination with general associations of ADHD with deficient WM capacity ( Willcutt et al, 2005 ; Alderson et al, 2013 ) was a major premise for using these measures again in our adult sample.…”

“…A related, yet different perspective, associates ADHD with life-time subcortical (basal ganglia and cerebellum) dysfunction, and that agerelated reductions in neurocognitive deficits in some cases are attributable to a healthy maturation of frontal lobes and the improved ability to issue cognitive control over subcortical systems (Halperin and Schulz, 2006). Presumably, such developmental differences between groups were exemplified through our WM capacity measures in our previous study with adolescents (Blomberg et al, 2019). We similarly note that concentration scores from the d2-Test of attention were also differential between groups in our adolescent study, but not in the current study.…”

“…Outside of the scanner, and in a quiet room, participants completed two WM span tests. The Reading span task ( Rönnberg et al, 1989 ) to measure WM maintenance, and the Size-comparison span test ( Sörqvist et al, 2010 ) as a measure of both WM gating and maintenance; the procedures for which are published in Blomberg et al (2019) .…”

The cognitive hearing science perspective on perceiving, understanding, and remembering language: The ELU model

“…An interesting extension of the generalization aspect is the study by Blomberg et al (2019) of adults with Attention Deficit Hyperactivity Disorder (ADHD). She also used different kinds of speech distortions (normal vs. noise-vocoded), orthogonally combined with type of background noise (clear speech, white noise, and speech babble).…”

The Effect of Age, Type of Noise, and Cochlear Implants on Adaptive Sentence-in-Noise Task

“…These results may reflect the high cognitive resources involved in the restoration of degraded auditory speech stimuli provided by the CI. Accordingly, the “ease of language understanding” model, which focuses on the role of cognitive processes in speech perception [ 22 , 48 ], indicates that when the auditory signal is degraded, it is difficult to match auditory input with its long-term stored representations. In these conditions, listeners make larger use of working memory to retain the input and resolve this mismatch.…”