Download Effects of Hearing Acuity on Recall of Expository Prose Master`s

Effects of Hearing Acuity on Recall of Expository Prose
Master’s Thesis
Presented to
The Faculty of the Graduate School of Arts and Sciences
Brandeis University
Department of Psychology
Arthur Wingfield, D.Phil., Advisor
In Partial Fulfillment
of the Requirements for the Degree
Master of Arts
in
Psychology
by
Heidi L. Sarles-Whittlesey
May 2017
Copyright by
Heidi L. Sarles-Whittlesey
© 2017
ACKNOWLEDGEMENTS
I would like to thank Art Wingfield, my advisor, for his wisdom, guidance, and this opportunity;
Hannah Snyder, for her insightful advice and support throughout this process; Eriko Atagi for
her endless patience and investment as a mentor; the entire Memory & Cognition Lab for their
team effort; and my family for making all of this possible.
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ABSTRACT
Effects of Hearing Acuity on Recall of Expository Prose
A thesis presented to the Department of Psychology
Graduate School of Arts and Sciences
Brandeis University
Waltham, Massachusetts
By Heidi L. Sarles-Whittlesey
The present study examined how memory processes may be impacted by uncorrected hearing
loss and increased expenditure of cognitive resources during encoding of spoken prose in older
adults (OAs). The effect of self-paced listening on the accuracy of recall was investigated, as
well as the relationship between the order of propositions in a passage and the order in which
they are recalled. 24 OAs were matched for cognitive ability, but differed in hearing acuity (12
had good hearing acuity (GH); 12 had mild to moderate poor hearing acuity (PH)). Expository
passages were presented in a self-paced or continuous listening condition; as well as at +10
dB above each listener’s speech reception threshold (SRT) or at +25 dB above SRT. Results
indicated a significant main effect of levels of detail on recall accuracy. Only the PH group’s
recall accuracy was significantly impacted by pacing and presentation level. Self-pacing
facilitated linear congruency of recall for the GH group only. Lag recency analysis suggested
that the GH group formed stronger between-proposition associations than the PH group.
Keywords: hearing acuity, effortful listening, free-recall, linear congruency, lag recency, memory, aging
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TABLE OF CONTENTS
ACKNOWLEDGEMENTS………………………………………………………………………iii
ABSTRACT……………………………………………………………………………………...iv
LIST OF TABLES……………………………………………………………………………......vi
LIST OF FIGURES...…………………………………………………………………………....vii
LIST OF APPENDICES...……………………………………………………………………...viii
INTRODUCTION.………………………………………………………………………………..1
METHODS..……………………………………………………………………………………....8
Participants………………………………………………………………………………...8
Cognitive Testing……………………………………………………………………….....8
Auditory Testing…………………………………………………………………………..9
Stimulus Materials……………………………………………………………………….10
Procedures………………………………………………………………………………..11
RESULTS..………………………………………………………………………………………13
Recall Accuracy………………………………………………………………………….13
Order of Recall…………………………………………………………………………...14
DISCUSSION..………………………………………………………………………………….17
REFERNCES...………………………………………………………………………………….23
TABLES………………………………………………………………………………………....25
FIGURES………………………………………………………………………………………..27
APPENDICES…………………………………………………………………………………...30
v
LIST OF TABLES
Participant characteristics………………………………………………………………………..25
Linear mixed-effects……………………………………………………………………………..26
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LIST OF FIGURES
Figure 1. Proportion of propositions recalled……………………………………………………27
Figure 2. Linear congruency of recall……………………………………………………………28
Figure 3. Lag recency plots………….…………………………………………………………...29
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LIST OF APPENDICES
Appendix A. Example of passage stimuli……………………………………………………….30
Appendix B. Sample of passage broken down into propositions………………………………..31
Appendix C. Sample scoring table for propositions, level of detail, and order of recall………..32
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Effects of Hearing Acuity on Recall of Expository Prose
The overall aim of this study is to assess how memory processes may be impacted by
cognitive aging, specifically as they pertain to uncorrected hearing loss and increased
expenditure of cognitive resources during encoding of spoken prose.
It is common knowledge that as people age their ability to form new memories becomes
compromised. Difficulties in remembering among older participants have been observed within
the context of a variety of tasks and experimental settings, however much less is known about
how these alterations are further impacted by changes co-occurring at the sensory level. The
following study explores a number of factors related to episodic recall in older adulthood through
a comparison of free-recall production between older adults matched for cognitive ability but
differing in their level of hearing acuity. The impact of listening effort on free-recall production
was assessed in terms of (1) presentation level (volume); (2) processing time (pacing); (3) the
level of ideas recalled determined by hierarchical propositional analysis; and (4) the order in
which ideas were recalled determined by their linear congruency to the original passage and their
temporal proximity to each other.
Effect of Listening Effort
Increased cognitive demands associated with effortful listening have been shown to
negatively impact the accuracy of recall. The effortful listening hypothesis put forth by Rabbitt
(1968) suggests that increased cognitive effort expended on simply trying to hear the speech
diverts mental resources away from encoding and storage processes necessary for later retrieval.
Consistent with this hypothesis, recall of the associated information is reduced even when the
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stimulus is presented at an audible level (supra-threshold)—i.e., where the individual is able to
hear every word but the acoustic signal is below a comfortable listening volume, thus requiring
extra effort on the part of the listener. Rabbitt (1991) later demonstrated that uncorrected hearing
loss in older adults produces similar negative effects on memory. Likewise, Ward, Rogers, Van
Engen, and Peelle (2016) observed a significant negative effect of effortful listening on the
percentage of total details recalled by young and older listeners who were presented with
spectrally degraded speech signals.
Interestingly, this negative effect of effortful listening has the potential to be remediated
by increasing the processing time available to the participant. In a study by Piquado, Benichov,
Brownell and Wingfield (2012), young adults were presented with auditory passages that were
either played continuously from beginning to end or paused periodically over the course of the
passage, allowing the participant to initiate each following segment at their own pace.
Researchers found that the extra processing time provided to the participants in the self-paced
listening condition facilitated overall recall, increasing the number of details accurately recalled.
Similarly, Titone, Prentice, and Wingfield (2000) found an effect of age on the amount of freely
recalled details in continuous passages versus self-paced passages, with younger adults recalling
more details overall and more minor details than the older adults. This gap in recall performance
was exacerbated in the continuous listening condition where processing time was diminished,
providing further support for the effortful listening hypothesis.
The assumption underlying this “effortfulness” follows from the notion of limited
attentional resources that must be allocated among simultaneous or closely successive perceptual
or cognitive operations (e.g., Kahneman, 1973). Although “effort” in the cognitive literature
remains poorly defined (e.g., McGarrigle et al., 2014), it is reasonable to predict that older adults
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with age-related hearing loss and/or with speech presented at a challenging sound level would
show poorer recall than age-matched participants with better hearing acuity and/or when speech
is delivered at a higher sound level based on what is known about the effects of listening effort
on recall. This prediction presupposes that the speech under all conditions is presented at a
supra-threshold level for each participant.
Self-pacing and Passage Recall
In addition to declines in working memory, and executive resources, adult aging is also
accompanied by a general slowing in a range of perceptual and cognitive operations (for reviews
see McCabe, Roediger, McDaniel, Balota, & Hambrick, 2010; Salthouse, 1991; Wingfield,
Amichetti, & Lash, 2015). This raises the question of whether allowing older adults extra time
to encode an incoming speech passage will facilitate recall of that speech passage. One way to
test this hypothesis is to allow listeners to self-pace their way through a passage using a so-called
auditory moving window (AMW) technique (Fallon, Peelle, & Wingfield, 2006; Ferreira,
Henderson, Anes, Weeks, & McFarlane, 1996). In this method, as a passage is presented via a
computer sound file, and is interrupted after each sentence with listeners instructed to press a key
when ready to hear the next sentence, with the goal of accurate recall of the entire passage when
it has been completed. Using a within-participants design the recall accuracy for self-paced
passages with recall of passages heard in a normal uninterrupted presentation will be contrasted
between hearing groups.
It is recognized that while the self-pacing task might differentially aid older adults’
passage recall, the dual-task nature of self-pacing (i.e., holding what has been heard in memory
up to that point while making a decision as to when to initiate the next sentence) might hinder
recall rather than help it. It is known, for example, that older adults are more susceptible to dual-
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tasking than younger adults, and especially so for younger and older adults with reduced hearing
acuity (e.g., Tun, McCoy, & Wingfield, 2009).
A ‘Levels Effect’ in Passage Recall
As a general rule, recall from both expository and narrative passages tends to show better
representation of the main ideas within a passage relative to more minor details, with the effect
of adult aging appearing to a differentially greater extent for details than for main ideas (Stine &
Wingfield, 1987). My question is whether listening effort as determined by the sound level of
passage presentations and participants’ audiometric classification will affect recall of passage
details to a differentially greater extent than recall of main ideas. To answer this question, three
levels of detail were determined for each passage based on a propositional analysis of sentence
content (Ward, et al., 2016; van Dijk & Kintsch, 1983; Turner & Greene, 1977; see Methods). If
listening effort reduces the cognitive resources needed to determine full coherence of a passage it
may be that main ideas will suffer more than recall of passage details.
Effects of Aging and Order of Recall
Lag recency. Although an overall negative effect of cognitive aging on memory has been
well established (Salthouse, 1991), much less is known about how aging impacts memory
functions, especially the processes of encoding and retrieving information. For instance,
researchers found no difference in the initiation of recall (which items were recalled first)
between younger and older adults during free recall tasks of word lists, but found a significant
difference in the lag recency effect between the two groups (Kahana, et al., 2002). Older adults’
recall transitions were much less influenced by the temporal context of the list items,
demonstrating a reduced lag recency effect relative to the younger adults (Kahana, et al., 2002).
These findings suggest a deficit in associative processes (Howard, Kahana, & Wingfield, 2006)
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and impairment in the ability to employ temporal context as a retrieval strategy (Kahana, et al.,
2002).
Whereas the traditional recency effect relates the temporal proximity of recalled items to
the time of the test, the lag recency effect relates the temporal proximity of recall to the item that
was just recalled (Howard & Kahana, 1999; Kahana, 1996). Temporal proximity in this context
refers to the number of items, or aggregate of distracting information, interfering between two
items in the list. This method emphasizes the order of recall as a critical component in
understanding the process of self-initiated memory retrieval as opposed to traditional models that
focus almost exclusively on recall as a function of the order in which items were presented
(Kahana, Howard, Zaromb, & Wingfield, 2002).
Using lag recency, the associative process in free recall (Howard & Kahana, 1999;
Kahana, 1996) and serial recall (Kahana & Caplan, 2002; Raskin & Cook, 1937) of word lists
are found to be asymmetric, favoring forward associations over backward associations at
approximately a 2:1 ratio (Kahana, et al., 2002). This is demonstrated in findings where positive
lag tends to be greater than negative lag, indicating the formation of stronger forward
associations during free recall and serial recall, and perhaps a facilitative effect of sequence on
memory.
To date, lag recency has been used exclusively with word lists. One might wonder if such
methods could be applied to longer bodies of text and if similar patterns of recall could be
observed. It turns out that canonically structured narratives, such as fairy tales, facilitate accurate
recall (Myers, Pezdek, & Coulson, 1973; Wolfe, 2005). Researchers have postulated that the
sequential order and recursive development of a story serves as a tool for recall by creating
strong associative links between details where the recall of one detail triggers the recall of
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another (Myers, et al., 1973). This facilitative effect of passage structure often results in greater
total recall than that recalled from expository passages or bodies of text that primarily serve to
deliver information and lack the sequentially dependent development of a storyline (Petros,
Tabor, Cooney, & Chabot, 1983; Wolfe, 2005). One could postulate that associations formed
between elements of a story are semantically more meaningful and therefore more robust (less
vulnerable to interference) than those formed from lists of words, but that is beyond the scope of
this thesis. Instead the lag recency effect will be employed here as a method to quantitatively
represent the recall tendencies that emerge during the free recall of expository passages. Due to
the inherent structure of a passage as opposed to lists of words, greater representation of the
primacy effect is expected compared with previous research findings gathered from word-list
recall, as well as a greater probability that the first items recalled will be among the first items
presented in the passage, across participants.
The Present Study
In summary, based on prior research, one could expect to find poorer overall recall across
groups when increased listening effort is required, (e.g., lower presentation amplitude and
uninterrupted passage presentations) and poorer overall recall for older adults with impaired
hearing compared to those with normal hearing, even when the stimuli are played at an audible
level for each participant. Poorer recall for passage details compared with recall for main ideas in
conditions of increased listening effort would be expected across groups, with increased level
effects observed among participants with impaired hearing. Self-paced listening, as a method of
increasing processing time, is expected to increase overall recall accuracy and reduce level
effects across groups, but be differentially beneficial for those with impaired hearing. Finally, it
is hypothesized that poorer linear congruency between recalled details and the original passage
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reflected in both reduced lag recency effects and greater departure in the order of recalled details
from the passage stimuli among older adults with impaired hearing, relative to older adults with
normal hearing. In the self-pacing condition it is expected that linear congruency for those with
impaired hearing will differentially benefit.
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Methods
Participants
Participant characteristics are provided in Table 1. A total of 24 participants were
recruited from the local community and were separated into two groups of 12 based on their pure
tone threshold average (PTA): those with good hearing acuity (GH) (PTA < 20dB HL; see
Auditory Testing), and those with mild to moderately poor hearing acuity (PH) (PTA ranging
from 20 – 55 dB HL). GH participants (2 male) ranged in age from 65.2 to 78.5 years (M = 73.6,
SD = 4.0); PH participants (5 male) ranged in age from 66.3 to 88.9 years, (M = 78.6, SD = 6.8.
Groups differed significantly by age, t(17.89) = 2.15, p = .05.
Participants did not differ in years of formal education, t(19.37) = .91, p = .37. All
participants were self-reported native speakers of American English in good health with no
reported history of neurologic or cognitive disorders that might interfere with their ability to
perform the experimental tasks. Participants provided written informed consent prior to
participating in the experiment in accordance with the protocol approved and overseen by the
Brandeis University Institutional Review Board.
Cognitive testing. Participants were further matched across working memory capacity,
vocabulary knowledge, and verbal fluency, in order to insure that any differences found between
the two hearing-level groups were not due to accidental differences in cognitive or verbal ability.
Working memory. Working memory was assessed using the reading span task introduced
by Daneman and Carpenter (1980), a common assessment of verbal working memory that
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focuses on complex span tasks in which material must be held in memory while other operations,
either related or unrelated to the information in memory, must be performed (Baddeley, 2012).
In this task participants are exposed to increasingly larger sets of sentences presented on a
computer screen with instructions to indicate after each sentence whether the statement in each
sentence is true or false. Once a full set of sentences has been presented participants are asked to
recall the last word of each of the sentences in the order in which the sentences were presented
for that set. The task thus requires the participant to make a true-false decision about the
statement in each sentence while simultaneously holding the final words of each of the prior
sentences in memory. Scores were calculated based on McCabe et al.’s (2010) scoring
procedure, in which participants receive three trials for any given number of sentences, with a
working memory score calculated as the total number of trials in which all sentence-final words
were recalled accurately and in the correct order. The maximum score on this test is 15. The
reading span version of this test was used rather than its analogous listening span version to
avoid performance being affected by differences in hearing acuity. GH reading span scores were
not significantly different than PH reading span scores, t(21.11) = 1.66, p = .11, thus confirming
participants were matched on working memory capacity.
Vocabulary knowledge. Vocabulary knowledge was assessed using a 20-item version of
the Shipley vocabulary test (Zachary, 1991). This is a written multiple choice test in which the
participant is required to indicate which of four listed words is synonymous with the given target
word. The vocabulary score was determined by summing the total number correct with no
penalty for incorrect answers. GH Shipley vocabulary scores were not significantly different that
PH Shipley vocabulary scores, t(16.94) = 1.92, p = .07, thus confirming participants were
matched on vocabulary knowledge.
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Verbal fluency. Participants were asked to name as many items as they could within a
given semantic category (e.g. animals), without repetition, in 60 seconds (e.g., Ardila, OstroskySolís, & Bernal, 2006). A practice trial of 20 seconds using a different semantic category (e.g.
fruits) was given prior to the actual assessment. Participants were scored based on the number of
unique items generated within the allotted time with no penalty for repeated or out-of-category
items. Scores were not significantly different between the two hearing groups, t(16.36) = .76, p =
.46, with GH participants’ production ranging from 9 to 30 unique items and PH participants’
production ranging from 18 to 28 unique items.
Auditory testing. Audiometric evaluation of each participant was carried out using a
Grason-Stadler AudioStar Pro clinical audiometer (Grason-Stadler, Inc., Madison, WI, USA) by
way of standard audiometric techniques in a sound-attenuated testing room. Individuals’ betterear pure tone threshold averages (PTA) were calculated across 500, 1000, 2000, and 4000 Hz
(Katz, 2002). This value was used to assign participants to their hearing acuity groups. Speech
Reception Thresholds (SRTs) were determined based on the lowest volume (dB) the participant
could accurately repeat back two-syllable words. SRTs were gathered separately for both ears
and the ear with the lower SRT was used as the base from which listening levels were set
(described below).
Stimulus Materials
Stimuli consisted of four approximately 400-word expository passages recorded onto
computer sound files by a male native speaker of American English using Sound Studio V2.2.4
(Macromedia, Inc., San Francisco, CA, USA) that digitizes (16-bit) at a sampling rate of 44.1
kHz. Root-mean-square (RMS) amplitude was equated across passages. Unlike passages that
have a narrative structure (a set-up, plot, and resolution), expository passages are primarily
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informative in nature. The passages used consisted of descriptions of topics not commonly
known in order to limit potential effects of prior knowledge on recall. Topics included: (1)
behaviors and characteristics of diving ducks, (2) the history of kites, (3) behaviors and
characteristics of snakes found in the Smoky Mountains National Park, and (4) the history of bird
banding (Spargo & Williston, 1980). See Appendix A for an example.
Procedures
Presentation conditions. Standard (uninterrupted) condition. In this condition the
passages were heard as recorded, from beginning to end without interruption. Following each
passage participants were asked to recall, as accurately as possible, as much of the speech
passage as they could remember. Responses were audio recorded and later, manually transcribed
and scored for accuracy and order (as described in Results). Following the recall of each
passage, participants answered five written true/false questions that appeared visually on the
computer screen as a check for comprehension.
Self-pacing condition. The self-paced listening condition was based on the auditory
moving window paradigm (Fallon, Peelle, & Wingfield, 2006; Ferreira et al., 1996; Wingfield,
Kemtes, & Miller, 2001). In this condition participants were told that they were allowed to
control the presentation rate of the passages themselves, with the goal of being able to provide as
much accurate recall as possible after the full passage had been heard. For this purpose, passages
automatically paused after each sentence, with the participant instructed to press a key on a
computer keyboard when he or she felt ready to hear the next sentence. In this way, the
participant worked their way through the passage, sentence-by-sentence until it had finished.
Following each passage recall was tested as described above. The critical feature of this
condition is that participants’ pause-times in between sentences were automatically recorded by
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the computer.
Sound levels. Although always presented at a supra-threshold level, passages were heard
at a lower sound level of 10 dB above the individuals’ better-ear SRT (i.e., 10 dB SRT) or a
louder level of 25 dB above better-ear SRT (25 dB SRT).
Counterbalancing control. Each participant heard all four passages, two uninterrupted,
and two self-paced, with one passage in each condition heard at 10 dB SRT and one at 25 dB
SRT. The order of passage presentation was rotated and the assignment of passage to
listening/pacing condition was randomized.
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Results
Recall Accuracy
Scoring. Each passage was divided into propositions (“idea units”) following Ward, et al.
(2016; van Dijk and Kintsch 1983; Turner & Greene, 1977). Recall accuracy was scored as the
proportion of propositions recalled. A participant received full credit (1 point) if they accurately
recalled the idea, partial credit (1/2 point) if they partially recalled the idea, and no credit (0
points) if they failed to recall the idea. A sample of this process can be found in Appendix B.
Determining levels of detail. An advantage of a propositional analysis of text is that it
allows one to give independent accuracy scores for detail versus recall of general gist, referred to
as levels of recall. Scoring procedures from Piquado et al., (2012) were used to score passage
recall at three levels, with propositions representing main ideas (Level 1), secondary ideas (Level
2 details), or tertiary ideas (Level 3 details). The scoring procedure as described above was used
to score the mean proportion of propositions recalled within each level of detail.
Outcomes. The four panels in Figure 1 show the proportion of propositions recalled for
self-paced and continuous presentation conditions for main ideas, mid-level ideas and details for
the GH and PH groups when heard at 10 dB above SRT (“HARD”) or 25 dB above SRT
(“EASY”). The most notable effect in these data is a levels effect (main ideas recalled better than
more detailed information). This was confirmed by a significant main effect of levels of detail,
F(1, 250) = 242.48, p < .001. Presumably because materials were in all cases presented suprathreshold, there was no main effect of hearing group, F(1,22) = 2.91, p = .10, and no significant
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main effect of presentation level, F(1, 250) = .02, p = .89. A significant main effect of pacing
condition on recall was found, F(1,250) = 4.35, p = .04, although the effect of self-pacing versus
continuous presentation was small and not consistent across levels of detail. Interestingly, in a
follow-up set of ANOVAs conducted for each hearing group, pace was only found to have a
significant effect on recall accuracy for the PH group, F(1, 125) = 6.98, p < .01, with self-pacing
facilitating overall recall accuracy compared to the continuous condition. Pacing conditions did
not appear to have a significant effect on the GH group, F(1, 125) = .22, p = .64, There was a
significant Hearing group X Presentation level interaction, F(1, 250) = 7.61, p < .01, with the
“EASY” listening level producing greater overall recall compared to the “HARD” listening
level. With follow-up comparisons, a significant within-group main effect of presentation level
was found for the PH participants, F(1, 125) = 3.99, p = .05, and approached significance for the
GH group, F(1, 125) = 3.68, p = .06, suggesting that the effect of presentation level had a
greater facilitative effect on the PH group. No other interactions were significant.
Order of Recall
Scoring. To assess the order in which participants recalled details, the initial word of the
recall output for each of the propositions the participant recalled was numbered based on the
word order of their recall. That word number was then compared to the proposition index of the
corresponding detail in the original passage. A sample of this procedure can be found in
Appendix C.
Figure 2 reflects the mean (across subjects) median-squared deviance from a perfectly
linear recall (i.e. the order in which ideas were presented in the passage), calculated by
normalizing each subject's recall to the total amount recalled (by number of words) and each
passage by total number of propositions in the passage such that each recall word number and
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each proposition is in terms of "serial proportion." Normalized recall then indicates how far into
the recall an idea was recalled in proportion to the total number of words uttered during recall,
and normalized proposition position reflects how far into the passage an idea was recalled in
proportion to the entire length of the passage. The deviance score captures how far the subject's
recall is from "perfect" recall, where the assumption is that in a perfectly ordered recall, an idea
recalled 10% into the recall would have occurred 10% into the original passage.
Outcomes. There was a significant main interaction between hearing group (GH, PH)
and pacing condition (continuous, self-paced), F(1, 47) = 5.57, p =.02. None of the main effects
or other interactions reached significance. These results indicate that the GH participants
differentially benefitted from the self-pacing condition in terms of the linear congruency of their
recall compared to the PH participants. The presentation level didn’t seem to have an effect, so
the data were collapsed across presentation levels for the post-hoc analyses. The follow-up
comparisons were run on this collapsed data (across presentation levels) within each group.
Results show that there was a significant difference between self-paced and continuous pacing
for the GH group, t(33.22) = 2.11, p = .04, but not for the PH group t(29.96) = -.89, p = .38,
suggesting that the GH participants benefitted from self-pacing, but the PH did not, in terms of
producing more linearly congruent recall.
Lag recency. Kahana (1996) demonstrated the strong influence interitem associations
within a list exert on the output order of free-recall. These temporally defined associations were
inferred from participants’ tendency to successively recall items from proximal list positions
rather than from distal list positions. To quantify this phenomenon Kahana proposed the
conditional response probability as a function of lag (lag-CRP). If a participant has just recalled
an item from Serial Position i and the next recalled item is from Serial Position j, the relationship
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between recall probability and the lag (separation, in items) can be used to measure the
distribution of successive recalls as a function of lag, or lag-CRP (Kahana, 1996). Within this
model, positive values of lag = (i – j) indicate forward recalls and negative values of lag indicate
backward recalls; large absolute values correspond to list items spaced widely apart and small
absolute values correspond to list items close together (Kahana, 1996).
Results from the lag recency analysis can be found in Figure 3. The lag recency appears
to suggest that forward-going recall occurred with greater frequency than backwards-going recall
for both groups. The GH participants seem to be overall more likely to recall positions
immediately after or before an idea than PH participants indicated by the greater lag-CRP values
for the GH group across pacing and presentation conditions. Findings suggest that the GH
participants as a group formed stronger between-proposition associations than the PH group.
Age
To examine the relative contribution of age and hearing acuity to proportion recalled, a
linear mixed effects model with age, PTA, levels of detail, and presentation level as factors was
fit. This model revealed a significant main effect of levels of detail, as well as a significant
interaction between PTA and presentation level. The main effect of age and PTA were not
significant (Table 2).
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Discussion
Memory changes in older adulthood are widely acknowledged, but less is known about
how these changes are impacted by reductions in hearing acuity. By age 70, 83% of the
population will have some degree of hearing loss (Cruickshanks, Wiley, Tweed, Klein, MaresPerlman, & Nondahl, 1998), the third most common physical condition after arthritis and heart
disease (Lethbridge-Cejku, Schiller, & Bernadel, 2004). In recent years hearing loss has also
been linked with the development of Alzheimer Disease and other dementias (Lin, Metter,
O’Brien, Resnick, Zonderman, & Ferucci, 2011), adding to the concern for public health
implications.
Recall Accuracy
Despite differences in hearing acuity, there were no differences observed in the overall
recall accuracy between groups. This suggests that presenting both sound levels at a level above
each participant’s audiometric threshold matched the two hearing groups on their overall recall
accuracy, in addition to the cognitive matching measures, enabling interpretation of significant
results in the context of differences in recall behavior.
A significant main effect of pace (self-pacing vs. continuous) on overall recall was found
suggesting that the two pacing conditions impacted recall outcomes differently, with self-pacing
generally resulting in greater recall accuracy than continuous listening. This finding supports
previous research on the effortful listening hypothesis and the benefit of increased processing
time on memory. As effort increases, cognitive resources normally available for encoding and
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storage processes are diminished and memory ability is impacted. Increasing the time available
to process effortful stimuli mitigates the strain and improves memory. However, in a follow-up
set of ANOVAs conducted for each hearing group, pace was only found to have a significant
effect on recall accuracy for the PH group with inconsistent effects across levels of detail.
Contrary to predictions, there was no main effect of presentation level suggesting that
presentation level (volume) did not significantly impact recall accuracy overall. However, in the
follow-up within group comparisons, a significant effect of presentation level was found for the
PH group, with the “EASY” (louder) listening level generally producing greater recall accuracy
compared to the harder (lower) listening level. These findings are interesting as they support the
notion that effortful listening may impact hearing groups differently, with PH participants
differentially affected by “HARDER” listening levels. Even though presentation levels for both
hearing groups were always presented suprathreshold and based on the individual’s SRTs, the
“HARDER” condition appears to have required greater effort on the part of the PH listeners than
GH listeners, resulting in reduced recall performance.
Similarly, there was a significant interaction between group and presentation level,
further suggesting that the GH and PH groups were differentially impacted by the two
presentation levels. Results show that PH participants as a group experienced greater gains in
recall accuracy from the “EASY” listening level compared to the “HARD” listening level than
the GH participants, suggesting greater remediation benefits for the PH group when volume was
increased. It is important to keep in mind that for all participants, listening levels were
determined based on individual hearing thresholds, so playing the stimuli 10 dB louder in the
easy condition should be the same for all participants. Nonetheless, this increase had a greater
effect on the PH group.
18
Levels Effect
An overall, main effect of level of detail on proposition recall was observed for both
groups under all conditions. The fact that an effect of levels was observed within both groups,
and in previous studies, supports the robustness of this phenomenon. Although there were minor
differences in self-pacing versus continuous presentation these differences were not consistent
across all levels of detail or across groups.
Order of Recall
In the assessment of linear congruency of recall to the presentation order of the passage, a
significant main interaction between group and pacing condition was observed. However, none
of the main effects or other interactions reached significance. Within-group analyses indicate that
the GH participants differentially benefitted from the self-pacing condition in terms of the linear
congruency of their recall compared to the PH participants. The increased linear congruency
observed in the recall output by the GH group in the self-paced condition suggests that increased
processing time was effective in enhancing the saliency of the associative links, or temporal
context, of the ideas presented in the passages. This can be seen in Figures 2 and 3. Figure 2
shows the increase in linear congruency of recall in the self-paced condition compared to the
continuous condition within the GH group, along with the relatively unchanged linear
congruency of recall for the PH group in the self-paced condition. Figure 3 depicts the increase
in GH participant use of the temporal context within the self-paced condition (discussed further
below). No effects of significance were observed on linear congruency within the PH group
suggesting they did not benefit from the self-pacing condition in terms of linearly congruent
recall.
19
One possible explanation for this is the increased effects dual-tasking impose on people
with hearing impairment (Tun et al., 2009). The self-pacing condition involved the participant
pressing a key to initiate the next sentence in the passage. Although a seemingly benign task, its
successful execution involved not only the target task of listening to the passage and trying to
remember as much as possible, but also simultaneously remembering to press the button after
each sentence, essentially diverting attentional resources away from the target task. The fact that
PH participants performed similarly across pacing conditions (self-pacing vs. continuous
presentation) suggests that any benefits they may have incurred from the increased processing
time were effectively eliminated from the dual-task nature of the experimental design. The
significant benefit gained by the GH participants combined with the fact that the PH did not
perform worse in the self-paced condition suggests that future experiments could expect to see
memory gains in both groups if processing time is increased in the absence of additional tasks or
attentional diversions. One way this could be achieved is by imposing a pause during the
interrupted (self-pacing) condition, where the recording automatically pauses after each sentence.
The pause times could be determined by averaging the pause times already collected for each
individual sentence in order to reflect participants’ pausing behavior without requiring them to
attend to anything other than the target task.
The lag recency effect appears to suggest that people, regardless of hearing group, have a
greater tendency to recall events in a forward-going direction as opposed to backwards-going
recall, at least for word lists and, in this case, for expository texts. This finding supports the idea
of a facilitative effect of sequence on memory, favoring forward over reverse sequences. The GH
participants appeared to be overall more likely to recall positions immediately after or before an
idea than PH participants suggesting that their recall was contextually bound to a greater extent
20
than the PH participants.
This finding is interesting as the GH participants did not recall with significantly greater
accuracy than the PH participants. Presumably, if you recall more, you’re also more likely to
recall the ideas that occur immediately after or before it. But since the two groups were not
significantly different in the amount recalled, the lag recency would seem to suggest that the GH
participants are recalling more “associatively,” that is employing temporal context as a strategy
for recall to a greater extent, compared to the PH group. It is important to note that the lag
recency only assessed main ideas as the hierarchical nature of the propositional analysis did not
lend the level 2 or level 3 details to this approach. This could potentially explain some of the
differences observed as the GH group recalled main ideas with greater accuracy than the PH
group did.
Conclusions
Overall, the present study yielded both expected and unexpected findings. As expected,
propositions more important to the gist of the passages were better recalled than propositions
representing more minor details. Moreover, these effects were seen to be very robust, appearing
in a similar manner for both continuous and self-paced conditions, and for both listening levels.
Unexpectedly, the easier presentation level and self-pacing condition only benefitted the PH
group on recall accuracy, while only the self-pacing condition benefitted the GH for linearly
congruent recall. Removing the dual-task nature of the self-paced condition along with
increasing the number of participants tested may produce expected results.
The demonstration of the lag recency effect in free-recall of unrelated word lists (Kahana
et al., 2002) raises the question of whether a similar effect would be found for recall of
meaningful extended speech passages. To my knowledge this is the first attempt to test this
21
possible extension. As seen, the lag recency data, showing stronger forward associations, yields
similar lag recency curves as those observed by Kahana and colleagues. It is important to note
that these results were obtained for expository passages, and need not necessarily extend to
passages with a narrative structure that might override order effects. Such findings warrant
further investigation into the impact uncorrected hearing loss may have on cognitive functions
such as memory.
22
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Table 1. Participant characteristics
Characteristics
Good Hearing
n
12
Age (years)
73.6(4.0)
Years of education
17.38(1.9)
Shipley Vocabulary
17.3(2.4)
Reading Span (total score)
8.7(3.1)
Verbal Fluency (total score)
23.08(6.11)
Better ear PTA (dB HL)
15.1(4.2)
Better ear SRT (dB HL)
15.4(3.3)
Note: Data are mean (SD).
Poor Hearing
12
78.6(6.8)
16.5(2.8)
16.3(1.3)
6.8(2.5)
21.58(3.12)
26.8(5.2)
23.3(8.1)
25
Table 2. Linear Mixed-Effects Results
Estimates
Std.Error
df
t-value
p-value
age
-0.002
0.003
21
-0.670
0.510
PTA
-0.008
0.004
21
-1.939
0.066
level of detail
-0.115
0.034
255
-3.340
0.001**
presentation level
-0.054
0.105
255
-0.509
0.611
level of detail * pres. level
-0.021
0.049
255
-0.424
0.672
age * levels of detail
0.000
0.001
255
-0.286
0.775
age * pres. level
-0.002
0.002
255
-0.825
0.410
PTA * levels of detail
0.002
0.001
255
1.658
0.099
PTA * pres. level
0.008
0.004
255
1.996
0.047*
age * level of detail *pres. level
0.002
0.001
255
1.332
0.184
PTA * level of detail *pres. level
-0.003
0.002
255
-1.566
0.119
Note: The main effect of age and Pure Tone Average (PTA) were not significant. *p < .05, **p < .01,
***p < .001
26
Proportion of Propositions Recalled
Proportion of Propositions Recalled
Proportion of Propositions Recalled
Proportion of Propositions Recalled
Figure 1. Proportion of propositions recalled for each level of detail by pace and listening level.
Error bars indicate standard error of the mean.
27
Figure 2. Linear congruency of recall compared to passage by group and pace. Smaller
“Deviance Score” signifies less congruency. Error bars indicate standard error of the mean.
28
Figure 3. Lag-recency plots for group, pace, and listening level. Error bars indicate standard
error of the mean.
29
Appendix A
The marking of birds was carried on during the days of the Roman Empire to identify the falcons of the
emperor. Modern bird banding really had its beginning with Hans Christian Mortensen, a schoolteacher of
Viborg, Denmark. In 1890, he began putting metal bands on the legs of teal, pintails, storks, starlings, and
two or three kinds of hawks. These bands had his name and address inscribed on them. As his banded
birds began to appear in many places in Europe, other bird students became interested in bird “ringing,”
as it is called in Europe. In a short time, more and more people began to band birds in the United States.
Banding birds has revealed many things about the individual bird as well as about the species or group to
which it belongs. Banding has shown that many birds live as long as ten years, and some live even longer.
For example, a red-winged blackbird that was banded in New York was shot 14 years later in North
Carolina, and a black duck banded on Cape Cod was taken by a hunter 17 years later in Newfoundland.
Some Canadian geese live to be more than 20 years old. The longest a North American bird has been
known to live in the wild is 36 years. The holder of this record was a herring gull, banded off the coast in
Maine in 1930 while still in the nest and found dead along the shore of northern Lake Michigan in 1966.
If banded birds are captured, released alive, and recaptured, the migration routes they were following can
be reconstructed. Or, when large numbers of birds are banded, one can form a general picture of the
pathways used by these birds between nesting and wintering grounds.
From banding information, we have learned that some birds, such as the golden plover, do not return
north in the spring over the same route they took south in the fall.
Many ducklings and goslings are banded each summer on their nesting grounds. Hunters who return the
bands they find on these birds during the hunting season are helping to ensure their own hunting in the
future. From the bands that are turned in from hunting areas, wildlife biologists can determine how many
waterfowl there will be along the various migration routes during the following autumn.
Appendix A. An example of one of the four passages in its entirety (Spargo & Williston, 1980).
30
Appendix B
T3
In 1890, he began putting metal bands on the legs of teal, pintails, storks, starlings, and two or
three kinds of hawks.
0
1
He put metal bands on birds
0
0
0
0
0
0
0
2
2
3
3
3
3
3
0
2
some birds
on the legs
teal
pintails
storks
starlings
two or three kinds of hawks
{8}
in 1890
Number of sentences in Section 1:
Number of propositions in Section 1:
Section 1 score (raw):
Section 1 score (proportion of propositions):
3
19
0
0.0
Appendix B. Sample of passage text broken down into propositions and arranged for initial scoring.
31
Appendix C
Sentence in passage:
In early March, diving ducks migrate. They leave the coastal waters and head north to their breeding
grounds.
Example recall:
“The diving ducks will migrate north around March… for a mating season.”
Recall
Score
Level
1
1
1
2
0
3
0
1
0
2
1
1
0.5
1
Proposition (“Idea Unit”)
Recall
Word #
Passage
Index
Diving ducks migrate
2
1
in March
8
2
0
3
0
4
0
5
5
6
10
7
early March
They leave the waters
coastal waters
they head north
to their breeding grounds
Appendix C. Sample scoring table for propositions, level of detail, and order of recall.
32