Auditory-Cognitive Training for Difficulty Understanding Speech in Older Adults

Recruiting at 1 trial location

Overseen By Michael A Johns, PhD

Age: 65+

Sex: Any

Trial Phase: Academic

Sponsor: University of Maryland, College Park

Must not be taking: Stimulants, depressants, mood stabilizers, others

Disqualifiers: Middle-ear pathology, learning disorders, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 2

100 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to assist older adults who struggle to understand speech in noisy environments. It tests a new training method, the auditory-cognitive training paradigm, which uses listening exercises and memory tasks to improve speech comprehension. The trial targets individuals aged 65 to 85 with normal hearing who often have difficulty discerning words in busy settings. Participants will be divided into groups; some will watch videos, while others will engage in specific listening and memory tasks to determine which method is most effective. As an unphased trial, this study provides participants the opportunity to contribute to innovative research that could enhance communication abilities in challenging environments.

Will I have to stop taking my current medications?

If you are currently taking psychoactive stimulant, depressant, mood stabilizing, anti-psychotic, or anti-seizure medications, you may not be eligible to participate in this trial.

What prior data suggests that this auditory-cognitive training paradigm is safe for older adults?

Research shows that auditory-cognitive training is generally safe. Studies indicate it helps improve listening skills by training the brain to better recognize sounds. If the training proves too difficult, its effectiveness might decrease. This does not imply it is unsafe, only that it might not work as well.

Research has found that this type of auditory training can enhance speech perception, especially in noisy environments. It has been used successfully without major safety concerns.

Both training methods aim to improve speech understanding, and no evidence of serious side effects exists. Participants usually do well with these programs, and they are considered safe for older adults seeking to improve hearing in noisy settings. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about these auditory-cognitive training techniques because they offer a fresh approach to helping older adults who struggle to understand speech in noisy environments. Unlike current options, such as hearing aids or traditional auditory training that primarily amplify sound, these methods incorporate engaging cognitive exercises that aim to enhance both listening and memory skills. By integrating real-world scenarios and adding a memory component, the training becomes more interactive and challenging, potentially leading to improved speech comprehension in everyday settings. This dual approach could revolutionize how we support older adults in maintaining their communication abilities.

What evidence suggests that this trial's treatments could be effective for improving speech understanding in older adults?

Research has shown that both auditory-cognitive training and auditory training, separate treatment arms in this trial, can help people understand speech in noisy environments. Participants in the auditory-cognitive training arm will engage in tasks that include a short-term memory component. Studies have found that short, focused sessions can improve how well people hear speech in noise. However, overly demanding training might reduce its benefits. Participants in the auditory training arm will focus on speech-in-noise perception tasks. Evidence suggests that shorter, intense sessions can effectively improve speech recognition, especially for older adults who struggle in noisy settings. Overall, both methods appear promising for aiding older adults with difficulties understanding speech in noise. ^{6 7 8 9 10}

Who Is on the Research Team?

Samira B Anderson, PhD

Principal Investigator

University of Maryland, College Park

Jonathan Z Simon, PhD

Principal Investigator

University of Maryland, College Park

Stefanie E Kuchinsky, PhD

Principal Investigator

Walter Reed National Military Medical Center

Are You a Good Fit for This Trial?

This trial is for older adults aged 65-85 with normal hearing and vision, fluent in American English, and have at least a high school education. It's not suitable for those with head injuries, claustrophobia affected by MRI environments, metal implants incompatible with MEG/MRI scans, learning disorders, ear pathologies or taking certain psychoactive medications.

Inclusion Criteria

Self-reported normal or corrected-to-normal vision

Dominant language: American English

Education: a high school diploma or higher education level

Exclusion Criteria

I am currently taking medication for mood, psychosis, seizures, or use recreational drugs.

A non-removable hairstyle or hair accessory that would prevent the participant from fitting comfortably in the MEG or MRI head coil

Metal in body that induces a data artifact for MEG recording (e.g., excessive metal dental work) or that poses a safety issue in the MRI portion (e.g., pacemakers, neural implants, metal plates or joints, shrapnel, and surgical staples)

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Pretest

Participants undergo pretest assessments including MEG and subjective ratings

2 weeks

1 visit (in-person)

Training

Participants engage in auditory-cognitive training or control activities

3 weeks

At-home sessions

Posttest

Participants undergo posttest assessments including MEG and subjective ratings

2 weeks

1 visit (in-person)

Follow-up

Participants are monitored for changes in speech-in-noise perception and cognitive measures

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

• Active Control of Informational videos
• Auditory-cognitive training paradigm
• Auditory training paradigm

Trial Overview The study tests if a new auditory-cognitive training can improve understanding speech in noisy situations for older adults. Participants will be divided into three groups: one watching videos (control), another doing auditory exercises recalling sentences from conversations, and the third group performing more complex memory tasks.

How Is the Trial Designed?

Group I: Auditory-cognitive training paradigm Experimental Treatment 1 Intervention

Participants perform speech-in-noise perception tasks with real-world scenarios. A short-term memory component is added to the training paradigm to make the task more engaging and challenging.

Group II: Auditory training paradigm Experimental Treatment 1 Intervention

Participants perform speech-in-noise perception tasks with real-world scenarios.

Who Is Running the Clinical Trial?

University of Maryland, College Park

Lead Sponsor

Trials

163

Recruited

46,800+

National Institute on Aging (NIA)

Collaborator

Trials

1,841

Recruited

28,150,000+

Published Research Related to This Trial

Auditory training can improve specific listening tasks for adults with hearing loss, but the benefits may not always translate to real-world situations, indicating a need for more effective training methods.

Incorporating cognitive training into auditory training programs may enhance overall listening abilities by targeting executive functions like attention and memory, potentially leading to better communication in challenging environments.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

How Does Auditory Training Work? Joined-Up Thinking and Listening. Ferguson, M., Henshaw, H.[2020]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC4910571/

The Effect of Short-Term Auditory Training on Speech in ... Difficulty understanding speech in noise ... Molloy et al found that shorter, more intensive training was more effective for auditory perceptual learning.

2. nature.com nature.com/articles/s41539-025-00306-5

Immersive auditory-cognitive training improves speech-in- ... The behavioral data from the current study suggested that short-term immersive auditory-cognitive training results in improved speech in noise ...

3. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC3548893/

Auditory training of speech recognition with interrupted and ... This study presents direct evidence that auditory training in interrupted noise can be beneficial in improving speech recognition in noise for children with HI.

4. journals.lww.com journals.lww.com/ear-hearing/fulltext/2025/07000/enhancing_speech_perception_in_noise_through.4.aspx

Enhancing Speech Perception in Noise Through Home ... In this study, we assessed whether competing talker training can improve listening in older adults that encounter problems with speech-in-noise perception (SPIN) ...

5. pubs.asha.org pubs.asha.org/doi/10.1044/2023_JSLHR-22-00621

Effects of Auditory Training in Older Adults This study examines the effects of an auditory training program on the auditory and cognitive abilities of older adults.

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC9884994/

Training Programs for Improving Speech Perception in Noise Understanding speech in the presence of noise is difficult and challenging, even for people with normal hearing. Accurate pitch perception, coding and decoding ...

7. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC4737899/

Auditory Perceptual Learning in Adults with and without ... Speech perception and communication in noisy environments become more difficult as we age. Specifically, older adults often experience considerable difficulties ...

8. sciencedirect.com sciencedirect.com/science/article/pii/S0378595516303513

Effects of noise on speech recognition: Challenges for ... The effects of noise on speech recognition vary significantly according to the sources of noise, the number and types of talkers, and the listener's hearing ...

9. tandfonline.com tandfonline.com/doi/full/10.1080/14992027.2022.2135032

The effect of phoneme-based auditory training on speech ... The study demonstrates that the training induced a robust refinement of auditory perception at a phoneme level but provides no evidence for the ...

10. researchgate.net researchgate.net/publication/395679851_The_Impacts_of_Two_Adaptive_Auditory-Cognitive_Training_Paradigms_on_Listening_to_Competing_Talkers

The Impacts of Two Adaptive Auditory–Cognitive Training ... Our results suggest that too-high levels of cognitive demand within the auditory–cognitive training may limit some aspects of training outcomes ...