The Benefits of Hearing Aids and Closed Captioning for Television Viewing by Older Adults with Hearing Loss

Abstract

Although watching television is a common leisure activity of older adults, the ability to understand televised speech may be compromised by age-related hearing loss. Two potential assistive devices for improving television viewing are hearing aids (HAs) and closed captioning (CC), but their use and benefit by older adults with hearing loss are unknown. The primary purpose of this initial investigation was to determine if older hearing-impaired adults show improvements in understanding televised speech with the use of these two assistive devices (HAs and CC) compared with conditions without these devices. A secondary purpose was to examine the frequency of HA and CC use among a sample of older HA wearers. The investigation entailed a randomized, repeated-measures design of 15 older adults (59 to 82 yr) with bilateral sensorineural hearing losses who wore HAs. Participants viewed three types of televised programs (news, drama, and game show) that were each edited into lists of speech segments and provided an identification response. Each participant was tested in four conditions: baseline (no HA or CC), HA only, CC only, and HA + CC. Also, pilot testing with young normal-hearing listeners was conducted to establish list equivalence and stimulus intelligibility with a control group. All testing was conducted in a quiet room to simulate a living room, using a 20 in flat screen television. Questionnaires were also administered to participants to determine the frequency of HA and CC use while watching television. A significant effect of viewing condition was observed for all programs. Participants exhibited significantly better speech recognition scores in conditions with CC than those without CC (p < 0.01). Use of personal HAs did not significantly improve recognition of televised speech compared with the unaided condition. The condition effect was similar across the three different programs. Most of the participants (73%) regularly wore their HAs while watching television; very few of them (13%) had ever used CC. On average, use of CC while watching television dramatically improved speech understanding by a sample of older hearing-impaired adults compared with conditions without CC, including when HAs were worn.