"Competing Noises": How Background Noise Impacts the Communication Experiences of People With Mild-to-Moderate Aphasia.

Purpose: The aim of this study was to explore the subjective experiences of people with aphasia when communicating in the presence of various types of background noise. We hypothesized that (a) people with aphasia would report greater perceived effort and stress than controls when talking in noise, (b) perceived effort and stress would be greater in noise than silence, and (c) people with aphasia would describe more negative reactions to communicating in noise than controls.

Method: Eleven people with aphasia and 11 age- and gender-matched controls retold stories in a baseline silent condition and five background noise conditions (pink noise, cocktail party, monologue, one-sided phone call, and conversation) and rated their perceived effort and stress after each story. Participants then described their experience in a semistructured interview. Perceived effort and stress ratings were analyzed statistically using quantitative methods. Interview data were analyzed qualitatively.

Results: Quantitative findings showed that people with aphasia reported significantly greater perceived effort and stress than controls. Across groups, phone call, conversation, and monologue conditions were perceived as either more effortful or stressful than the silent baseline condition. Although both participant groups discussed cognitive and emotional challenges and strategies related to talking in noise, qualitative findings showed distinct difficulties for people with aphasia. Specifically, unlike controls, participants with aphasia mentioned difficulty ignoring background noise, decreased processing speed, fatigue, negative emotional reactions, deliberately focusing, slowing down/taking breaks, and consciously regulating their emotions.

Conclusions: Although aphasia therapy often occurs in quiet clinic environments, everyday communication does not. The increased perceived difficulty that people with aphasia have for coping with background noise should be acknowledged, and training should be designed to prepare people with aphasia to communicate in noisy environments.

Supplemental material: https://doi.org/10.23641/asha.27893445.