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A hearing loss leads to problems with speech perception; this is exacerbated when competing noise is present. The speech signal is recognized by the cognitive system of the listener; noise and distortion tax the cognitive system when interpreting it. The auditory system must interact with the cognitive system for optimal signal decoding. This article discusses this interaction between the signal and cognitive system based on two models: an auditory model describing signal transmission and degeneration due to a hearing loss and a cognitive model for Ease of Language Understanding. The signal distortion depends on the specifics of the hearing impairment and thus differently distorted signals can affect the cognitive system in different ways. Consequently, the severity of a hearing loss may not only depend on the lesion itself but also on the cognitive recourses required to interpret the signal.
Stenfelt et al. (Thu,) studied this question.