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The Effects of Age and Hearing Loss on Recognition of Accented Speech

Natacha Moreno, M.S., CCC-SLP


When it comes to aging patients and those with hearing difficulties, a physician’s unfamiliar accent, characterized by unique stress and timing cues,  can present as a processing challenge.  Factors such as age-related hearing loss and changes in cognitive function can affect speech perception as people age (Cristia et al., 2012).  For this reason, the confluence of these two aspects can lead to significant impairments when aging adults are faced with processing the unusual patterns of accented speech.


Stress and timing are important cues that support speech recognition, and are two patterns that differ between languages.  Alterations of these prosodic features often occur when non-native speakers transfer the patterns and features of their native language.  At the word level, this can mean multisyllabic words are pronounced with different stress than what is expected in American English. 


In 2013, researchers from the Department of Hearing and Speech Sciences at the University of Maryland investigated the effects of age and hearing loss on recognition of unaccented and accented words of varying syllable length.  The researchers hypothesized that “with increments in length of syllables, there would be atypical alterations in syllable stress in accented compared to native English, and that these altered stress patterns would be sensitive to auditory temporal processing deficits with aging.” (Gordon-Salant et al., 2015)


Participants of the study included three sets of 15 listeners.  All were native speakers of American English.  One group was made up of young listeners, the second group was older listeners with normal hearing, and the third group was also composed of older listeners, but with mild-to-moderate hearing loss.  The speech stimuli were sets of one, two, three, and four syllable English words, and the recorded samples were performed by one speaker of native American English, and two native speakers of Spanish with mild-moderate accentedness.


Overall results indicated that hearing loss, age, and cognitive factors associated with aging, limit the ability to recognize Spanish-accented speech. For multisyllabic words of increasing syllable length and accent, all participants demonstrated lowered performance.  Older listeners, however, struggled more than younger listeners with the deviations of stress and timing.  Phonetic contrast cues like vowel duration and onset of voicing were particularly challenging.  Older participants also exhibited lower recognition scores for moderately accented words in sentence contexts than in isolation, suggesting increased demands on processing resources that may be declining with age, such as working memory, speed of processing, selective attention, etc.  There were no age-related differences for unaccented multisyllabic words, and hearing loss effects were apparent for both unaccented and accented monosyllabic words.


In the healthcare setting, accented production of multisyllabic terms threatens the clarity of a physician’s communication with his patients, and particularly those who are older and hearing-impaired.  Foreign-born physicians may seek support in acquiring American English stress patterns for medical vocabulary from a speech-language pathologist trained in accent reduction.   Additionally, resources such as Medline Plus Medical Dictionary are available on-line to assist in theAmerican English pronunciation of multisyllabic words.



Cristia, Alejandrina et al. “Linguistic Processes of Accented Speech Across the Lifespan.” Frontiers in Psychology 3 (2012): 479. PMC. Web 17 June 2015


Gordon-Salant, Sandra, Grace Yeni-Komshian, Peter Fitzgibbons, and Julie Cohen.  Effects of Age and Hearing Loss on Recognition of Unaccented and Accented Multisyllabic Words. AIP/Scitation, June 2015. Web. 16 June 2015.



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