You're in a bustling cafe with a friend. The din is making it hard to tune in to the conversation. The scenario might suggest you'd benefit from a hearing aid. On the other hand, new research suggests that speech-perception difficulty might relate to your cognitive ability.
In a study of three groups — individuals with autism, fetal alcohol syndrome and a "neurotypical" control group — researchers found that cognitive ability was significantly associated with how well the participants, all with typical hearing, processed speech in noisy environments.
"The relationship between cognitive ability and speech-perception performance transcended diagnostic categories. That finding was consistent across all three groups," said the study's lead investigator, Bonnie Lau . She is a research assistant professor in otolaryngology-head and neck surgery at the University of Washington School of Medicine and directs lab studies of auditory brain development.
The findings are scheduled to be published Sept. 24, 2025, in the journal PLOS One. [Reports on the findings are embargoed from publication until 11 a.m. Pacific Time on Sept. 24.]
Lau said upfront that the study's small scale of fewer than 50 participants warrants validation with larger populations. But the findings, she said, demonstrate that intellectual ability is among the variables that influence how well people hear in complex acoustic settings, like lively classrooms and social events.
To test their hypothesis, the researchers designed a study that included people with autism and fetal alcohol syndrome. People with those conditions, despite having typical hearing, frequently report difficulty listening in noisy environments. And groups of people with those "neurodivergent" conditions represented a wider range of IQ scores — some of them higher, Lau emphasized — than would be seen among neurotypical participants alone.
The study participants were 12 people with autism, 10 with fetal alcohol syndrome, and 27 age- and biological sex-matched people in a control group. They ranged in age from 13 to 47 years.
All participants first underwent an audiology screening to confirm clinically normal hearing. They were then equipped with headphones and a computer program that posed a complex listening challenge.
Participants were introduced to a primary speaker's voice and instructed to attend to that speaker's voice as two other "background" voices emerged, all speaking simultaneously. The primary speaker's voice was always male, and the secondary voices were male and female or both male. Each voice stated a single sentence that began with a call sign followed by a color and number, for example: "Ready, Eagle, go to green five now."
On the computer program, study participants were tasked to select a colored, numbered box that corresponded to the primary speaker's statement, while the volume of the secondary voices gradually increased.
Subsequently, participants underwent brief, standardized tests of intelligence, including verbal and nonverbal ability, and perceptual reasoning. Those scores were analyzed against individuals' scores on the "multitalker" listening challenge.
"We found a highly significant relationship between directly assessed intellectual ability and multitalker speech perception," the researchers reported. "Intellectual ability was significantly correlated with speech perception thresholds in all three groups."
A lot of brain processing contributes to successful listening in complex environments, Lau said.
"You have to segregate the streams of speech. You have to figure out and selectively attend to the person that you're interested in, and part of that is suppressing the competing noise characteristics. Then you have to comprehend from a linguistic standpoint, coding each phoneme, discerning syllables and words. There are semantic and social skills, too — we're smiling, we're nodding. All these factors increase the cognitive load of communicating when it is noisy."
The study directly addresses a common misconception, Lau added, that any person who has trouble listening is suffering from peripheral hearing loss.
"You don't have to have a hearing loss to have a hard time listening in a restaurant or any other challenging real-world situation," she said.
The authors suggested that neurodivergent individuals and individuals with lower cognitive ability could benefit from an assessment of the environments that may challenge their complex listening thresholds. This could lead to helpful classroom interventions, for instance, such as moving a child to the front row or providing hearing-assistive technology .
Lau works at the UW Virginia Merrill Bloedel Hearing Research Center. Study coauthors were from the UW Autism Center and the Institute for Learning and Brain Sciences, as well as from the departments of bioengineering, epidemiology, pediatrics, radiology, and speech and hearing sciences, all at the University of Washington, and the Department of Otolaryngology – Head and Neck Surgery at the University of Michigan, Ann Arbor.
