5SThe Fifth Eriksholm Workshop on "Hearing Impairment and Cognitive Energy" was convened to develop a consensus among interdisciplinary experts about what is known on the topic, gaps in knowledge, the use of terminology, priorities for future research, and implications for practice. The general term cognitive energy was chosen to facilitate the broadest possible discussion of the topic. It goes back to Titchener (1908) who described the effects of attention on perception; he used the term psychic energy for the notion that limited mental resources can be flexibly allocated among perceptual and mental activities. The workshop focused on three main areas: (1) theories, models, concepts, definitions, and frameworks; (2) methods and measures; and (3) knowledge translation. We defined effort as the deliberate allocation of mental resources to overcome obstacles in goal pursuit when carrying out a task, with listening effort applying more specifically when tasks involve listening. We adapted Kahneman's seminal (1973) Capacity Model of Attention to listening and proposed a heuristically useful Framework for Understanding Effortful Listening (FUEL). Our FUEL incorporates the well-known relationship between cognitive demand and the supply of cognitive capacity that is the foundation of cognitive theories of attention. Our FUEL also incorporates a motivation dimension based on complementary theories of motivational intensity, adaptive gain control, and optimal performance, fatigue, and pleasure. Using a three-dimensional illustration, we highlight how listening effort depends not only on hearing difficulties and task demands but also on the listener's motivation to expend mental effort in the challenging situations of everyday life.

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Seeing, Doing, and Knowing is a philosophical framework for thinking about sensory systems as active devices for data extraction B rather than, in the traditional way, as passive recorders of ambient energy patterns. Sensory systems are automatic sorting machines that assign real-world objects to classes. A sense feature is the property of belonging to such a class. A sensory experience, or sensation, is a label that the system uses in order to allow the organism access to the classifications that it has performed. This Sensory Classification Thesis (SCT), discussed in Chs 1–3, inverts the normally assumed relationship between sensory classes and sensations. Philosophers standardly hold that red is to be defined in terms of the sensation of red; here, sensations derive from sensory classes and are thus unsuitable for defining them. SCT is a simplification: some sensory systems order real-world objects in relations of similarity, and do not just put them into discrete classes (Chs 4–5). SCT makes sense of sensory specialization across species—different kinds of organisms employ different classification schemes to serve their idiosyncratic data-extraction needs (Chs 6–8). This leads to an output-driven account of sensory content. Sense features are defined in terms of their aptness for epistemic (not just sensorimotor) actions, and the content of sensations in terms of the features with which they are associated by an internal convention (Chs 9–11). This leads to a form of realism: sensory classifications are correct if the states of affairs in which they consistently occur are indeed right for the actions with which they are paired. Finally, the nature of object perception is explored: Chs 12–13 speculate about the psychological origins of sensory reference and of the feeling in perception that external objects are present (by contrast, for instance, with objects depicted in paintings and photographs).

Listening effort helps explain why people who are hard of hearing are prone to fatigue and social withdrawal. However, a one-factor model that cites only effort due to hardness of hearing is insufficient as there are many who lead happy lives despite their disability. This article explores other contributory factors, in particular motivational arousal and pleasure. The theory of rational motivational arousal predicts that some people forego listening comprehension because they believe it to be impossible and hence worth no effort at all. This is problematic. Why should the listening task be rated this way, given the availability of aids that reduce its difficulty? Two additional factors narrow the explanatory gap. First, we separate the listening task from the benefit derived as a consequence. The latter is temporally more distant, and is discounted as a result. The second factor is displeasure attributed to the listening task, which increases listening cost. Many who are hard of hearing enjoy social interaction. In such cases, the actual activity of listening is a benefit, not a cost. These people also reap the benefits of listening, but do not have to balance these against the displeasure of the task. It is suggested that if motivational harmony can be induced by training in somebody who is hard of hearing, then the obstacle to motivational arousal would be removed. This suggests a modified goal for health care professionals. Do not just teach those who are hard of hearing how to use hearing assistance devices. Teach them how to do so with pleasure and enjoyment.