Exploring the effect of cognitive factors in lipreading: The roles of auditory–verbal learning, inhibition, verbal fluency, and visuospatial working memory

Abstract

Lipreading is a critical component of communication; however, substantial individual differences in performance have been consistently observed. Although several cognitive factors have been proposed as potential determinants of lipreading ability, empirical evidence supporting these associations is limited. This study investigated the roles of auditory–verbal learning, verbal fluency, inhibition, and visuospatial working memory in adults’ lipreading. The study was conducted in two phases. First, the Lipreading Test (LRT) was developed through a literature review, expert evaluation, and a preliminary study. The LRT consists of 50 items across phoneme, word, sentence, and question–answer subtests. Item analysis showed balanced difficulty (pj = 0.30–0.90) and strong discrimination (dj = 0.30–0.83). Data from 420 participants were used to establish the construct validity, discriminant validity, and reliability of the scale. The item–total correlations ranged from .501 to .898. Exploratory factor analysis (n = 170) revealed a two-factor structure (eigenvalue = 2.92) explaining 56.18% of the variance, confirmed by confirmatory factor analysis (n = 200). Discriminant validity analysis (n = 100) indicated that performance on the LRT demonstrated significant differentiation by gender and hearing loss onset. Reliability was evaluated using internal consistency (α = .831), test–retest correlations (r = .404–.961), and interrater reliability (κ = .91–.99). In phase 2, hierarchical regression (n = 96) indicated that gender, auditory–verbal learning, verbal fluency, visuospatial memory, and inhibition together accounted for 21.8% of variance in lipreading performance (p < .05). Lipreading emerges from the combined influence of multiple cognitive processes, highlighting the importance of an integrated assessment.