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Speech is the central medium of conscious communication. For the overwhelming majority of us it is received through the hearing apparatus. Through that apparatus we can discern various qualities of the sound of speech, such as volume or pitch, as well as the dynamic fluctuations of volume or pitch. In my experience, the common perception of speech in daily exchanges is acoustic only in the background. What typically takes precedence and moves into the foreground are the words, and their syntactical arrangement renders them meaningful. The sound qualities are not necessarily ignored, but are perceived mostly semi-unconsciously or unconsciously altogether.
When one hears an unfamiliar language, where the meaning and the syntax are not readily recognizable, the sound qualities move into the foreground. Even then, I frequently find it very tempting to hear familiar phonemes or words whether or not they are actually there. This can be also be seen in the way children fill in lyrics of a song with words that they incorrectly recognize in the flow of speech sound. Another example is our attempts to imitate the sound of other languages, which to native speakers is a clear distortion of the sound, but to the imitator is a rather close approximation.
The point I am trying to make is that our knowledge of language can readily interfere with the perception of the sound of speech. Similarly, the sound of it can readily interfere with comprehension. An example of the former is a case I was asked to consult on in a nursing home. The primary reason for the consultation was that a man with severe vascular dementia, who