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Speech Pathology and Audiology

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Full-Text Articles in Speech and Hearing Science

How Music Is Used To Facilitate Communication In Speech-Language And Music Therapy For Children With A Diagnosis Of Autism Spectrum Disorder, Anna Mcgreevy May 2025

How Music Is Used To Facilitate Communication In Speech-Language And Music Therapy For Children With A Diagnosis Of Autism Spectrum Disorder, Anna Mcgreevy

Honors College Theses

The goal of this research was to determine how music is being used in speech and music therapy sessions for children with a diagnosis of autism spectrum disorder, to discover the most common targets of these therapy sessions, and to examine the anatomical and physiological constructs that support the inclusion of music. This study was a review of literature, and included research from a variety of articles, several written in the past 25 years. Overall, results showed that music-based speech interventions such as Melodic Based Communication Therapy and Developmental Speech and Language Training, as well as music therapy interventions, are …


Development Of The Hearing Emotion/Activity Restrictions On Teenagers (Heart), Robin G. Axelrod Jun 2024

Development Of The Hearing Emotion/Activity Restrictions On Teenagers (Heart), Robin G. Axelrod

Dissertations, Theses, and Capstone Projects

DEVELOPMENT OF THE HEARING EMOTION/ ACTIVITY RESTRICTIONS ON TEENAGERS (HEART)

By: Robin Axelrod

Advisor: Barbara Weinstein

Background:

The Hearing Handicap Inventory for the Elderly is a self-assessment tool used to assess and quantify the impact of hearing loss on emotional and social wellness in the geriatric population. However, there is not an existing version for the teenage population. Hearing loss has the potential to impact social, emotional, and academic domains in the daily lives of teenagers with hearing loss. In this study, a new self-assessment tool called the Hearing Emotion/ Activity Restrictions on Teenagers (HEART) was created and distributed via …


Audiological Evaluation Of Persons With Dementia: A Systematic Review, Yehudis Hoch Jun 2024

Audiological Evaluation Of Persons With Dementia: A Systematic Review, Yehudis Hoch

Dissertations, Theses, and Capstone Projects

Background: Dementia and hearing loss are both prevalent, age-related conditions and recent research has established a correlation between the two. Audiological evaluations of persons with dementia are important due to a likely comorbidity of dementia and hearing loss, the detrimental effect that hearing loss has on cognition and cognitive tests, and because the similar presentation of the two conditions can cause hearing loss to be overlooked. Hearing loss intervention is critical for this population due to the positive effects that amplification has on cognition, social engagement, and listening effort. Despite the importance of hearing assessment and intervention, audiological evaluation of …


Toolkit For Users Of Over-The-Counter Hearing Aids, Sabrina Malasarte Jun 2024

Toolkit For Users Of Over-The-Counter Hearing Aids, Sabrina Malasarte

Dissertations, Theses, and Capstone Projects

Untreated hearing loss oftentimes has significant adverse effects on the quality of life of older adults. The associations include, but are not limited to loneliness, isolation, anxiety, and a decrease in cognitive function. Hearing aids significantly improve audibility, social interactions, and decrease feelings of loneliness or isolation. However, despite technological advances, and evidence of positive outcomes associated with hearing aid use, uptake and continued use of hearing aids remain low. Accessibility and affordability are considered barriers to uptake. Purchasing a prescription hearing aid from an audiologist is the traditional approach to receiving an amplification device, but the advent of over …


Impact Of Testosterone Therapy On Voices In Trans-Masculine People: A Scoping Review, Samuel E. Hedine, Jeff Conn, Deanna Britton May 2024

Impact Of Testosterone Therapy On Voices In Trans-Masculine People: A Scoping Review, Samuel E. Hedine, Jeff Conn, Deanna Britton

Student Research Symposium

Treatment of trans people by speech-language pathologists (SLPs) dates back to at least the 1980s. However, the majority of early research on the voices of trans people focused on trans-women. More recently, the field of speech-language pathology has garnered more interest in the effects of testosterone therapy in trans-masculine individuals. The goal of this project is to review current research, and compile the known effects of testosterone therapy in the trans-masculine population on common acoustic indices of voice production, including fundamental frequency (pitch), decibels/sound pressure level (dB SPL; loudness) and cepstral peak prominence (voice quality). A scoping literature search was …


The Role Of The Speech-Language Pathologist With Survivors Of Traumatic Brain Injury From Intimate Partner Violence And Providers’ Knowledge Of This Role, Nicolle Mcadams May 2024

The Role Of The Speech-Language Pathologist With Survivors Of Traumatic Brain Injury From Intimate Partner Violence And Providers’ Knowledge Of This Role, Nicolle Mcadams

Electronic Theses and Dissertations

Intimate partner violence occurs globally at alarming rates. Many experience adverse health impacts such as traumatic brain injury. Healthcare providers do not know the role of the speech-language pathologist, or the rehabilitation needs of survivors.

Aims: This scoping review aims to identify speech-language pathology services for survivors of intimate partner violence with a resulting traumatic brain injury, and knowledge of healthcare providers on the rehabilitation needs of this population. A search was completed in May to October 2023, resulting in a total of 13 articles reviewed.

Main contributions: Speech-language pathologists lack knowledge to provide services to intimate partner violence survivors …


Parkinson's Disease And Voice Perception: A Little Bit Louder Now!, Samantha Manes, Taylor Desimone May 2024

Parkinson's Disease And Voice Perception: A Little Bit Louder Now!, Samantha Manes, Taylor Desimone

Graduate Student Research: Capstone Competition

This proposed study aims to address gaps in research literature on Parkinson’s disease by investigating the neural mechanisms involved in PD patients' perception of volume using electroencephalography (EEG). By examining brain activity during voice perception tasks, the research seeks to uncover specific areas within the brain that may contribute to the lack of awareness of speaking softly. Insights gained from this study could inform the development of targeted interventions to improve communication and overall quality of life for PD patients. Ultimately, the research aims to provide a louder voice to those affected by Parkinson's disease, enhancing their ability to engage …


Exploring The Relationship Between College Students' Self-Reported Listening Habits With Apple Airpods Or Earbuds And Pure Tone Hearing Threshold Outcomes, Blake Roth, Maegan Koch, Aubree Warner, Annika Wallace, Romina Gehrts, Austin Drake Apr 2024

Exploring The Relationship Between College Students' Self-Reported Listening Habits With Apple Airpods Or Earbuds And Pure Tone Hearing Threshold Outcomes, Blake Roth, Maegan Koch, Aubree Warner, Annika Wallace, Romina Gehrts, Austin Drake

SACAD: John Heinrichs Scholarly and Creative Activity Days

This study investigated the relationship between self-reported listening habits of college students and their auditory threshold screening outcomes. Survey data was collected in addition to the completion of basic audiometry screening procedures. Results indicated most participants listen to portable devices within safe ranges. While these results are encouraging, continued efforts should be made to educate users of portable listening devices on the negative effects of music-induced hearing loss.


The Cross-Linguistic And Cross-Situational Association Between Accentedness And Its Impact As Rated By Speakers, Makaila Groves Jan 2024

The Cross-Linguistic And Cross-Situational Association Between Accentedness And Its Impact As Rated By Speakers, Makaila Groves

The Journal of Purdue Undergraduate Research

No abstract provided.


The Role Of Vocal Development Patterns: Predicting Neurogenetic Risk In Infancy Using Early Vocal Development And Sex, Alyssa Cregg, Rachel Siela, Olivia Battaglia, Kaylee Bobay, Madison Chin, Athena Fordwor, Conghao Gao, Deeksha Handa, Erin Lee, Tiernan Mcdivitt, Grace Strabala, Victoria Tuell, Laurel Williams Jan 2024

The Role Of Vocal Development Patterns: Predicting Neurogenetic Risk In Infancy Using Early Vocal Development And Sex, Alyssa Cregg, Rachel Siela, Olivia Battaglia, Kaylee Bobay, Madison Chin, Athena Fordwor, Conghao Gao, Deeksha Handa, Erin Lee, Tiernan Mcdivitt, Grace Strabala, Victoria Tuell, Laurel Williams

The Journal of Purdue Undergraduate Research

Extant literature documents a higher rate of language/speech disorders in males; however, despite sex being a potential moderator of outcomes, we do not know what role it plays in early vocal behavior of infants at high risk for such disorders. The purpose of this study was to ask: (1) Do high-risk infants demonstrate atypical vocal development patterns? (2) Is the quality and quantity of early babble distinct for male and female infants, and does this pattern vary across risk? To answer these questions, we examined the canonical babbling ratio (CBR; the ratio of canonical syllables, those with a consonant and …


Understanding The Effects Of Hormone Treatments On The Transgender Singer: A Pedagogical Study And Voice Studio Guide, Erin M. Hannon Jan 2024

Understanding The Effects Of Hormone Treatments On The Transgender Singer: A Pedagogical Study And Voice Studio Guide, Erin M. Hannon

Theses and Dissertations--Music

Transitioning from one gender to another can be an arduous and emotionally charged experience, accompanied by many physical and mental transformations. The journey of self-discovery and vocal explorations is both unique and deeply personal. Modifications that emerge in an individual's vocal characteristics have a profound influence on their capacity to communicate and express themselves.

Transgender vocal students and professional singers must navigate the delicate balance between their vocal and gender identities while considering the possible risks of Gender Affirming Hormone Therapy. Though these therapies may significantly alter one's appearance and overall well-being, they are also capable of causing notable declines …


Scholarship Of Teaching And Learning In Communication Sciences And Disorders: Past, Present, And Future, Sarah M. Ginsberg, Colleen F. Visconti, Jennifer C. Friberg Jan 2024

Scholarship Of Teaching And Learning In Communication Sciences And Disorders: Past, Present, And Future, Sarah M. Ginsberg, Colleen F. Visconti, Jennifer C. Friberg

Books - Communication Sciences and Disorders

No abstract provided.


Hearing Loss As A Risk Factor For Cognitive Decline In The Elderly: A Rapid Review, Natalie Large, Nannette Nicholson Dec 2023

Hearing Loss As A Risk Factor For Cognitive Decline In The Elderly: A Rapid Review, Natalie Large, Nannette Nicholson

Internet Journal of Allied Health Sciences and Practice

Purpose: The aim of this rapid review was to identify and evaluate evidence exploring hearing loss as a risk factor for cognitive decline in the elderly population. Methods: A literature search was performed in three databases: CINAHL, Cochrane Central, and PubMed. The PRISMA template was used to record the search and selection process. Search criteria included older adults aged 65 and up with diagnosed or self-reported hearing loss and no previous diagnosis of dementia or Alzheimer’s disease. Participants were excluded if they had been diagnosed with dementia or tested for it before the study began. Hearing loss was categorized using …


Numerical Investigation Of Subglottal Stenosis Effects On Human Voice Production, Dariush Bodaghi Dec 2023

Numerical Investigation Of Subglottal Stenosis Effects On Human Voice Production, Dariush Bodaghi

Electronic Theses and Dissertations

This dissertation aimed to advance knowledge of how subglottal stenosis impacts voice production physiology. An in-house fluid-structure-acoustic interaction approach based on the hydrodynamic/acoustic splitting technique was employed. This technique was rigorously verified for simulating phonation by matching the acoustic behavior to a compressible flow solver for phonation-relevant geometries. Simulations of an idealized 2D vocal tract model demonstrated the effects of supraglottal acoustic resonance on vocal fold kinematics and glottal flow waveform. Results showed that the acoustic coupling between higher harmonics and formats generated pressure oscillations, modifying vocal fold dynamics and glottal flow rate.

A major novelty was the incorporation and …


Core Vocabulary Intervention For Language-Delayed Kindergarten Students Using Augmentative And Alternative Communication, Angela M. Riccelli, Ravi Nigam Oct 2023

Core Vocabulary Intervention For Language-Delayed Kindergarten Students Using Augmentative And Alternative Communication, Angela M. Riccelli, Ravi Nigam

Journal of Applied Disciplines

The purpose of this study was to measure the impact of core vocabulary selection and the subsequent usage of a prescribed core vocabulary intervention over a period of one trimester (13-week period) and to report its impact on the overall communicative effectiveness of kindergarten students with language delay using augmentative and alternative communication (AAC). Study participants were provided with a pretest, speech and language therapy sessions in which intervention took place, and a posttest, which was administered by a speech–language pathologist. Intervention implementation commenced at the beginning of the school year and extended through the end of the trimester.13-week period. …


Knowledge And Perceptions Of Slp Graduate Students Regarding Multiculturalism, Evy Jewell Hayes, Laura Amanda Mathews Oct 2023

Knowledge And Perceptions Of Slp Graduate Students Regarding Multiculturalism, Evy Jewell Hayes, Laura Amanda Mathews

Teaching and Learning in Communication Sciences & Disorders

Populations in the United States rise daily, as do the number of people who are considered multicultural. With this comes a greater need for speech-language pathologists (SLPs) who are able to assess and treat such individuals – a training process that begins in graduate programs. The primary objective of this study was to determine the knowledge and perceptions of graduate students in speech-language pathology as it pertains to multiculturalism. A survey was conducted to explore graduate students’ knowledge and perceptions of multicultural topics. Participants were recruited from programs in the southeastern United States via email. Just under 400 surveys were …


The Directional Effect Of Target Position On Spatial Selective Auditory Attention, Heesung Park Aug 2023

The Directional Effect Of Target Position On Spatial Selective Auditory Attention, Heesung Park

Dissertations, 2020-current

Spatial selective auditory attention plays a crucial role in listening in a mixture of competing speech sounds. Previous neuroimaging studies have reported alpha band neural activity modulated by auditory attention, along with the alpha lateralization corresponding to attentional focus. A greater cortical representation of the attended speech envelope compared to the ignored speech envelope was also found, a phenomenon known as 'neural speech tracking’. However, little is known about the neural activities when attentional focus is directed on speech sounds from behind the listener, even though understanding speech from behind is a common and essential aspect of daily life. The …


The Use Of A Myofunctional Device In An Aged Care Population For Oral Care And Swallowing: A Feasibility Study, Hollie-Ann L. Shortland, Gwendalyn Webb, Anne E. Vertigan, Sally Hewat Jun 2023

The Use Of A Myofunctional Device In An Aged Care Population For Oral Care And Swallowing: A Feasibility Study, Hollie-Ann L. Shortland, Gwendalyn Webb, Anne E. Vertigan, Sally Hewat

International Journal of Orofacial Myology and Myofunctional Therapy

Purpose: Poor oral health is a known predictor of aspiration pneumonia in vulnerable populations such as the elderly and chronically ill. This study examined the feasibility of using myofunctional devices during a 5-week intervention for the management of oral care and dysphagia for residents in a residential aged-care facility.

Method: Feasibility was determined through evaluation of study recruitment and retention rates, adherence to intervention, and resident and staff acceptability of the intervention. Thirteen residents, ages 74–99, participated in the intervention and 10 care staff completed feedback on post-intervention questionnaires.

Results: Enrolment and retention rates were 61.9% and 92.3%, respectively. Adherence …


Establishing Cueing Skills When Treating Bilingual Speech Sound Disorders, Carlos D. Irizarry-Pérez, Mirza J. Lugo-Neris, Andrea Martinez-Fisher Jun 2023

Establishing Cueing Skills When Treating Bilingual Speech Sound Disorders, Carlos D. Irizarry-Pérez, Mirza J. Lugo-Neris, Andrea Martinez-Fisher

Teaching and Learning in Communication Sciences & Disorders

Purpose: This study sought to train cueing skills in first-year graduate students when working with bilingual children with speech sound disorders to ensure fidelity of intervention of a larger research investigation.

Method: Before explicitly training cueing skills, three students were randomly assigned bilingual clients that had been previously diagnosed with a speech sound disorder and asked to administer trial therapy. During the instructional phase, we gave students a cueing protocol, a scoring template, and feedback. We assessed performance according to challenge-point criteria and adherence to our cueing protocol.

Results: Performance varied per student, but overall scores were higher during the …


Examining The Effect Of Training Using Natural And Noise-Vocoded Sentences On Noise-Vocoded Speech Perception In Normal-Hearing Listeners, Alexis Leiderman Jun 2023

Examining The Effect Of Training Using Natural And Noise-Vocoded Sentences On Noise-Vocoded Speech Perception In Normal-Hearing Listeners, Alexis Leiderman

Dissertations, Theses, and Capstone Projects

Auditory training has been shown to be an intervention strategy that may improve speech perception abilities in individuals with and without hearing loss. Within the cohort of individuals with hearing loss, auditory training has also been shown to have an improvement on speech perception in cochlear implant users. In several training studies, normal-hearing listeners have been exposed to noise-vocoded speech using auditory training paradigms to mimic how cochlear implant users may in turn be affected by these paradigms. These studies have highlighted certain areas for improvement in speech perception abilities based off of the training paradigms put in place. Several …


Exploring The Potential Of Hearing Screening Smartphone Applications To Enhance Access To Hearing Healthcare: A Literature Review, Adam Sulaiman Jun 2023

Exploring The Potential Of Hearing Screening Smartphone Applications To Enhance Access To Hearing Healthcare: A Literature Review, Adam Sulaiman

Dissertations, Theses, and Capstone Projects

In 2016, the National Academies of Sciences (NAS) published a landmark consensus report with several recommendations to enhance the availability and affordability of hearing healthcare in the United States. Among the most notable of the recommendations was the creation of a new category of FDA-approved Over-the-Counter (OTC) hearing aids. Unlike the traditional hearing aid model, which requires a comprehensive hearing test by a hearing health professional prior to purchase, OTC hearing aids would be directly available for sale to any American adult with a self-perceived mild-to-moderate degree of hearing loss. This proposal has now become reality with the passage of …


Caring For Individuals Who Are Experiencing Homelessness: An Audiologist’S Toolkit, Jenna Marie Sparacio Jun 2023

Caring For Individuals Who Are Experiencing Homelessness: An Audiologist’S Toolkit, Jenna Marie Sparacio

Dissertations, Theses, and Capstone Projects

National-level counts for individuals experiencing homelessness have been steadily on the rise. People experiencing homelessness face extraordinary barriers and challenges in accessing health care services, including hearing healthcare. Additionally, there is a high prevalence of self- reported hearing difficulties and hearing handicap among people experiencing homelessness. Hearing loss status and management is often not prioritized in healthcare settings, and treatment plans are not typically modified to best address the hearing needs of individuals who are homeless. This evidence-based toolbox for audiologists was developed to help understand and mediate healthcare barriers that people experiencing homelessness face, as well as to help …


Examining The Effect Of Talker Familiarity Using Familiar And Unfamiliar Talkers On Noise-Vocoded Speech Perception In Normal-Hearing Listeners: A Training Study, Daria N. Collins Jun 2023

Examining The Effect Of Talker Familiarity Using Familiar And Unfamiliar Talkers On Noise-Vocoded Speech Perception In Normal-Hearing Listeners: A Training Study, Daria N. Collins

Dissertations, Theses, and Capstone Projects

Auditory training studies utilizing stimuli that are applicable to real-world processing of speech have been shown to improve speech perception abilities in normal hearing populations, those with hearing loss, and cochlear implant wearers. In particular, exposing normal hearing adults to noise-vocoded speech via auditory training studies has been shown to not only simulate the perceptual experience of a cochlear implant wearer, but have demonstrated promising improvements on speech perceptual abilities via the training paradigm. Additionally, studies have highlighted various variables that impact speech perception, including, talker familiarity. Talker familiarity has been shown to enhance speech perception both in listeners with …


Audiological Management Of Children With Down Syndrome: A Toolkit For Caregivers, Natalie Lisiewicz Jun 2023

Audiological Management Of Children With Down Syndrome: A Toolkit For Caregivers, Natalie Lisiewicz

Dissertations, Theses, and Capstone Projects

Children with Down syndrome may have multiple medical co-morbidities. This can result in an overwhelming number of medical appointments and information for caregivers to keep track of. Middle ear dysfunction, among other otologic abnormalities, is common in the Down syndrome population, and the presence of these conditions will result in referrals to an audiologist to monitor hearing sensitivity. While hearing may not be the most pressing concern as compared to a possible life-threatening condition such as a heart defect, it is still a crucial factor in a child’s overall development.

This toolkit is designed with the intention of educating caregivers …


Multilingualism And Augmentative Alternative Communication: A Review Of The Literature, Hannah N. Lamarca, Natalie R. Andzik May 2023

Multilingualism And Augmentative Alternative Communication: A Review Of The Literature, Hannah N. Lamarca, Natalie R. Andzik

Honors Capstones

Purpose: Individuals from culturally and linguistically diverse backgrounds who use Alternative and Augmentative Communication (AAC) are often offered English-only AAC systems that do not meet their language needs. Devices that host multiple languages often only offer one at a time.

Method: The authors reviewed the literature by searching relevant databases using a variety of search strings. Following our inclusionary and exclusionary criteria, 15 articles were yielded for analysis.

Results: Authors found that more than half of the included articles were discussion-based papers on AAC delivery, barriers to AAC and multilingualism, and codeswitching using AAC. The included interview studies aimed to …


The Effects Of An Intervention Using Pokemon Trading Card Game On The Decoding Abilities Of Children, Derek Emmett May 2023

The Effects Of An Intervention Using Pokemon Trading Card Game On The Decoding Abilities Of Children, Derek Emmett

Open Access Theses & Dissertations

The present study focuses on illustrating the relationship between word decoding instruction and word decoding abilities within the context of a trading card game. Additionally, an argument for reading motivation and improvement of literacy skills is made. Three participants between the ages of 9 and 13 were recruited for participation in this study. Several decoding strategies such as phonemic awareness and morphological awareness strategies were implemented and trained over the course of several trading card games. Performance in decoding of several lists of compiled nonwords following treatment phases were systematically measured by the researcher. Two of the three participants demonstrated …


The Effects Of Using Baby Sign Training On The Interactions Between Mothers And Infants, Ayzzar Gurrola May 2023

The Effects Of Using Baby Sign Training On The Interactions Between Mothers And Infants, Ayzzar Gurrola

Open Access Theses & Dissertations

Baby sign has been becoming more popular and known through the publication of parenting books and websites dedicated to its use. Research continues to blossom on the subject, demonstrating that it is indeed beneficial on many levels for both the infant and their caregiver. Several researchers have implicated the effects of baby sign on infantsâ?? cognitive and behavioral development. The purpose of this research is to analyze the effects of a baby sign training on the interactions of mothers and their babies. Five typically developing infants between the ages of eight and fourteen months and their parent participated in this …


Examining Perception And Understanding Of Stroke And Its Risk Factors In A Rural Population, Mackenzie King, Gabrielle Scarpa, Mary Gardiner Apr 2023

Examining Perception And Understanding Of Stroke And Its Risk Factors In A Rural Population, Mackenzie King, Gabrielle Scarpa, Mary Gardiner

Theses & Honors Papers

Stroke, also sometimes referred to as a brain attack, occurs when there is a blockage in blood supply to the brain or when a blood vessel bursts within the brain (CDC, 2022). Rural populations have a higher incidence of stroke and higher stroke mortality in the United States (Howard et al., 2017). Although there is a higher incidence rate of stroke in rural populations, researchers have also found that these populations appear to have limited knowledge on stroke and its risk factors. The current study employed a non-experimental descriptive design that explored stroke knowledge in adults residing in rural populations …


Alternative Techniques For Amplification: A Capstone Case Series, Toryn Davis, Antony Joseph Mar 2023

Alternative Techniques For Amplification: A Capstone Case Series, Toryn Davis, Antony Joseph

AuD Capstone Projects - Communication Sciences and Disorders

Abstract 1- Introduction: Charcot-Marie-Tooth (CMT) disease is a rare and chronic hereditary disorder that causes motor and sensory damage to the peripheral nervous system. As the disease progresses, hearing sensitivity may worsen. Case Presentation: A young adult-aged patient presented to the clinic with congenital hearing loss and difficulty with conversational speech in quiet and noisy conditions. Discussion: When encountering a patient with CMT, clinicians should be cognoscente of amplification options, especially if nerve pathways begin to deteriorate. When audiologic testing reveals a progression of hearing loss, alternative amplification may be indicated because conventional hearing aids may not provide enough …


Audiological Intervention For Late-Identified Children And Teenagers With Hearing Loss, Melissa Wiedeman, Antony Joseph Mar 2023

Audiological Intervention For Late-Identified Children And Teenagers With Hearing Loss, Melissa Wiedeman, Antony Joseph

AuD Capstone Projects - Communication Sciences and Disorders

Abstract 1 - Introduction: The family of every child referred for definitive care after a newborn hearing screening should follow up with an audiologist to rule out hearing impairment. Early identification, diagnosis, and intervention are crucial for individualized planning and outcomes. Children who need binaural amplification and are not managed appropriately become exposed to sound deprivation, which leads to diminished speech audibility, sound localization, and speech and language development. Case Presentation: A young child presented to the clinic with an unspecified bilateral mild to moderate hearing loss at 500, 2000, and 4000 Hz. Discussion: Children with monaural amplification have shown …