Survey of collaboration supporting students who are deaf and hard of hearing.

Collaboration between teachers of students who are deaf and hard of hearing (TSDHH) and educational audiologists is essential when developing successful, comprehensive service delivery plans for students who are deaf and hard of hearing. Despite the importance, little is known about how these two professions work together. This study sought to describe the current state of collaboration between educational audiologists and TSDHH and to explore the barriers and facilitators to this collaboration. Anonymous survey responses from 752 educational audiologists and TSDHH showed that collaboration is considered valuable and is occurring frequently, via a variety of formats and despite significant barriers. More research is needed to understand how efforts to minimize barriers to collaboration might improve the quality of collaboration and ultimately impact the success of student support.

Test-Retest Reliability and the Role of Task Instructions when Measuring Listening Effort Using a Verbal Response Time Paradigm.

Listening amidst competing noise taxes one's limited cognitive resources, leading to increased listening effort. As such, there is interest in incorporating a reliable test of listening effort into the clinical test battery. One clinically promising method for measuring listening effort is verbal response time (VRT) because it can be obtained using already-established clinical tasks. In order for widespread implementation of the VRT paradigm, a better understanding of the psychometric properties is needed. The purpose of this work was to improve the understanding of the reliability and sensitivity of the VRT listening task. Using within-subject study designs, we completed a pilot study to evaluate the test-retest reliability (Study 1) and the effects of task instructions and listening condition (Study 2). Preliminary results show that the VRT paradigm enjoys good to excellent test-retest reliability and that neither task instructions nor listening condition meaningfully influence VRT once measurement error is accounted for. Future studies should account for measurement error when considering statistically significant versus meaningful effects of experimental parameters when using listening effort tasks.

Effect of Auditory Distractors on Speech Recognition and Listening Effort.

OBJECTIVES: Everyday listening environments are filled with competing noise and distractors. Although significant research has examined the effect of competing noise on speech recognition and listening effort, little is understood about the effect of distraction. The framework for understanding effortful listening recognizes the importance of attention-related processes in speech recognition and listening effort; however, it underspecifies the role that they play, particularly with respect to distraction. The load theory of attention predicts that resources will be automatically allocated to processing a distractor, but only if perceptual load in the listening task is low enough. If perceptual load is high (i.e., listening in noise), then resources that would otherwise be allocated to processing a distractor are used to overcome the increased perceptual load and are unavailable for distractor processing. Although there is ample evidence for this theory in the visual domain, there has been little research investigating how the load theory of attention may apply to speech processing. In this study, we sought to measure the effect of distractors on speech recognition and listening effort and to evaluate whether the load theory of attention can be used to understand a listener's resource allocation in the presence of distractors. DESIGN: Fifteen adult listeners participated in a monosyllabic words repetition task. Test stimuli were presented in quiet or in competing speech (+5 dB signal-to-noise ratio) and in distractor or no distractor conditions. In conditions with distractors, auditory distractors were presented before the target words on 24% of the trials in quiet and in noise. Percent-correct was recorded as speech recognition, and verbal response time (VRT) was recorded as a measure of listening effort. RESULTS: A significant interaction was present for speech recognition, showing reduced speech recognition when distractors were presented in the quiet condition but no effect of distractors when noise was present. VRTs were significantly longer when distractors were present, regardless of listening condition. CONCLUSIONS: Consistent with the load theory of attention, distractors significantly reduced speech recognition in the low-perceptual load condition (i.e., listening in quiet) but did not impact speech recognition scores in conditions of high perceptual load (i.e., listening in noise). The increases in VRTs in the presence of distractors in both low- and high-perceptual load conditions (i.e., quiet and noise) suggest that the load theory of attention may not apply to listening effort. However, the large effect of distractors on VRT in both conditions is consistent with the previous work demonstrating that distraction-related shifts of attention can delay processing of the target task. These findings also fit within the framework for understanding effortful listening, which proposes that involuntary attentional shifts result in a depletion of cognitive resources, leaving less resources readily available to process the signal of interest; resulting in increased listening effort (i.e., elongated VRT).

Narrative Review of Loudness Perception Measures in Children.

Recent surveys of pediatric audiologists have highlighted the need for improved understanding of pediatric loudness perception and their role in the hearing device fitting process. The purpose of this article is to provide a brief overview of methods used to measure loudness perception and summarize the existing literature exploring loudness perception in children. A narrative literature review was conducted and 29 articles were reviewed to (1) provide evidence for or against developmental differences, (2) describe variability across listeners of the same age, and (3) discuss evaluations of test-retest reliability on measures of loudness discomfort levels (LDLs), loudness growth, and loudness balancing. A wide variety of methods have been used to measure loudness perception in children. Results of existing studies point to potential developmental differences in LDLs but relatively consistent growth of loudness across age. Considerable across-child variability of loudness perception suggests that estimating LDLs from hearing thresholds could introduce error into the hearing device fitting/mapping process. Additional areas in need of research include work using loudness balancing measures, improved understanding of how variations in clinical loudness scaling measures could influence measured loudness perception, and examination of the benefit of individually-measured loudness perception during pediatric hearing device fitting.

Clinical Practice Patterns With Pediatric Loudness Perception Measures.

PURPOSE: Obtaining a patient's loudness discomfort level (LDL) can assist the audiologist in defining their dynamic range so that the hearing device fitting can ensure that low-level sounds are audible, average-level sounds are comfortable, and more intense sounds are loud but not too loud. A 2016 survey showed that 67.5% of 350 pediatric audiologist reported to never or rarely measure LDLs with pediatric patients. The purpose of this study was to identify factors influencing this previously reported limited use of LDL measures. METHOD: Sixty-two pediatric audiologists in the United States were surveyed using a questionnaire that sought to improve our understanding of the (non)use of loudness perception measures with pediatric patients and to assess familiarity with various loudness perception measurements. In addition, the questionnaire gathered information about the needs of pediatric audiologists in relation to LDL measures. RESULTS: Audiologist report being largely unfamiliar with methods of assessing loudness perception in children, with categorical loudness scaling being the method with which they are most familiar. In addition, audiologists reported being more willing and able to measure LDLs in older compared to younger pediatric patients. Limited use of pediatric loudness perception measures appears to be driven by a lack of familiarity with measurement methods and the belief that loudness perception measures may not be useful for clinical practice. CONCLUSIONS: Findings highlight audiologists' need for further information regarding the relevance of loudness perception measurements with pediatric patients and the need for easy-to-implement LDL measurement procedures for pediatric patients of all ages.

Pediatric Hearing Loss Guidelines and Consensus Statements-Where Do We Stand?

A large number of guidelines and position statements have been published with the aim of improving outcomes for children with hearing loss. The purpose of this article is to review the current state of clinical practice guidelines as they relate to screening, diagnosis, and management of hearing loss in children. This summary is intended for the practicing otolaryngologist.

Perceived Listening Difficulty in the Classroom, Not Measured Noise Levels, Is Associated With Fatigue in Children With and Without Hearing Loss.

PURPOSE: The purpose of this study was to examine if classroom noise levels and perceived listening difficulty were related to fatigue reported by children with and without hearing loss. METHOD: Measures of classroom noise and reports of classroom listening difficulty were obtained from 79 children (ages 6-12 years) at two time points on two different school days. Forty-four children had mild to moderately severe hearing loss in at least one ear. Multiple regression analyses were conducted to evaluate if measured noise levels, perceived listening difficulty, hearing status, language abilities, or grade level would predict self-reported fatigue ratings measured using the Pediatric Quality of Life Inventory Multidimensional Fatigue Scale. RESULTS: Higher perceived listening difficulty was the only predictor variable that was associated with greater self-reported fatigue. CONCLUSIONS: Measured classroom noise levels showed no systematic relationship with fatigue ratings, suggesting that actual classroom noise levels do not contribute to increased reports of subjective fatigue. Instead, perceived challenges with listening appears to be an important factor for consideration in future work examining listening-related fatigue in children with and without hearing loss.

Individual Differences Offer Insight Into Clinical Recommendations for Directional and Remote Microphone Technology Use in Children.

Purpose This study sought to evaluate the effects of common hearing aid microphone technologies on speech recognition and listening effort, and to evaluate potential predictive factors related to microphone benefits for school-age children with hearing loss in a realistic listening situation. Method Children (n = 17, ages 10-17 years) with bilateral, sensorineural hearing loss were fitted with hearing aids set to include three programs: omnidirectional, adaptive directional, and omnidirectional + remote microphone. Children completed a dual-task paradigm in a moderately reverberant room. The primary task included monosyllabic word recognition, with target speech presented at 60 dB A from 0° (front) or 180° (back) azimuth. The secondary task was a "go/no-go," visual shape-recognition task. Multitalker babble noise created a +5 dB SNR. Children were evaluated in two speaker conditions (front, back) using all three hearing aid programs. The remote microphone transmitter remained at the front speaker throughout testing. Speech recognition performance was calculated from the primary task while listening effort was measured as response time during the secondary task. Results Speech presented from the back significantly increased listening effort and caused a reduction in speech perception when directional and remote microphones were used. Considerable variability was found in pattern of benefit across microphones and source location. Clinical measures did not predict benefit patterns with directional or remote microphones; however, child age and performance with omnidirectional microphones did. Conclusions When compared to a traditional omnidirectional setting, the directional and remote microphone configurations evaluated in this study have the potential to provide benefit for some children and increase difficulty for others when used in dynamic environments. A child's performance with omnidirectional hearing aids could be used to better inform clinical recommendations for these technologies.

Perceptual organization and stability of auditory streaming for pure tones and /ba/ stimuli.

The dynamics of auditory stream segregation were evaluated using repeating triplets composed of pure tones or the syllable /ba/. Stimuli differed in frequency (tones) or fundamental frequency (speech) by 4, 6, 8, or 10 semitones, and the standard frequency was either 250 Hz (tones and speech) or 400 Hz (tones). Twenty normal-hearing adults participated. For both tones and speech, a two-stream percept became more likely as frequency separation increased. Perceptual organization for speech tended to be more integrated and less stable compared to tones. Results suggest that prior data patterns observed with tones in this paradigm may generalize to speech stimuli.

Effect of competing noise on cortical auditory evoked potentials elicited by speech sounds in 7- to 25-year-old listeners.

Child listeners have particular difficulty with speech perception when competing speech noise is present; this challenge is often attributed to their immature top-down processing abilities. The purpose of this study was to determine if the effects of competing speech noise on speech-sound processing vary with age. Cortical auditory evoked potentials (CAEPs) were measured during an active speech-syllable discrimination task in 58 normal-hearing participants (age 7-25 years). Speech syllables were presented in quiet and embedded in competing speech noise (4-talker babble, +15 dB signal-to-noise ratio; SNR). While noise was expected to similarly reduce amplitude and delay latencies of N1 and P2 peaks in all listeners, it was hypothesized that effects of noise on the P3b peak would be inversely related to age due to the maturation of top-down processing abilities throughout childhood. Consistent with previous work, results showed that a +15 dB SNR reduces amplitudes and delays latencies of CAEPs for listeners of all ages, affecting speech-sound processing, delaying stimulus evaluation, and causing a reduction in behavioral speech-sound discrimination. Contrary to expectations, findings suggest that competing speech noise at a +15 dB SNR may have similar effects on various stages of speech-sound processing for listeners of all ages. Future research directions should examine how more difficult listening conditions (poorer SNRs) might affect results across ages.

Behavioral Measures of Listening Effort in School-Age Children: Examining the Effects of Signal-to-Noise Ratio, Hearing Loss, and Amplification.

OBJECTIVES: Increased listening effort in school-age children with hearing loss (CHL) could compromise learning and academic achievement. Identifying a sensitive behavioral measure of listening effort for this group could have both clinical and research value. This study examined the effects of signal-to-noise ratio (SNR), hearing loss, and personal amplification on 2 commonly used behavioral measures of listening effort: dual-task visual response times (visual RTs) and verbal response times (verbal RTs). DESIGN: A total of 82 children (aged 6-13 years) took part in this study; 37 children with normal hearing (CNH) and 45 CHL. All children performed a dual-task paradigm from which both measures of listening effort (dual-task visual RT and verbal RT) were derived. The primary task was word recognition in multi-talker babble in three individually selected SNR conditions: Easy, Moderate, and Hard. The secondary task was a visual monitoring task. Listening effort during the dual-task was quantified as the change in secondary task RT from baseline (single-task visual RT) to the dual-task condition. Listening effort based on verbal RT was quantified as the time elapsed from the onset of the auditory stimulus to the onset of the verbal response when performing the primary (word recognition) task in isolation. CHL completed the task aided and/or unaided to examine the effect of amplification on listening effort. RESULTS: Verbal RTs were generally slower in the more challenging SNR conditions. However, there was no effect of SNR on dual-task visual RT. Overall, verbal RTs were significantly slower in CHL versus CNH. No group difference in dual-task visual RTs was found between CNH and CHL. No effect of amplification was found on either dual-task visual RTs or verbal RTs. CONCLUSIONS: This study compared dual-task visual RT and verbal RT measures of listening effort in the child population. Overall, verbal RTs appear more sensitive than dual-task visual RTs to the negative effects of SNR and hearing loss. The current findings extend the literature on listening effort in the pediatric population by demonstrating that, even for speech that is accurately recognized, school-age CHL show a greater processing speed decrement than their normal-hearing counterparts, a decrement that could have a negative impact on learning and academic achievement in the classroom.

Fatigue Related to Speech Processing in Children With Hearing Loss: Behavioral, Subjective, and Electrophysiological Measures.

Purpose: The purpose of this study was to examine fatigue associated with sustained and effortful speech-processing in children with mild to moderately severe hearing loss. Method: We used auditory P300 responses, subjective reports, and behavioral indices (response time, lapses of attention) to measure fatigue resulting from sustained speech-processing demands in 34 children with mild to moderately severe hearing loss (M = 10.03 years, SD = 1.93). Results: Compared to baseline values, children with hearing loss showed increased lapses in attention, longer reaction times, reduced P300 amplitudes, and greater reports of fatigue following the completion of the demanding speech-processing tasks. Conclusions: Similar to children with normal hearing, children with hearing loss demonstrate reductions in attentional processing of speech in noise following sustained speech-processing tasks-a finding consistent with the development of fatigue.

Hearing Technology Use and Management in School-Age Children: Reports from Data Logs, Parents, and Teachers.

BACKGROUND: Consistency of hearing aid and remote microphone system use declines as school-age children with hearing loss age. One indicator of hearing aid use time is data logging, another is parent report. Recent data suggest that parents overestimate their children's hearing aid use time relative to data logging. The potential reasons for this disparity remain unclear. Because school-age children spend the majority of their day away from their parents and with their teachers, reports from teachers might serve as a valuable and additional tool for estimating hearing aid use time and management. PURPOSE: This study expands previous research on factors influencing hearing aid use time in school-age children using data logging records. Discrepancies between data logging records and parent reports were explored using custom surveys designed for parents and teachers. Responses from parents and teachers were used to examine hearing aid use, remote microphone system use, and hearing aid management in school-age children. STUDY SAMPLE: Thirteen children with mild-to-moderate hearing loss between the ages of 7 and 10 yr and their parents participated in this study. Teachers of ten of these children also participated. DATA COLLECTION AND ANALYSIS: Parents and teachers of children completed written surveys about each child's hearing aid use, remote microphone system use, and hearing aid management skills. Data logs were read from hearing aids using manufacturer's software. Multiple linear regression analysis and an intraclass correlation coefficient were used to examine factors influencing hearing aid use time and parent agreement with data logs. Parent report of hearing aid use time was compared across various activities and school and nonschool days. Survey responses from parents and teachers were compared to explore areas requiring potential improvement in audiological counseling. RESULTS: Average daily hearing aid use time was ∼6 hr per day as recorded with data logging technology. Children exhibiting greater degrees of hearing loss and those with poorer vocabulary were more likely to use hearing aids consistently than children with less hearing loss and better vocabulary. Parents overestimated hearing aid use by ∼1 hr per day relative to data logging records. Parent-reported use of hearing aids varied across activities but not across school and nonschool days. Overall, parents and teachers showed excellent agreement on hearing aid and remote microphone system use during school instruction but poor agreement when asked about the child's ability to manage their hearing devices independently. CONCLUSIONS: Parental reports of hearing aid use in young school-age children are largely consistent with data logging records and with teacher reports of hearing aid use in the classroom. Audiologists might find teacher reports helpful in learning more about children's hearing aid management and remote microphone system use during their time at school. This supplementary information can serve as an additional counseling tool to facilitate discussion about remote microphone system use and hearing aid management in school-age children with hearing loss.

Subjective Fatigue in Children With Hearing Loss Assessed Using Self- and Parent-Proxy Report.

PURPOSE: The primary purposes of this study were to examine the effects of hearing loss and respondent type (self- vs. parent-proxy report) on subjective fatigue in children. We also examined associations between child-specific factors and fatigue ratings. METHOD: Subjective fatigue was assessed using the Pediatric Quality of Life Inventory Multidimensional Fatigue Scale (PedsQL-MFS; Varni, Burwinkle, Katz, Meeske, & Dickinson, 2002). We compared self- and parent-proxy ratings from 60 children with hearing loss (CHL) and 43 children with normal hearing (CNH). The children ranged in age from 6 to 12 years. RESULTS: School-age CHL experienced more overall and cognitive fatigue than CNH, although the differences were smaller than previously reported. Parent-proxy report was not strongly associated with child self-report, and parents tended to underestimate their child's fatigue, particularly sleep/rest fatigue. Language ability was also associated with subjective fatigue. For CHL and CNH, as language abilities increased, cognitive fatigue decreased. CONCLUSIONS: School-age CHL experience more subjective fatigue than CNH. The poor association between parent-proxy and child reports suggests that the parent-proxy version of the PedsQL-MFS should not be used in isolation when assessing fatigue in school-age children. Future research should examine how language abilities may modulate fatigue and its potential academic consequences in CHL.

Speech-Processing Fatigue in Children: Auditory Event-Related Potential and Behavioral Measures.

Purpose: Fatigue related to speech processing is an understudied area that may have significant negative effects, especially in children who spend the majority of their school days listening to classroom instruction. Method: This study examined the feasibility of using auditory P300 responses and behavioral indices (lapses of attention and self-report) to measure fatigue resulting from sustained listening demands in 27 children (M = 9.28 years). Results: Consistent with predictions, increased lapses of attention, longer reaction times, reduced P300 amplitudes to infrequent target stimuli, and self-report of greater fatigue were observed after the completion of a series of demanding listening tasks compared with the baseline values. The event-related potential responses correlated with the behavioral measures of performance. Conclusion: These findings suggest that neural and behavioral responses indexing attention and processing resources show promise as effective markers of fatigue in children.

Salivary Cortisol Profiles of Children with Hearing Loss.

OBJECTIVES: It has long been speculated that effortful listening places children with hearing loss at risk for fatigue. School-age children with hearing loss experiencing cumulative stress and listening fatigue on a daily basis might undergo dysregulation of hypothalamic-pituitary-adrenal (HPA) axis activity resulting in elevated or flattened cortisol profiles. The purpose of this study was to examine whether school-age children with hearing loss show different diurnal salivary cortisol patterns than children with normal hearing. DESIGN: Participants included 32 children with mild to moderate hearing loss (14 males; 18 females) and 28 children with normal hearing (19 males; 9 females) ranging in age from 6 to 12 years. Saliva samples were obtained six times per day on two separate school days. Cortisol levels were measured by mass spectrometric detection after liquid-liquid extraction. Salivary cortisol levels between children with hearing loss and children with no hearing loss over the course of the day were examined with hierarchical linear modeling using mixed model statistical analysis. Between-group comparisons were also computed for the area under the curve, an analytical approach for calculating overall cortisol secretion throughout the day. RESULTS: Significant differences in the cortisol awakening response (CAR) were observed between children with hearing loss and children with normal hearing; however, no differences were observed between the two groups subsequent to the cortisol awakening response (60-min postawakening, 10:00 A.M., 2:00 P.M., and 8:00 P.M.). Compared with children with normal hearing, children with hearing loss displayed elevated cortisol levels at awakening and a reduced growth in cortisol secretion from awakening to 30-min postawakening. No significant differences in overall cortisol secretion throughout the day were found between groups (area under the curve). Finally, cortisol levels increased with increasing age for children with hearing loss but not for children with normal hearing. CONCLUSIONS: Results of this preliminary study indicate a possible dysregulation in HPA axis activity in children with hearing loss characterized by elevated salivary cortisol levels at awakening and a diminished increase in cortisol from awakening to 30-min postawakening. The pattern of elevated cortisol levels at awakening is consistent with some studies on adults with burnout, a condition characterized by fatigue, loss of energy, and poor coping skills. These findings support the idea that children with hearing loss may experience increased vigilance and need to mobilize energy promptly in preparation for the new day.

Factors Influencing Hearing Aid Use in the Classroom: A Pilot Study.

PURPOSE: This pilot study examined factors influencing classroom hearing aid use in school-age children with hearing loss. METHOD: The research team visited classrooms of 38 children with mild-to-moderate hearing loss (Grades 1-7) on 2 typical school days, twice per day, to document hearing aid use. In addition, parents reported the number of hours their children used hearing aids at school. RESULTS: Nearly 24% of children were observed not wearing their hearing aids in the classroom on either observation day. Both grade level and degree of hearing loss appeared to affect hearing aid use. Children in Grades 5-7 and those with milder hearing losses were less likely to wear hearing aids. Overall, parents accurately reported classroom hearing aid use; however, those with children in Grades 5-7 were less accurate than those with children in earlier grades. CONCLUSIONS: These preliminary results suggest that children with milder hearing loss and those in Grades 5-7 are at increased risk for reduced hearing aid use in the classroom. Also, parents of school-age children in these later grades are less accurate reporters of classroom hearing aid use compared to parents of children in earlier grades.

Activation-strain analysis reveals unexpected origin of fast reactivity in heteroaromatic azadiene inverse-electron-demand diels-alder cycloadditions.

Heteroaromatic azadienes, especially 1,2,4,5-tetrazines, are extremely reactive partners with alkenes in inverse-electron-demand Diels-Alder reactions. Azadiene cycloaddition reactions are used to construct heterocycles in synthesis and are popular as bioorthogonal reactions. The origin of fast azadiene cycloaddition reactivity is classically attributed to the inverse frontier molecular orbital (FMO) interaction between the azadiene LUMO and alkene HOMO. Here, we use a combination of ab initio, density functional theory, and activation-strain model calculations to analyze physical interactions in heteroaromatic azadiene-alkene cycloaddition transition states. We find that FMO interactions do not control reactivity because, while the inverse FMO interaction becomes more stabilizing, there is a decrease in the forward FMO interaction that is offsetting. Rather, fast cycloadditions are due to a decrease in closed-shell Pauli repulsion between cycloaddition partners. The kinetic-thermodynamic relationship found for these inverse-electron-demand cycloadditions is also due to the trend in closed-shell repulsion in the cycloadducts. Cycloaddition regioselectivity, however, is the result of differences in occupied-unoccupied orbital interactions due to orbital overlap. These results provide a new predictive model and correct physical basis for heteroaromatic azadiene reactivity and regioselectivity with alkene dieneophiles.

Main-group compounds selectively oxidize mixtures of methane, ethane, and propane to alcohol esters.

Much of the recent research on homogeneous alkane oxidation has focused on the use of transition metal catalysts. Here, we report that the electrophilic main-group cations thallium(III) and lead(IV) stoichiometrically oxidize methane, ethane, and propane, separately or as a one-pot mixture, to corresponding alcohol esters in trifluoroacetic acid solvent. Esters of methanol, ethanol, ethylene glycol, isopropanol, and propylene glycol are obtained with greater than 95% selectivity in concentrations up to 1.48 molar within 3 hours at 180°C. Experiment and theory support a mechanism involving electrophilic carbon-hydrogen bond activation to generate metal alkyl intermediates. We posit that the comparatively high reactivity of these d(10) main-group cations relative to transition metals stems from facile alkane coordination at vacant sites, enabled by the overall lability of the ligand sphere and the absence of ligand field stabilization energies in systems with filled d-orbitals.

Sentence perception in listening conditions having similar speech intelligibility indices.

OBJECTIVE: The objective of this study was to examine the relation between bandwidth and speech perception in normally hearing adults and children at a single value of the Speech Intelligibility Index (SII). DESIGN: The SII of meaningful and nonsense sentences were held constant for each of three bandwidths to test the hypothesis that perception would be equivalent in each condition. The sentences were filtered to produce three bandwidth conditions (low-pass cut-off frequency: 0.8, 1.25, 2.5 kHz) and the sensation level within each bandwidth was adjusted to produce a similar SII (0.43-0.48). Sentences were presented in broadband noise to facilitate equivalent audibility across subjects in each bandwidth condition. STUDY SAMPLE: Participants were 20 adults between the ages of 19 and 47 years and 20 eight-year-old children. All participants had normal hearing. RESULTS AND CONCLUSION: Contrary to the hypothesis, performance of both groups increased significantly as bandwidth increased. Significant main effects of group and sentence type were also found. These results indicate that performance was governed largely by the bandwidth of the stimuli and that those effects were not represented well in the SII.