Auditory Brain Training to Enhance Satisfaction and Usage of New Hearing Aids by Older Adults
Phase: PHASE1
Conditions: Hearing Impairment, Sensorineural
Sponsor: Washington University School of Medicine

______________________________________________________________________________________ 
1 
Auditory Brain Training to Enhance Satisfaction and Usage of New Hearing 
Aids by Older Adults
NCT04230876
Version Date/Number:  6/14/22 

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2 
A 
INTRODUCTION ..................................................................................................................... 3 
A1 
STUDY ABSTRACT .............................................................................................................. 4 
A2 
PRIMARY HYPOTHESIS ....................................................................................................... 4 
A3 
PURPOSE OF THE STUDY PROTOCOL .................................................................................. 4 
B 
BACKGROUND ...................................................................................................................... 4 
B1 
PRIOR LITERATURE AND STUDIES ....................................................................................... 5 
B2 
RATIONALE FOR THIS STUDY ............................................................................................... 5 
C 
STUDY OBJECTIVES ............................................................................................................. 7 
C1 
PRIMARY AIM ..................................................................................................................... 7 
C2 
SECONDARY AIM ................................................................................................................ 7 
C3 
RATIONALE FOR THE SELECTION OF OUTCOME MEASURES .................................................. 7 
D 
INVESTIGATIONAL AGENT .................................................................................................. 7 
D1 
PRECLINICAL DATA ............................................................................................................ 7 
D2 
CLINICAL DATA TO DATE .................................................................................................... 7 
D3 
DOSE RATIONALE AND RISK/BENEFITS ................................................................................ 7 
E 
STUDY DESIGN ...................................................................................................................... 7 
E1 
OVERVIEW OR DESIGN SUMMARY ....................................................................................... 7 
E2 
SUBJECT SELECTION AND WITHDRAWAL ............................................................................. 8 
2.a
Inclusion Criteria .......................................................................................................... 8 
2.a
Exclusion Criteria ......................................................................................................... 8 
2.b
Ethical Considerations ................................................................................................. 9 
2.c
Subject Recruitment Plans and Consent Process ....................................................... 9 
2.d
Randomization Method and Blinding ........................................................................... 9 
2.e
Risks and Benefits ....................................................................................................... 9 
2.f
Early Withdrawal of Subjects ....................................................................................... 9 
2.g
When and How to Withdraw Subjects ......................................................................... 9 
2.h
Data Collection and Follow-up for Withdrawn Subjects ............................................ 10 
E3 
STUDY DRUG ................................................................................................................... 10 
3.a
Description ................................................................................................................. 10 
3.b
Treatment Regimen ................................................................................................... 10 
3.c
Method for Assigning Subjects to Treatment Groups ................................................ 10 
3.d
Preparation and Administration of Study Drug .......................................................... 10 
3.e
Subject Compliance Monitoring ................................................................................. 10 
3.f
Prior and Concomitant Therapy ................................................................................. 10 
3.g
Packaging .................................................................................................................. 10 
3.h
Blinding of Study Drug ............................................................................................... 10 
3.i
Receiving, Storage, Dispensing and Return.............................................................. 10 
F 
STUDY PROCEDURES ........................................................................................................ 10 
F1 
SCREENING FOR ELIGIBILITY ............................................................................................. 10 
F2 
SCHEDULE OF MEASUREMENTS ........................................................................................ 10 
F3 
VISIT 1 ............................................................................................................................ 11 
F4 
VISIT 2 ETC. ..................................................................................................................... 11 
F5 
SAFETY AND ADVERSE EVENTS ........................................................................................ 11 
5.a
Safety and Compliance Monitoring ............................................................................ 11 
5.b
Medical Monitoring ..................................................................................................... 11 
i
Investigator only .......................................................................................................................11
ii
Independent expert to monitor .................................................................................................11
TABLE OF CONTENTS 

 
 
 
 
 
 
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3 
iii 
Institutional Data and Safety Monitoring Board ........................................................................11 
iv 
Independent Data and Safety Monitoring Board ......................................................................11 
5.c 
Definitions of Adverse Events .................................................................................... 11 
5.d 
Classification of Events.............................................................................................. 11 
i 
Relationship .............................................................................................................................11 
ii 
Severity ....................................................................................................................................11 
iii 
Expectedness ...........................................................................................................................11 
5.e 
Data Collection Procedures for Adverse Events ....................................................... 11 
5.f 
Reporting Procedures ................................................................................................ 12 
5.g 
Adverse Event Reporting Period ............................................................................... 12 
5.h 
Post-study Adverse Event ......................................................................................... 12 
F6 
STUDY OUTCOME MEASUREMENTS AND ASCERTAINMENT .................................................. 12 
G 
STATISTICAL PLAN............................................................................................................. 12 
G1 
SAMPLE SIZE DETERMINATION AND POWER ...................................................................... 12 
G2 
INTERIM MONITORING AND EARLY STOPPING ..................................................................... 12 
G3 
ANALYSIS PLAN ............................................................................................................... 12 
G4 
STATISTICAL METHODS .................................................................................................... 12 
G5 
MISSING OUTCOME DATA ................................................................................................. 12 
G6 
UNBLINDING PROCEDURES ............................................................................................... 12 
H 
DATA HANDLING AND RECORD KEEPING ...................................................................... 12 
H1 
CONFIDENTIALITY AND SECURITY ...................................................................................... 13 
H2 
TRAINING ......................................................................................................................... 13 
H3 
CASE REPORT FORMS AND SOURCE DOCUMENTS ............................................................. 13 
H4 
RECORDS RETENTION ...................................................................................................... 13 
H5 
PERFORMANCE MONITORING ............................................................................................ 13 
I 
STUDY MONITORING, AUDITING, AND INSPECTING ...................................................... 13 
I1 
STUDY MONITORING PLAN.................................................................................................... 13 
I2 
AUDITING AND INSPECTING ................................................................................................... 13 
J 
STUDY ADMINISTRATION .................................................................................................. 13 
J1 
ORGANIZATION AND PARTICIPATING CENTERS ....................................................................... 13 
J2 
FUNDING SOURCE AND CONFLICTS OF INTEREST ................................................................... 13 
J3 
COMMITTEES ....................................................................................................................... 13 
J4 
SUBJECT STIPENDS OR PAYMENTS ....................................................................................... 13 
J5 
STUDY TIMETABLE ............................................................................................................... 14 
K 
PUBLICATION PLAN ........................................................................................................... 14 
L 
ATTACHMENTS ................................................................................................................... 14 
L1 
TABLES ........................................................................................................................... 14 
L2 
INFORMED CONSENT DOCUMENTS ..................................................................................... 14 
L3 
PATIENT EDUCATION BROCHURES ..................................................................................... 14 
L4 
SPECIAL PROCEDURES PROTOCOLS .................................................................................. 14 
L5 
QUESTIONNAIRES OR SURVEYS ......................................................................................... 14 
M 
REFERENCES ...................................................................................................................... 15 
 
A Introduction 
 

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4 
A1 Study Abstract 
Auditory training as the potential to dramatically affect older persons’ adjustment 
to a new hearing aid and to maximize the benefits they receive from wearing one. 
In turn, by wearing hearing aids, they experience easier and more successful 
communication patterns. They enhance their ability to engage in everyday 
conversations and will be able to become more socially involved with their family 
and friends. In this study we will try to determine the extent to which web-based 
clEAR auditory brain training, with concomitant support from a clEAR in-house 
audiologist, affects satisfaction with new hearing aids and increases daily use 
time. Thirty adults over the age of 60 years will receive new hearing aids for the 
first time. After an adjustment period, half will complete clEAR’s auditory brain 
training program right away and the other half will complete it after a delay 
period, and both will complete a control condition. To establish the level of 
feasibility and clinical utility we will measure hearing aid satisfaction, benefit 
ratings, and hearing aid use time. 
A2 Primary Hypothesis 
Use of the web-based clEAR auditory brain training system with concomitant 
support from a clEAR in-house audiologist improves satisfaction with new 
hearing aids and increases daily use time. 
A3 Purpose of the Study Protocol 
Determine the extent to which web-based clEAR auditory brain training with 
concomitant support from a clEAR in-house audiologist affects satisfaction  
with new hearing aids and increases daily use time. 
B Background 

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5 
B1 Prior Literature and Studies 
Barcroft, J., Sommers, M., Tye-Murray, N., Mauzé, E., Schroy, C., & Spehar, B. 
(2011). Tailoring auditory training to patient needs with single and multiple 
talkers: Transfer-appropriate gains on a four-choice discrimination test. 
International Journal of Audiology, 50(11), 1802–1808.  
Barcroft, J., Spehar, B., Tye-Murray, N., & Sommers, M. (2016). Task-and talker-
specific gains in auditory training. Journal of Speech, Language, and Hearing 
Research, 59(4), 862-870.  
Sommers, M. S., Tye-Murray, N., Barcroft, J., & Spehar, B. (2015). The effects of 
meaning-based auditory training on behavioral measures of perceptual effort in 
individuals with impaired hearing. Seminars in Hearing, 36(4), 263-272.  
Tye-Murray, N., Sommers, M., Mauzé, E., Schroy, C., Barcroft, J., & Spehar, B. 
(2012). Using patient perceptions of relative benefit ad enjoyment to assess 
auditory training. Journal of the American Academy of Audiology, 23(8), 623–
634.  
Tye-Murray, N., Spehar, B., Sommers, M., & Barcroft, J. (2016). Auditory training 
with frequent communication partners. Journal of Speech, Language, and 
Hearing Research, 59(4), 871-875.  
Tye-Murray, N., Spehar, B., Barcroft, J., & Sommers, M. (2017). Auditory training 
for adults who have hearing loss: A comparison of spaced versus massed 
practice schedules. Journal of Speech, Language, and Hearing Research, 60(8), 
2337-2345.  
B2 Rationale for this Study 
clEAR auditory brain training has been shown to be effective and that patients 
like the contact with an audiologist during training. Barcroft et al. (2011; see also 
Tye-Murray et al., 2017) showed that computerized, game-like auditory training is 
beneficial for older adults (mean age=66 years, SD=16) who have hearing loss 
by conducting a 3-year large-scale study that addressed the effectiveness of 
computerized training for a talker trained with and for a talker not trained with. 
We also considered whether benefits were maintained three months later. A one-
way ANOVA revealed a significant overall effect of training regardless of the 
talker. In a second study, Adults with hearing loss completed the clEAR program 
and were placed in a group that trained on either multiple talkers or a single 
talker (Barcroft et al., 2016). A control group also completed 12 hours of training 
in American Sign Language. The experimental group’s training included a 4-
choice discrimination task but not an open-set sentence test. The assessment 
phase included the same 4-Improvement on 4-choice discrimination was 

 
 
 
 
 
 
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6 
observed in the experimental group as compared with the control group. Gains 
were (a) highest when the task and talker were the same between training and 
assessment; (b) second highest when the task was the same but the talker only 
partially so; and (c) third highest when task and talker were different. The findings 
support applications of transfer-appropriate processing to auditory training and 
favor tailoring programs toward the specific needs of the individuals being trained 
for tasks, talkers, and perhaps, for stimuli, in addition to other factors.  
 
Auditory brain training has been shown to reduce perceptual effort. Sommers et 
al. (2015) assessed the extent to which engaging in gamified auditory training 
would reduce perceptual or listening effort. As the name implies, perceptual effort 
pertains to the cognitive resources that must be allocated to recognizing speech. 
Perceptual effort was assessed using an n-back memory task. Eighty-three 
participants heard lists of words presented without background noise and were 
asked to continually update their memory of the three most recently presented 
words. Perceptual effort was gauged by memory for items in the three-back 
position immediately before, immediately after, and 3 months after participants 
completed 12 sessions (approximately 8 hours) of the clEAR auditory brain 
training games. Immediate post-training measures of perceptual effort indicated 
that participants could remember approximately one additional word compared to 
pre-training. Moreover, some training gains were retained at the 3-month follow-
up, as indicated by significantly greater recall for the three-back item at the 3-
month measurement than at pretest. A significant correlation was found between 
gains in intelligibility and gains in perceptual effort.  
 
Auditory brain training enhances recognition of familiar voices. Tye-Murray et al. 
(2016) conducted a study to determine whether auditory training with the speech 
of an adult’s spouse would lead to enhanced recognition of that person’s speech. 
Ten older participants (mean age=73 years, SD=6) completed 6 weeks (12 
hours) of training. Their spouses recorded the stimuli and each participant 
(partner with hearing loss) completed auditory training that presented the 
recordings. Training led participants to better discriminate their spouse’s speech, 
as indicated by the 4-AFC. Subjectively, responses on a questionnaire indicated 
that training reduced participants’ communication difficulties. Couples had been 
married an average of 14 years showed that providing training with a formerly 
unfamiliar talker led to significant gains in participants’ ability to recognize the 
speech of the talker, and that gains were seen for the speech of untrained 
talkers, although not to the same extent.  
 
Patients want regular contact with an audiologist. In a study of 93 adults (mean 
age=66 years, SD=17), we asked the question, what did you like best about the 
auditory training (Tye-Murray et al., 2012). One of the three top answers was 
“regular contact with an audiologist”. The other two were “the games were fun to 
play” and “training gave me empowerment over my hearing loss.” By completing 
auditory brain training, participants also reported increased confidence to engage 
in everyday conversations.  
 

 
 
 
 
 
 
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C Study Objectives 
 
C1 Primary Aim 
It is the objective of this study to determine if the use of clEAR following a first-time 
hearing aid fitting will increase satisfaction and daily hearing aid use. 
C2 Secondary Aim 
N’A 
C3 Rationale for the Selection of Outcome Measures 
1. Primary outcome measures are questionnaires used in hearing clinics to assess 
hearing aid satisfaction.   
2. Hearing aids log use time.  This information will also be collected to determine 
the average daily use time for each participant. 
D Investigational Agent  
 
D1 Preclinical Data 
N/A 
D2 Clinical Data to Date  
N/A 
D3 Dose Rationale and Risk/Benefits  
N/A 
E Study Design  
 
E1 Overview or Design Summary 
 
All qualified participants will first be fitted with one hearing aid using manufacturer 
recommended settings. The settings will be verified using real-ear measurements 
and any initial adjustments to the hearing aid will be made at the time of fitting. 
The participants will return again in 2-3 weeks to complete any final adjustments 
needed before they continue with the protocol.  
After fitting and final adjustments are complete, all participants will be receive 
aided speech perception testing using the Speech in Noise Test (SPIN) and the 
NU-6.  
Half of the participants will be assigned to the Early Group and receive 8 hours of 
clEAR auditory brain training in 20 minute intervals spread over four weeks. The 
other half will be assigned to the Late Group and receive the clEAR training after 

 
 
 
 
 
 
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8 
a four week control period. The Early Group will do the control period after their 
training period.  
For the control period, participants will be given a choice of three audio books 
stored on Amazon Kindle (a mystery, a biography, or a popular fiction) to ensure 
that the book will engage a participant’s interest and that they will be motivated to 
follow the training schedule. They will be provided with a formal schedule that 
parallels the training schedule for the clEAR training, and will receive 8 hours of 
training. We will confirm their compliance through weekly phone calls, email, and 
by asking them to report how far along they are in the book. If participants do not 
have a tablet for reading, they will provided with a loaner tablet which allow 
access to Kindle books. A final period will be four weeks after either type of 
intervention.  
At the end of each period participants will receive the speech perception battery 
(SPIN and NU-6) and the subjective assessment battery. The subjective 
assessment battery includes questionnaires and scales commonly used to 
assess hearing aid satisfaction and changes in listening challenges. The battery 
will include three subjective measures, The SADL (Satisfaction with Amplification 
in Daily Life), the IOI-HA (The International Outcome Inventory for Hearing Aids, 
and the COSI (Client Oriented Scale of Improvement). Finally, at the end of the 
clEAR training period participants will complete a questionnaire designed to gain 
feedback about the games, participants will also complete a questionnaire about 
their clEAR experience, indicating what they did and did not like about the 
system. 
 
E2 Subject Selection and Withdrawal  
 
2.a 
Inclusion Criteria  
All participants have the same inclusion/exclusion criteria but be assigned to one 
of two groups that differ only in the schedule, this will allow participants will act as 
their own control group.  
 
All participants will:  
1. Be over 60 years old  
2. Have a bilateral sensorineural hearing loss mild-to-severe range  
3. Vision will need to be corrected to at least 20/40 so participants can see the 
training games on the computer or tablet monitor.  
2.a 
Exclusion Criteria  
English must be the first language of the participant 
Participants must pass a dementia screener (MMSE) 
Must have the manual dexterity to manipulate and insert a hearing aid 
Must have an email address and access to the internet 

 
 
 
 
 
 
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9 
2.b 
Ethical Considerations  
Nobody will be discriminated against based on conditions not noted in the 
inclusion/exclusion criteria. 
2.c 
Subject Recruitment Plans and Consent Process 
Lists of potential participants will be obtained from multiple sources including the 
Washington University’s Volunteers for Health program and from an extensive 
database maintained in the Tye-Murray lab. Potential participants will hear about 
the study and complete a health and hearing screening questionnaire over the 
telephone. If they pass the telephone screening, they will be asked to come to 
the hearing lab for the hearing and vision assessment. The hearing screening will 
include pure-tone threshold testing and speech perception testing at comfortable 
levels.  
To be enrolled in the study potential participants will have bilateral mild to severe 
sensori-neural hearing loss, and have never used hearing aids. They will also 
require the basic skills for wearing and maintaining a hearing aid including the 
manual dexterity to insert the aid and the anatomy required to wear the aid. They 
will also have corrected static visual acuity of 20/40 or better. They will be 
required to pass a dementia screener (MMSE). If they qualify for the study and 
wish to continue they will be consented after completing the assessments. Those 
that do not qualify will be paid for their time and any collected data destroyed.  
2.d 
Randomization Method and Blinding 
Because participants act as their own control per se, they will not be randomized and no 
blinding will occur. 
2.e 
Risks and Benefits 
There are no foreseeable risks to the participant beyond the basic risks associated with 
hearing aid fitting.  These risks are rare but include possible skin irritation from the 
device or the occasional uncomfortably loud sound.  Hearing aids are equipped with 
safety mechanisms that are supposed to reduce the possibility that a very uncomfortable 
level is produced. 
The participant will participate in a study that provides amplification and auditory 
training. These devices and procedures are designed to be of benefit to 
individuals with hearing loss. The participants will also be providing feedback on 
their experiences. This feedback may improve the procedures and methods 
currently used in online auditory training practices, this may benefit society. 
2.f 
Early Withdrawal of Subjects  
Participants that have not completed the study but can no longer participate will be 
asked to return the hearing aid.  They will be reimbursed for their time at 10$/hour.  
2.g 
When and How to Withdraw Subjects  
If it is deemed that they can no longer fulfill the needs of the study because they are not 
training or coming to the in-clinic assessments participants will be notified by phone or 
email  if they are to be withdrawn from the study. 

 
 
 
 
 
 
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10
2.h 
Data Collection and Follow-up for Withdrawn Subjects  
There will be no follow-up with withdrawn participants. 
 
E3 Study Drug  
 
3.a 
Description  
N/A 
3.b 
Treatment Regimen  
N/A 
3.c 
Method for Assigning Subjects to Treatment Groups  
N/A 
3.d 
Preparation and Administration of Study Drug  
N/A 
3.e 
Subject Compliance Monitoring  
N/A 
3.f 
Prior and Concomitant Therapy  
N/A 
3.g 
Packaging  
N/A 
3.h 
Blinding of Study Drug  
N/A 
3.i 
Receiving, Storage, Dispensing and Return  
N/A 
F Study Procedures  
 
F1 Screening for Eligibility 
A telephone survey will screen all potential participants that would not be eligible for 
reasons other than the hearing and vision screening.  Hearing and vision testing will be 
conducted after the informed consent process. 
F2 Schedule of Measurements 
 

 
 
 
 
 
 
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11
F3 Visit 1  
 
F4 Visit 2 etc.  
 
F5 Safety and Adverse Events  
 
5.a 
Safety and Compliance Monitoring 
 
5.b 
Medical Monitoring  
 
i 
Investigator only 
 
ii 
Independent expert to monitor 
 
iii 
Institutional Data and Safety Monitoring Board 
 
iv 
Independent Data and Safety Monitoring Board 
 
5.c 
Definitions of Adverse Events 
 
5.d 
Classification of Events 
 
i 
Relationship 
 
ii 
Severity 
 
iii 
Expectedness 
 
5.e 
Data Collection Procedures for Adverse Events 
 

 
 
 
 
 
 
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12
5.f 
Reporting Procedures 
 
5.g 
Adverse Event Reporting Period 
 
5.h 
Post-study Adverse Event 
 
F6 Study Outcome Measurements and Ascertainment 
 
G Statistical Plan  
 
G1  Sample Size Determination and Power 
We determined the power to detect an effect size for differences as large as or 
larger than in Tye-Murray et al. (mean = .733, SD = .783) with an alpha level of 
.05 will exceed .95 using a one-tailed test for the within-subjects comparisons in 
each group. 
G2  Interim Monitoring and Early Stopping 
We will monitor progress in the software to be sure participants are following protocol. 
G3  Analysis Plan 
We will assess the effect of training on hearing aid use time, changes in speech 
perception, and subjective changes indicated by the questionnaire rating-scale 
responses. Three post-fitting times will be assessed to look at the effects of 
clEAR testing (Baseline/post-fitting, post-training, post control, and four weeks 
post intervention).  
G4  Statistical Methods  
Data will be analyzed with t-tests and repeated measures ANOVA. 
G5  Missing Outcome Data 
Participants with missing data will not be included in the analyses for that outcome 
measure. 
G6  Unblinding Procedures  
N/A 
H Data Handling and Record Keeping  
 

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13
H1 Confidentiality and Security 
H2 Training 
H3 Case Report Forms and Source Documents 
H4 Records Retention 
H5 Performance Monitoring 
I Study Monitoring, Auditing, and Inspecting 
I1 
Study Monitoring Plan 
I2 
Auditing and Inspecting 
J Study Administration 
J1 Organization and Participating Centers 
J2 Funding Source and Conflicts of Interest 
INCLUDE INFO FROM CIRC?  BUT WE ARE NOT THE PI, SO IT WOULDN’T MAKE 
SENSE HERE. 
J3 Committees 
J4 Subject Stipends or Payments 
Participants will be paid $10/hour for the time spent in assessments and training. 

 
 
 
 
 
 
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14
Other  -  The project involves first time hearing aid users. We need to control for 
the level of technology and hearing aid quality across participants, so the hearing 
aid will be provided. The aid will be 'used' after the study so the participant will be 
allowed to keep the aid after the study is complete. 
J5 Study Timetable 
 
 
K Publication Plan  
 
 
 
 
L  Attachments  
 
L1  Tables  
 
L2  Informed consent documents 
Adult SBIR HA and AT Informed 
consent.rtf 
Consent & Assent 
Forms 
1 407 k E 08/20/19 
 
L3  Patient education brochures 
 
L4  Special procedures protocols  
 
L5  Questionnaires or surveys 
 
Attachment Name 
Category 
Ver 
Size 
Attached 
 
 
 
 
 
 
JIT Letter.doc 
Notice of Just in Time (JIT) 
Documentation 
1 
25 k E 
08/15/19 
Telephone 
Recruitment Script: Phone 
1 
59 k E 
08/19/19 

______________________________________________________________________________________ 
15
Questionnaire.rtf
AT and HA Flier.rtf
Recruitment Materials: 
Ads/Brochures/Posters/News 
Release/Fliers 
1 115 k E 
08/19/19 
COSI.pdf 
Subject Data Collection 
Instruments 
1 
36 k E 
08/21/19 
Demographic - 
Case History 
Form.rtf
Subject Data Collection 
Instruments 
1 
86 k E 
08/20/19 
Email and Phone 
Script for 
Followups.doc 
Subject Data Collection 
Instruments 
1 
23 k E 
08/20/19 
IOI-HA.pdf 
Subject Data Collection 
Instruments 
1 
37 k E 
08/21/19 
SADL Form.pdf
Subject Data Collection 
Instruments 
1 
58 k E 
08/21/19 
Assurance Form 
Signed.pdf
Assurance Document 
1 226 k E 
08/21/19 
M References 
Barcroft, J., Sommers, M., Tye-Murray, N., Mauzé, E., Schroy, C., & Spehar, B. 
(2011). Tailoring auditory training to patient needs with single and multiple 
talkers: Transfer-appropriate gains on a four-choice discrimination test. 
International Journal of Audiology, 50(11), 1802–1808.  
Barcroft, J., Spehar, B., Tye-Murray, N., & Sommers, M. (2016). Task-and talker-
specific gains in auditory training. Journal of Speech, Language, and Hearing 
Research, 59(4), 862-870.  
Sommers, M. S., Tye-Murray, N., Barcroft, J., & Spehar, B. (2015). The effects of 
meaning-based auditory training on behavioral measures of perceptual effort in 
individuals with impaired hearing. Seminars in Hearing, 36(4), 263-272.  
Tye-Murray, N., Sommers, M., Mauzé, E., Schroy, C., Barcroft, J., & Spehar, B. 

______________________________________________________________________________________ 
16
(2012). Using patient perceptions of relative benefit ad enjoyment to assess 
auditory training. Journal of the American Academy of Audiology, 23(8), 623–
634.  
Tye-Murray, N., Spehar, B., Sommers, M., & Barcroft, J. (2016). Auditory training 
with frequent communication partners. Journal of Speech, Language, and 
Hearing Research, 59(4), 871-875.  
Tye-Murray, N., Spehar, B., Barcroft, J., & Sommers, M. (2017). Auditory training 
for adults who have hearing loss: A comparison of spaced versus massed 
practice schedules. Journal of Speech, Language, and Hearing Research, 60(8), 
2337-2345.