“…However, clinicians and researchers have long noted that the impact of hearing loss is not solely a decline in the number of words that can be correctly recognized. Individuals with hearing loss also report increased effort and fatigue, particularly when listening in noise (Hétu, Riverin, Lalande, Getty, & St-Cyr, 1988;Hicks & Tharpe, 2002;McCoy et al, 2005;Nachtegaal et al, 2009;Pichora-Fuller, 2006), even when performance is equivalent (Bologna, Chatterjee, & Dubno, 2013;Hicks & Tharpe, 2002;McCoy et al, 2005). Though not standards of clinical care, research evaluations of interventions have employed subjective measures of effort via self-assessment scales (Ahlstrom, Horwitz, & Dubno, 2014;Cox & Alexander, 1992;Humes, Garner, Wilson, & Barlow, 2001;Sweetow & Sabes, 2006).…”