OAEs are considered to be related to the amplification function of the cochlea. In the absence of external stimulation, the activity of the cochlear amplifier increases, leading to the production of sound. Several lines of evidence suggest that, in mammals, outer hair cells are the elements that enhance cochlear sensitivity and frequency selectivity and hence act as the energy sources for amplification. One theory is that they act to increase the discriminability of signal variations in continuous noise by lowering the masking effect of its cochlear amplification.
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In conjunction with audiometric testing, OAE testing can be completed to determine changes in the responses. Studies have found that exposure to noise can cause a decline in OAE responses. In a study, industrial workers who were exposed to 84.5 dBA of noise were compared to workers who were exposed to 53.2 dBA of noise by considering hearing thresholds and OAEs before and after 5 days of work. This study revealed that hearing thresholds and OAE results were significantly lower among the workers who were exposed to higher levels of noise.
There are myriad sections without references. At other times the authors reference secondary sources (in discussing toilet training they note that "Pediatrician Lindy Woodard believes that a child can and should be trained by thirty months; in her professional experience, children who are trained at an older age have more problems learning to use the toilet." p. 168). Often the subject of a section would lack focus and context, such as p. 209 where the authors talk about "soul disorders" in reference to mental health. One assumes they are referencing the work of someone else, but it isn't cited or put into context. This leaves the reader to wonder why the authors would consider if "wisdom teeth extraction impacts our souls."
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