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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.[4]
“Our daughter, Juliana, joined the TLE Aurora family at 8 weeks old and we could not be happier with our choice in a childcare facility. Ms. Bethany in the Infant A room is truly amazing! We are put at ease knowing that we have such a caring and loving teacher taking care of our daughter. She is truly dedicated to making sure Juliana progresses and has fun at the same time. Juliana always has a smile on her face when I drop her off in the morning and when I pick her up in the afternoon. We truly appreciate the staff at TLE Aurora for the way they have cared for our daughter as though she was family!”

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.[12]


Otoacoustic emissions are clinically important because they are the basis of a simple, non-invasive test for hearing defects in newborn babies and in children who are too young to cooperate in conventional hearing tests. Many western countries now have national programmes for the universal hearing screening of newborn babies. Periodic early childhood hearing screenings program are also utilizing OAE technology. One excellent example has been demonstrated by the Early Childhood Hearing Outreach Initiative at the National Center for Hearing Assessment and Management (NCHAM) at Utah State University, which has helped hundreds of Early Head Start programs across the United States implement OAE screening and follow-up practices in those early childhood educational settings.[8][9][10] The primary screening tool is a test for the presence of a click-evoked OAE. Otoacoustic emissions also assist in differential diagnosis of cochlear and higher level hearing losses (e.g., auditory neuropathy).
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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