“…The majority of research associated with the acceptance of background noise has focused on factors that may or may not influence the measure. Factors having little or no effect on the ANL measurement include, but are not limited to, age, gender, degree of hearing loss, loudness tolerance, and hearing-aid experience (Nabelek et al, 1991(Nabelek et al, , 2006Crowley and Nabelek, 1996;Rogers et al, 2003;Nabelek et al, 2006;Moore et al, 2011;Franklin et al, 2012). Factors known to affect the ANL include speech presentation level, medications related to attention disorders, digital noise reduction (DNR), and directional microphone technology (Freyaldenhoven et al, 2005(Freyaldenhoven et al, , 2007Franklin et al, 2006;Mueller et al, 2006).…”