Often, HA programming algorithms automatically provide additional gain if a fitting is monaural only. However, when the patient receives a second device, the ability to fit the second device optimally will be compromised if the output of the first device is not readjusted and often reduced. When technology is not balanced or when binaural summation has created an overly loud input, children will often go to great lengths, such as removing the battery or turning off the loud or interfering device, to make the sound more tolerable.