Mode of Administration of LittlEARS® (MED-EL) Auditory Questionnaire (LEAQ) as a Screening Tool in Ghana: Are there any differences in final test scores between “Self Administration” and “Interview”?

The mode of administration of LittlEARS® Auditory Questionnaire (LEAQ) in Ghana, where a Universal Newborn Hearing Screening (UNHS) has not been implemented and in addition about 31% of adults have never been to school was investigated. The original LEAQ English version was adapted into three Akan (Ghanaian) languages using the translation/back-translation procedure recommended by the International Test Commission and validated using data collected for N= 402 children. The effect of administration mode was however, investigated by collecting data from N=152 respondents. Our results show that it does not make any difference in terms of LEAQ scores whether the questionnaire was administered via interview or by self - administration.  Results of the study support the position that LEAQ is an appropriate screening tool for children living in developing countries where adult illiteracy rates are high

Validation of the Maltese Adaptive Auditory Speech Test (AAST)

The Adaptive Auditory Speech Test (AAST) was developed to record the Speech Recognition Threshold (SRT) in children in quiet or with background noise. AAST is an interlingually valid and reliable standardised tool with speech material developed in several languages. The Maltese version of the Adaptive Auditory Speech Test (AAST) was developed to examine the speech recognition skills of 208 children and 40 Maltese-speaking adults in quiet, noise and high frequency. The aims were to determine the norms in these three settings in adults and children aged 4 years and older. The Maltese version of AAST confirms an age dependent norm threshold with a significant improvement in threshold being observed as children grow older, similar to other AAST versions. This was evident across the three test settings. An approximate difference of 10 dB was also noted between 4-year-old and 10-year-old children in AAST in quiet. Thresholds of 10-year-olds and adults were similar in both the quiet and high frequency versions. Implications for post Universal Newborn Hearing Screening using these tools are addressed

Validation of the LittlEARS (R) Questionnaire in Hearing Maltese-Speaking Children

Objectives: To adapt the LittlEARS (R) Auditory Questionnaire into the Maltese language and evaluate the psychometric properties of the Maltese version of the questionnaire for hearing children. Methods: The English version of LittlEARS (R) Auditory Questionnaire was adapted into Maltese using a translation/back translation procedure. In this cross-sectional study, a total of 398 parents of normal hearing children aged between 5 days and 36 months completed the Maltese version of LittlEARS (R). Psychometric validation was performed through scale analysis, item analysis, and analysis of reliability and validity. A non-linear regression model was derived to obtain normative data for expected and minimum values of total scores from the questionnaire according to age. Results: Predictive accuracy (Guttman's lambda) was 0.921, the Cronbach's alpha coefficient value was 0.921, and the split-half reliability coefficient was 0.949. The Pearson correlation coefficient between scores and age was 0.903. The regression analysis showed that 82% of the variance in the total scores can be explained by age. Norm curves were comparable to the original German data. Conclusion: This study confirmed that the Maltese version of LittlEARS (R) is a valid and reliable tool to evaluate auditory development in children less than two years of age

LittlEARS auditory questionnaire as an infant hearing screening in Germany after the newborn hearing screening

Objective: To investigate the feasibility of using the LittlEARS (R) Auditory Questionnaire (LEAQ (R)) as part of the infant hearing screening programme in Germany. Design: LEAQ (R) s were distributed to 47 paediatric practices and were completed by the parents/guardians of the infants (aged between 9-14 months) involved in the study (= LEAQA (R) screening). The infants who failed the LEAQA (R) screening were invited to a LEAQ rescreening. Infants who failed the LEAQA (R) rescreening were sent to a paediatric ENT specialist. After 3 years, a follow-up was performed on two groups: the first group comprised infants who failed the LEAQ screening; the second group (control group) comprised 200 infants who passed the LEAQ screening. Study Sample: 5316 questionnaires were returned. Results: Six infants with permanent hearing loss were identified using the LEAQA (R) as a screening tool. Conclusions: An infant hearing screening using the LEAQA (R) is easily implementable in paediatric practices and may be a good alternative in countries where no objective screening instruments are available. The LEAQA (R) was suitable for monitoring hearing development in infants in general and could help to identify a late-onset or progressive hearing loss in infants

Voruntersuchung zur Praktikabilität des Adaptiven Auditiven Sprachtestes (AAST) als Screeninginstrument bei Vorschulkindern

BACKGROUND AND QUESTION: For the detection of a hearing impairment and realistic assessment of the hearing performance in everyday situations, the measurement of speech perception in noise is of great practical relevance. Only a few suitable instruments are currently available for the simple, quick and child-friendly assessment of hearing performance in children aged between four and six years. The aim of the study was to investigate whether the AAST (Adaptive Auditory SpeechTest) test procedure fulfills the essential prerequisites for use as a screening tool in preschool children and whether the implementation in a kindergarten is practicable and feasible. METHODS: This descriptive cross-sectional study included N = 25 (MW: 5.05 years) preschool children who were tested in a German- speaking kindergarten binaurally diotically (using headphones) with the AAST. The AAST adjusts itself automatically to the hearing performance and determines the speech perception threshold in quiet and in different background noise conditions. The test sequence included the testing in quiet, with steady state noise (SSN) without spatial separation, and spatial International Female Fluctuating Masker signal (IFFM) 90 degrees from the left. RESULTS: The average total test duration was 12 minutes per child. The duration of the test decreased with increasing age. The analysis of the data confirmed the AAST normal values in quiet and in noise. The speech intelligibility threshold (SRT) for children was on average 13.2 dB lower in IFFM90 than in SSN. DISCUSSION: The AAST seems to fulfill essential requirements for the implementation as a screening method for hearing loss in preschool children. The method proves to be practicable in use, characterized by a short assessment time and quickly delivers stable results. All children of the sample were able to complete the procedure. Due to its infrastructure the kindergarten is a suitable venue for implementing pre-school hearing screening.HINTERGRUND UND FRAGESTELLUNG: Für die Erfassung einer Hörstörung und die realistische Einschätzung der Hörleistung in Alltagssituationen ist die Messung der Sprachwahrnehmung im Störgeräusch von großer praktischer Relevanz. Für die einfache, schnelle und kindgerechte Überprüfung des Hörvermögens bei Kindern im Alter zwischen vier und sechs Jahren stehen derzeit nur wenige Verfahren zur Verfügung. Ziel der Studie war es herauszufinden, ob das Testverfahren AAST (Adaptiver Auditiver Sprachtest) wesentliche Voraussetzungen für den Einsatz als Screeninginstrument bei Vorschulkindern erfüllt und ob die Durchführung in einem Kindergarten praktikabel und machbar ist. METHODE: In die vorliegende deskriptive Querschnittsstudie wurden N = 25 (MW: 5,05 Jahre) Vorschulkinder eingeschlossen, die in einem deutschsprachigen Kindergarten binaural diotisch (Darbietung über Kopfhörer) mit dem AAST-Verfahren getestet wurden. Der Schallpegel wird im Testverfahren adaptiv an die Hörleistung angepasst und ermittelt die Sprachverständlichkeitsschwelle in Ruhe und in unterschiedlichen Störgeräuschbedingungen. Die Testsequenz umfasste die Testung in Ruhe, im stationären Störgeräusch (SSN: Steady state noise) (ohne räumliche Trennung von Stör- und Nutzschall) und im fluktuierenden Signal mit 90 Grad räumlicher Trennung von Stör- und Nutzschall (IFFM90: International Female Fluctuating Masker). ERGEBNISSE: Die durchschnittliche Gesamttestdauer betrug 12 Minuten pro Kind. Die Dauer der Testung sank mit zunehmendem Alter. Die Analyse der Daten entsprach den AAST-Normalwerten in Ruhe und im Störschall. Die Sprachverständlichkeitsschwelle der untersuchten Kinder lag in der IFFM90 Störschallbedingung durchschnittlich 13,2 dB unter der SSN-Bedingung. DISKUSSION: Das AAST-Verfahren scheint wesentliche Voraussetzungen für die Durchführung als Screeningverfahren für Hörverluste bei Vorschulkindern zu erfüllen. Das Verfahren erweist sich als praktikabel in der Anwendung, zeichnet sich durch eine kurze Durchführungsdauer aus und liefert schnell stabile Ergebnisse. Alle Kinder der Stichprobe konnten das Verfahren absolvieren. Aufgrund seiner Infrastruktur erscheint der Kindergarten geeignet zur Durchführung eines Vorschulhörscreenings

Validation of the LittlEARS® Questionnaire in Hearing Maltese-Speaking Children

Objectives: To adapt the LittlEARS® Auditory Questionnaire into the Maltese language and evaluate the psychometric properties of the Maltese version of the questionnaire for hearing children. Methods: The English version of LittlEARS® Auditory Questionnaire was adapted into Maltese using a translation/back translation procedure. In this cross-sectional study, a total of 398 parents of normal hearing children aged between 5 days and 36 months completed the Maltese version of LittlEARS®. Psychometric validation was performed through scale analysis, item analysis, and analysis of reliability and validity. A non-linear regression model was derived to obtain normative data for expected and minimum values of total scores from the questionnaire according to age. Results: Predictive accuracy (Guttman’s lambda) was 0.921, the Cronbach’s alpha coefficient value was 0.921, and the split-half reliability coefficient was 0.949. The Pearson correlation coefficient between scores and age was 0.903. The regression analysis showed that 82% of the variance in the total scores can be explained by age. Norm curves were comparable to the original German data. Conclusion: This study confirmed that the Maltese version of LittlEARS® is a valid and reliable tool to evaluate auditory development in children less than two years of age