Validation of the LittlEARS® Questionnaire and the Adaptive Auditory Speech Test (AAST) in normal-hearing Maltese-speaking children

Despite the widespread screening of hearing loss at birth, some children with permanent hearing loss still go undetected, and delayed onset hearing loss remains a concern. Screening post Universal Newborn Hearing Screening (UNHS) is attracting increased interest across researchers and clinicians alike. This study aimed to develop tools that evaluate auditory development and speech recognition skills of Maltese speaking children. A translated version of the LittlEARS® questionnaire was used to examine auditory development in 398 young children less than 2 years of age. Analysis aimed at generating normative data from the total scores of the participants and their age in months. A Maltese version of the Adaptive Auditory Speech Test (AAST) was used to examine the speech recognition skills of 208 children and 40 adults in Quiet, Noise and High Frequency. The aims were to determine the norms in these 3 settings, in adults and children aged 4 years and older. 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. Norm curves were comparable to the original German data. 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 3 test settings. An approximate difference of 10dB 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 UNHS using these tools are addressed

Comparison of hearing aid outcome measures in adult hearing aid users

Hearing aid outcome measures have become an essential part of audiological intervention. This study aimed to explore hearing aid benefit in Maltese hearing aid users through subjective and objective outcome measures. The Profil Imqassar dwar il-Benefiċċju tal-Hearing Aids (PIBHA), a translated version of the Abbreviated Profile of Hearing Aid Benefit (APHAB) questionnaire, was used to subjectively examine hearing aid benefit in 56 adult hearing aid users falling in the 20- to 60-year age range. Thirty of these hearing aid users subsequently participated in clinical testing to evaluate hearing aid benefit objectively. Real ear measurements (REMs) and two non-word repetition tests, the Maltese Non-Words in Quiet (MNWQ) and the Maltese Non-Words in Noise (MNWN), were used in the study. Analysis aimed to identify which factors correlated with hearing aid benefit. It also explored the extent to which subjective perception of hearing aid benefit correlated with performance on non-word repetition and REMs in the local population. Daily use was associated with gender and hearing aid type. Non-word repetition scores were correlated with the PIBHA scores and with REMs. Unlike findings reported in the literature, REMs were not correlated with the self-reported measures of the PIBHA. Implications for including both subjective and objective measures in hearing aid fitting protocols are addressedpeer-reviewe

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

COMPARISON OF HEARING AID OUTCOME MEASURES IN ADULT HEARING AID USERS

Abstract. Hearing aid outcome measures have become an essential part of audiological intervention. This study aimed to explore hearing aid benefit in Maltese hearing aid users through subjective and objective outcome measures. The Profil Imqassar dwar il-Benefiċċju tal-Hearing Aids (PIBHA), a translated version of the Abbreviated Profile of Hearing Aid Benefit (APHAB) questionnaire, was used to subjectively examine hearing aid benefit in 56 adult hearing aid users falling in the 20-to 60-year age range. Thirty of these hearing aid users subsequently participated in clinical testing to evaluate hearing aid benefit objectively. Real ear measurements (REMs) and two non-word repetition tests, the Maltese Non-Words in Quiet (MNWQ) and the Maltese Non-Words in Noise (MNWN), were used in the study. Analysis aimed to identify which factors correlated with hearing aid benefit. It also explored the extent to which subjective perception of hearing aid benefit correlated with performance on non-word repetition and REMs in the local population. Daily use was associated with gender and hearing aid type. Non-word repetition scores were correlated with the PIBHA scores and with REMs. Unlike findings reported in the literature, REMs were not correlated with the self-reported measures of the PIBHA. Implications for including both subjective and objective measures in hearing aid fitting protocols are addressed

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

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