RP305 - Asking the Right Questions for Unilateral Loss: Development of a New Questionnaire

Abstract:
For adolescents with unilateral hearing loss, listening in the classroom can be difficult. Talkers of interest, who include not only the teacher, are often dynamic and in multiple locations. To assess classroom listening challenges, and evaluate intervention benefits, a questionnaire was developed. Based on data from more than 1000 participants with unilateral hearing loss, three sub-scales were created, based on the distance between the talker and the listener. The results of this work demonstrate that listening to a talker who is far away is particularly challenging for adolescents with unilateral hearing loss.

Summary:
Children with unilateral hearing loss experience difficulties in classroom listening situations. There are a limited number of validated questionnaires available for monitoring listening development and quantifying the challenges school-aged children with unilateral hearing loss experience. The purpose of this study was to evaluate a questionnaire that queries the classroom listening challenges reported by children with unilateral hearing loss with and without the use of personal hearing devices (air conduction hearing aid, bone conduction hearing aid, cochlear implant, contralateral routing of signals [CROS] system).

Design:
Children aged 9-17 with self-reported unilateral hearing loss completed an online questionnaire about classroom listening difficulties without using a personal device (n = 1148) or with the use of a personal hearing device (n = 897). The questionnaire includes 15 questions examining different scenarios common in modern classrooms, each with a picture depicting the listening situation specific to the question. Exploratory factor analysis was used to develop subscales and the internal reliability of the subscales was evaluated. To validate the questionnaire, the relationships between self-reported hearing difficulties or device use and survey scores were evaluated (unaided and aided scores, respectively). Scores were analyzed using exploratory factor analysis to construct subscales and then using regression analyses to evaluate the degree of self-reported hearing loss or type of device use.

Results:
Factor analysis revealed survey scores for individual items statistically loaded onto three factors. Based on these factors, subscales were created, which are related to: 1) listening situations where the talker is far away from the child, 2) listening situations where the talker is close to the child and they are inside a building, and 3) listening situations where the talker is close to the child, and they are outside the building. Regression analyses revealed children reported the greatest difficulty in school settings when the sound of interest is far away from them. Although scores were generally higher, indicating listening was easier, when children were wearing their hearing devices, situations with far away signals were still reported as more challenging than situations where signals were close.

Conclusions:
This set of findings highlights the need to incorporate distance effects into laboratory evaluations that include children with unilateral hearing loss. In addition, the findings support clinical interventions that address talker-to-listener distances, such as preferential seating and remote microphone systems. Finally, the results of this study validate the classroom listening difficulty survey for use with children aged 9 to 17 years of age with unilateral hearing loss. The subscales are empirically driven and internally reliable and focus on three types of listening situations encountered in classrooms. Importantly, the survey results demonstrate the expected pattern of results, with participants who have greater self-reported hearing difficulty rating classroom listening situations as more difficult than participants with less self-reported hearing difficulty.