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Objectives: Listening-related fatigue can be a significant problem for adults who struggle to hear and understand, particularly adults with hearing loss. However, valid, sensitive, and clinically useful measures for listening-related fatigue do not currently exist. The purpose of this study was to develop and validate a brief clinical tool for measuring listening-related fatigue in adults., Design: The clinical scale was derived from the 40-item version of the Vanderbilt Fatigue Scale for Adults (VFS-A-40), an existing, reliable, and valid research tool for measuring listening-related fatigue. The study consisted of two phases. Phase 1 ( N = 580) and Phase 2 ( N = 607) participants consisted of convenience samples of adults recruited via online advertisements, clinical records review, and a pool of prior research participants. In Phase 1, results from item response theory (IRT) analyses of VFS-A-40 items were used to identify high-quality items for the brief (10-item) clinical scale: the VFS-A-10. In Phase 2, the characteristics and quality of the VFS-A-10 were evaluated in a separate sample of respondents. Dimensionality was evaluated using exploratory factor analyses (EFAs) and item quality and characteristics were evaluated using IRT. VFS-A-10 reliability and validity were assessed in multiple ways. IRT reliability analysis was used to examine VFS-A-10 measurement fidelity. In addition, test-retest reliability was assessed in a subset of Phase 2 participants ( n = 145) who completed the VFS-A-10 a second time approximately one month after their initial measure (range 5 to 90 days). IRT differential item functioning (DIF) was used to assess item bias across different age, gender, and hearing loss subgroups. Convergent construct validity was evaluated by comparing VFS-A-10 responses to two other generic fatigue scales and a measure of hearing disability. Known-groups validity was assessed by comparing VFS-A-10 scores between adults with and without self-reported hearing loss., Results: EFA suggested a unidimensional structure for the VFS-A-10. IRT analyses confirmed all test items were high quality. IRT reliability analysis revealed good measurement fidelity over a wide range of fatigue severities. Test-retest reliability was excellent ( rs = 0.88, collapsed across participants). IRT DIF analyses confirmed the VFS-A-10 provided a valid measure of listening-related fatigue regardless of respondent age, gender, or hearing status. An examination of associations between VFS-A-10 scores and generic fatigue/vigor measures revealed only weak-to-moderate correlations (Spearman's correlation coefficient, rs = -0.36 to 0.57). Stronger associations were seen between VFS-A-10 scores and a measure of perceived hearing difficulties ( rs = 0.79 to 0.81) providing evidence of convergent construct validity. In addition, the VFS-A-10 was more sensitive to fatigue associated with self-reported hearing difficulties than generic measures. It was also more sensitive than generic measures to variations in fatigue as a function of degree of hearing impairment., Conclusions: These findings suggest that the VFS-A-10 is a reliable, valid, and sensitive tool for measuring listening-related fatigue in adults. Its brevity, high sensitivity, and good reliability make it appropriate for clinical use. The scale will be useful for identifying those most affected by listening-related fatigue and for assessing benefits of interventions designed to reduce its negative effects., Competing Interests: The authors have no conflict of interest to report., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)

Purpose: Growing evidence suggests that fatigue associated with listening difficulties is particularly problematic for children with hearing loss (CHL). However, sensitive, reliable, and valid measures of listening-related fatigue do not exist. To address this gap, this article describes the development, psychometric evaluation, and preliminary validation of a suite of scales designed to assess listening-related fatigue in CHL: the pediatric versions of the Vanderbilt Fatigue Scale (VFS-Peds)., Method: Test development employed best practices, including operationalizing the construct of listening-related fatigue from the perspective of target respondents (i.e., children, their parents, and teachers). Test items were developed based on input from these groups. Dimensionality was evaluated using exploratory factor analyses (EFAs). Item response theory (IRT) and differential item functioning (DIF) analyses were used to identify high-quality items, which were further evaluated and refined to create the final versions of the VFS-Peds., Results: The VFS-Peds is appropriate for use with children aged 6-17 years and consists of child self-report (VFS-C), parent proxy-report (VFS-P), and teacher proxy-report (VFS-T) scales. EFA of child self-report and teacher proxy data suggested that listening-related fatigue was unidimensional in nature. In contrast, parent data suggested a multidimensional construct, composed of mental (cognitive, social, and emotional) and physical domains. IRT analyses suggested that items were of good quality, with high information and good discriminability. DIF analyses revealed the scales provided a comparable measure of fatigue regardless of the child's gender, age, or hearing status. Test information was acceptable over a wide range of fatigue severities and all scales yielded acceptable reliability and validity., Conclusions: This article describes the development, psychometric evaluation, and validation of the VFS-Peds. Results suggest that the VFS-Peds provide a sensitive, reliable, and valid measure of listening-related fatigue in children that may be appropriate for clinical use. Such scales could be used to identify those children most affected by listening-related fatigue, and given their apparent sensitivity, the scales may also be useful for examining the effectiveness of potential interventions targeting listening-related fatigue in children., Supplemental Material: https://doi.org/10.23641/asha.19836154.

Purpose: The purpose of this study was to examine if classroom noise levels and perceived listening difficulty were related to fatigue reported by children with and without hearing loss., Method: Measures of classroom noise and reports of classroom listening difficulty were obtained from 79 children (ages 6-12 years) at two time points on two different school days. Forty-four children had mild to moderately severe hearing loss in at least one ear. Multiple regression analyses were conducted to evaluate if measured noise levels, perceived listening difficulty, hearing status, language abilities, or grade level would predict self-reported fatigue ratings measured using the Pediatric Quality of Life Inventory Multidimensional Fatigue Scale., Results: Higher perceived listening difficulty was the only predictor variable that was associated with greater self-reported fatigue., Conclusions: Measured classroom noise levels showed no systematic relationship with fatigue ratings, suggesting that actual classroom noise levels do not contribute to increased reports of subjective fatigue. Instead, perceived challenges with listening appears to be an important factor for consideration in future work examining listening-related fatigue in children with and without hearing loss.

Purpose: Children with hearing loss (CHL) are considered at risk for listening-related fatigue and its negative consequences. We collected data via focus groups and interviews from three stakeholder groups-CHL, their parents, and teachers/school professionals-in order to define the construct of listening-related fatigue from the perspective of CHL and key stakeholders. This is an important first step in our long-term goal to construct and validate a measure (i.e., scale) of listening-related fatigue for the pediatric population, with a focus on CHL. This article provides an overview of the data gathering process, analysis of qualitative reports, and the development of a theoretical framework for understanding the experience of listening-related fatigue in CHL., Method: We conducted focus groups and interviews in school-age children exhibiting bilateral, moderate-to-profound hearing loss ( n = 43), their parents ( n = 17), and school professionals who work with CHL ( n = 28). The discussions were audio-recorded, transcribed, and coded using a hierarchical coding system. Qualitative analysis was conducted using an iterative inductive-deductive approach., Results: We identified primary themes from the focus group/interview discussions to develop a theoretical framework of listening-related fatigue in CHL. The framework demonstrates the complex interaction among situational determinants that impact fatigue, symptoms or manifestations of fatigue, and the utilization of, and barriers to, coping strategies to reduce listening-related fatigue., Conclusions: Participant discussion suggests that listening-related fatigue is a significant problem for many, but not all, CHL. Qualitative data obtained from these stakeholder groups help define the construct and provide a framework for better understanding listening-related fatigue in children.

There is mounting evidence to support the premise that children with hearing loss (CHL) are at increased risk for listening-related fatigue and its associated sequelae. This article provides an overview of the construct of listening-related fatigue in CHL, its importance, possible academic and psychosocial consequences, and recommendations for the identification and management of fatigue associated with pediatric hearing loss., (Copyright © 2021 Elsevier Inc. All rights reserved.)