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Purpose We aimed to develop and validate the Musicians' Hearing Handicap Index (MHHI), a new self-evaluation tool for quantifying occupation-related auditory difficulties in music professionals. Although pure-tone audiometry is often considered the “gold standard” and is usually employed as the main instrument for hearing assessment, it cannot fully describe the impact of hearing dysfunction. The MHHI is an attempt to complement the hearing impairment assessment toolbox and is based on a unique approach to quantify the effects of hearing-related symptoms or hearing loss on the performance of musicians and other music industry professionals. Method An initial set of 143 questionnaire items was successively refined through a series of critical appraisals, modifications, and suggestions. This yielded an intermediate questionnaire consisting of 43 items, which was administered to 204 musicians and sound engineers. After exploratory factor analysis, the final form of the MHHI questionnaire was obtained, consisting of 29 items. The questionnaire's test–retest reliability, internal consistency, discriminating power, content validity, criterion validity, and aspects of construct validity and inherent conceptual structure were assessed. Results Exploratory factor analysis revealed a combination of four common factors for the 29 validated questionnaire items. They were named “impact on social and working lives,” “difficulties in performance and sound perception,” “communication difficulties,” and “emotional distress.” The MHHI was shown to be a valid and reliable instrument to assess musicians' and sound engineers' occupational difficulties due to hearing impairment and related symptoms. Conclusion The ability of the MHHI to discriminate between groups of music professionals with different auditory symptoms or pure-tone audiometry thresholds suggests that auditory symptoms might influence a professional's performance to an extent that cannot be assessed by a pure-tone audiogram.

PURPOSE: This study evaluates initial validity and reliability of the "Galker test of speech reception in noise" developed for Danish preschool children suspected to have problems with hearing or understanding speech against strict psychometric standards and assesses acceptance by the children.METHODS: The Galker test is an audio-visual, computerised, word discrimination test in background noise, originally comprised of 50 word pairs. Three hundred and eighty eight children attending ordinary day care centres and aged 3-5 years were included. With multiple regression and the Rasch item response model it was examined whether the total score of the Galker test validly reflected item responses across subgroups defined by sex, age, bilingualism, tympanometry, audiometry and verbal comprehension.RESULTS: A total of 370 children (95%) accepted testing and 339 (87%) completed all 50 items. The analysis showed that 35 items fitted the Rasch model. Reliability was 0.75 before and after exclusion of the 15 non-fitting items. In the stepwise linear regression model age group of children could explain 20% of the variation in Galker-35-score, sex 1%, second language at home 4%, tympanometry in best ear 2%, and parental education another 2%. Other variable did not reach significance.CONCLUSION: The Galker-35 was well accepted by children down to the age of 3 years and results indicate that the scale represents construct valid and reliable measurement.

OBJECTIVES: The Occupational Earcheck (OEC) is an online internet test to detect high-frequency hearing loss for the purposes of occupational hearing screening. In this study, we evaluated the OEC in an occupational setting in order to assess test sensitivity, specificity, and validity. METHODS: A cross-sectional study was conducted in 2015, in which the optimized OEC was evaluated on 94 employees from the army and three different companies in construction and manufacturing. Subjects underwent OEC in an office-like room. Pure-tone air conduction audiometry was performed as a reference test. The OEC was repeated for a subset of subjects (N=19). Important test characteristics (ie, sensitivity and specificity, test validity, and test–retest reliability) were assessed. RESULTS: When analyzed on the individual level, the sensitivity and specificity of OEC were 90% and 77%, respectively. The speech reception threshold results correlated strongly with the pure-tone average of the frequencies 3, 4 and 6 kHz, reflecting good test validity (r=0.79). The difference between test and retest was not significant. The intra-class correlation coefficient was moderate (r=0.57), indicating a reasonable agreement between test and retest. CONCLUSIONS: The OEC appears to be a suitable test for the detection of high-frequency hearing loss among noise-exposed employees, with good sensitivity and specificity values, even when performed in a semi-controlled occupational setting, though a possible learning effect should be taken into account.

OBJECTIVE: The speech, spatial, and qualities of hearing questionnaire (SSQ) is a self-report test of auditory disability. The 49 items ask how well a listener would do in many complex listening situations illustrative of real life. The scores on the items are often combined into the three main sections or into 10 pragmatic subscales. We report here a factor analysis of the SSQ that we conducted to further investigate its statistical properties and to determine its structure. DESIGN: Statistical factor analysis of questionnaire data, using parallel analysis to determine the number of factors to retain, oblique rotation of factors, and a bootstrap method to estimate the confidence intervals. STUDY SAMPLE: 1220 people who have attended MRC IHR over the last decade. RESULTS: We found three clear factors, essentially corresponding to the three main sections of the SSQ. They are termed "speech understanding", "spatial perception", and "clarity, separation, and identification". Thirty-five of the SSQ questions were included in the three factors. There was partial evidence for a fourth factor, "effort and concentration", representing two more questions. CONCLUSIONS: These results aid in the interpretation and application of the SSQ and indicate potential methods for generating average scores.

Objectives/Hypothesis To study hearing status and quality of life outcomes in patients with conductive hearing loss (CHL), and to develop a prognostic disease severity staging system for use in future clinical outcomes studies in CHL. Study Design Clinical outcomes research study in three stages: 1) Prospective development and psychometric validation of a disease-specific hearing status outcomes instrument for CHL. 2) Prospective observational outcomes study of patient-based hearing status and quality of life (QOL) outcomes after treatment of CHL. 3) Development of a prognostic disease-severity staging system to stratify patients into groups of similar treatment outcome. Methods Psychometric instrument validation: assessment of test–retest reliability, internal consistency reliability, content, construct and criterion validity, and responsiveness to change. Statistical assessment of the impact of CHL on patient-based hearing status and QOL, and the change in hearing status and QOL after treatment. Using data from the prospective study and multivariate regression, identification of pretreatment independent variables, which predict good outcome after treatment, and development of a severity staging system. Results Test–retest reliability (r >0.70) and internal consistency reliability (α >0.70) were adequate for both subscales of the hearing status instrument. Construct validity was demonstrated by adequate convergent/divergent validity with other health status instruments on multi-item multitrait correlation matrixes. Criterion validity was demonstrated using audiometric threshold data. Responsiveness to change was demonstrated using the standardized response mean after treatment (SRM = 0.40 and 0.61 for the two subscales). Emotional hearing status and social/situational hearing status improved significantly after treatment of CHL: emotional score, 31.1 to 56.6 (P

The study aims to develop a test of speech reception disability under simulated classroom conditions for use in young (5-8 year old) schoolchildren, to manage children with otitis media with effusion more effectively. A new video test, TADAST (Two Alternative Auditory Disability and Speech Reception Test), has been constructed in stages by extensively modifying the FADAST (Four Alternative) currently used to assess auditory disability in adults. Minimal word pair lists which were easily identifiable in picture form were developed and refined, and then formulated as a two alternative forced choice picture test. The distribution characteristics of the new test were defined in 89 schoolchildren with and without otitis media with effusion (OME) and compared with pure-tone audiometry performed at the same time. The test correlated highly with audiometry in older children. The distribution characteristics revealed a considerable proportion of children with bilateral OME with little functional disability who might otherwise be at risk of surgery. The test appeared to be sensitive to a 'history of OME' effect. Further refinements are needed to develop a final version which could also be used to evaluate hearing disability in 4-year-old children.

This study investigated the screening efficiency of a descending version of Hattler's Lengthened Off-time (LOT) Bekesy test. The Descending LOT (DELOT) test was administered to 24 subjects who presented unequivocal audiometric evidence of functional hearing loss during clinical examinations and 30 subjects with no audiometric evidence of functional loss. The DELOT format substantially increased screening sensitivity: 29.2% more functional group subjects and 42.2% more functional group ears were identified correctly relative to LOT test identifications. There was one marginally positive DELOT outcome involving one ear in the nonfunctional group. The high sensitivity of the DELOT test was clearly a function of significantly larger intertrace gaps caused by the DELOT trace. The mean intertrace gap for the DELOT test was more than 10 dB greater than the gap for the LOT test.

This study investigated the feasibility of a prerecorded speech threshold procedure that was used in a picture-pointing format, and was administered to Spanish-speaking children by non-Spanish-speaking clinicians. The derived Spanish word list was compared for equivalency to English spondees on a group of bilingual adults. The test, administered to 16 children ages three to six years, resulted in good agreement between SRT and pure-tone average. The test was found to be feasible, rapid, and reliable.

This investigation examined the effect of kindergarten experience on the performance of two groups of children on the Bankson Language Screening Test. One group of children was tested at the beginning of their kindergarten experience and a second group was tested five months later. Performance of the two groups on the Bankson was determined to be significantly different, independent of age. The different performance pattern for each group is described as well as the possible implications. There may be a need for different sets of language test norms for children with kindergarten experience and for children without this experience.

The efficiency of the Verbal Auditory Screening for Children (VASC) compared to a pure-tone threshold test as a technique to identify hearing impairment among preschool children was investigated with 162 subjects. The VASC-1 test correctly identified 84.6% of the total subjects. Of the 41 subjects failed by the pure-tone threshold test, 48.8% were missed by the VASC-1. An analysis of the average hearing threshold loss for 500–2000 Hz or the ears misclassified by the VASC-1 revealed 83.3% ranged from 0 to 13 dB. The VASC-1 and the verbal portion of the VASC-2 appear to be fairly equivalent forms.

Kreul et al. (1968), using three talkers at three speech-to-noise differentials (levels), recorded six of the House et al. (1963, 1965) Modified Rhyme word lists (MRT) for clinical use. Copies of these recordings were sent to several laboratories for further validation studies. Scores from 27 normal listeners from San Diego State College were 2–3% lower than the scores of 75, 83, and 96% found by Kruel et al. (1968). Averaging for all levels and talkers yielded no statistically significant differences among lists. However, there were differences between lists (talkers) within levels. The speech-to-noise differential should conceivably be altered slightly for certain talkers at certain levels to make the list more homogeneous.

This paper describes an audiologic test battery for hearing-impaired children which includes otoscopic examination, tympanometry, pure-tone audiometry, speech perception testing, and hearing aid evaluation. Several of the procedures and modifications to apparatus have been developed specifically for use with deaf children. Clinical data are presented from 160 hearing-impaired children (age range three-16 years). Eighteen percent of their ears were found to contain excessive cerumen and to require ear canal irrigation. The incidence of abnormal tympanograms was high for young children but decreased with increasing age. A simple auditory speech perception test designed for use with both severely and profoundly deaf children is described, which provides for evaluation of a child’s ability to recognize words, categorize them into stress patterns, or both. The children’s word recognition and word categorization scores were found to relate to their audiometric averages. The overall test battery is easy to administer and also is efficient, in that considerable audiologic information can be obtained quickly.

The LOT test was administered to 100 normal-hearing subjects ranging in age from seven years, six months to 10 years, six months. The test was conducted at 500, 1000, 2000, and 4000 Hz with 99 subjects who were able to perform the required task. The LOT test misclassified (false-positive result) only 4% of the normal-hearing children at 1000 Hz. The test misclassified 3% at 2000 Hz, 3% at 4000 Hz, and 14% at 500 Hz. A new criterion for the use of the LOT test with children is proposed which reduces the percentage of misclassification to 2% at 1000, 2000, and 4000 Hz. The frequency of 500 Hz is not recommended for the preadolescent population.

Experience with patient-controlled audiometers in a clinical setting suggests that group testing can be accomplished satisfactorily with most adult subjects. Some of the findings and a comparison of results obtained with automatic and conventional audiometry are presented as a basis for evaluating this means of auditory screening. Generally, the findings justify the use of automatic screening audiometry as one means of handling large numbers of patients with relative convenience and economy. Certain problems inherent in the procedure appear to make it impractical for some clinical patients.

The reliability and intercorrelations of selected lists from the clinical version of the Modified Rhyme Test (MRT) were examined using normal-hearing young listeners and older listeners believed to have incurred noise-induced hearing loss. Stability of means and variances was generally acceptable for the lists of the MRT, but the reliability coefficients and intercorrelations were generally low. In its present state, the clinical MRT appears to lack the precision to discriminate among normal young listeners, if normal young listeners really do differ in speech discrimination ability with a closed response set. We do not yet have adequate knowledge of the range of expected normal performance for the MRT. The MRT appears far more reliable when used with a much more heterogeneous hearing loss population.