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1.
Ear Hear ; 2024 Jun 03.
Article in English | MEDLINE | ID: mdl-38825739

ABSTRACT

OBJECTIVES: Assessing listening difficulties and associated complaints can be challenging. Often, measures of peripheral auditory functions are within normal ranges, making clinicians feel unsure about proper management strategies. The range and nature of observed or experienced difficulties might be better captured using a qualitative measure. The Evaluation of Children's Listening and Processing Skills (ECLiPS) questionnaire was designed to broadly profile the auditory and cognitive problems often present in children with listening difficulties. This 38-item questionnaire was initially standardized in British children aged 6 to 11 years, was subsequently modified for use with North-American children, and was recently translated into Flemish-Dutch. This study aimed to compare typical scores of the Flemish version with the UK and US versions, and to evaluate and compare its psychometric quality based on Rasch analysis. DESIGN: We selected 112 Flemish children aged 6 to 11 years with verified normal hearing and typical development, and asked two caregivers of every child to fill out the ECLiPS. Data from two comparator samples were analyzed, including responses for 71 North-American children and 650 British children. Typical values for ECLiPS factors and aggregates were determined as a function of age and gender, and meaningful differences across samples were analyzed. Rasch analyses were performed to evaluate whether ECLiPS response categories work as intended, and whether item scores fit a linear equal interval measurement scale that works the same way for everyone. Item and person metrics were derived, including separation and reliability indices. We investigated whether items function similarly across linguistically and culturally different samples. RESULTS: ECLiPS scores were relatively invariant to age. Girls obtained higher scores compared with boys, mainly for items related to memory and attention, and pragmatic and social skills. Across ECLiPS versions, the most pronounced differences were found for items probing social skills. With respect to its psychometric quality, ECLiPS response categories work as intended, and ECLiPS items were found to fit the Rasch measurement scale. Cultural differences in responses were noted for some items, belonging to different factors. Item separation and reliability indices generally pointed toward sufficient variation in item difficulty. In general, person separation (and reliability) metrics, quantifying the instrument's ability to distinguish between poor and strong performers (in a reproducible manner), were low. This is expected from samples of typically developing children with homogeneous and high levels of listening ability. CONCLUSIONS: Across the languages assessed here, the ECLiPS caregiver questionnaire was verified to be a psychometrically valid qualitative measure to assess listening and processing skills, which can be used to support the assessment and management of elementary school children referred with LiD.

2.
Brain Sci ; 12(6)2022 May 31.
Article in English | MEDLINE | ID: mdl-35741611

ABSTRACT

The Tinnitus Functional Index (TFI) was developed to be responsive to small treatment-related changes in the impact of tinnitus. Yet, no studies have integrated anchor-based and distribution-based techniques to produce a single Minimal Important Change (MIC) score. Here, we evaluated the responsiveness and interpretability of the TFI, determining for the first time a robust MIC score in a UK clinical population. Two-hundred and fifty-five patients with tinnitus participated in this prospective longitudinal validation study. Distribution-based estimates (Standard Error of Measurement, Smallest Detectable Change and Effect size) and anchor-based estimates of important change (minimal clinically important difference and Receiver Operator Curve optimal value) were calculated and then integrated using a visual anchor-based MIC distribution plot. A reduction in score of -14 was determined as the MIC estimate that exceeds the measurement error, most of the variability and reliably identifies patients demonstrating true improvement. It is therefore recommended that a reduction of 14 points should be used as a minimum change required when calculating statistical power and sample size in tinnitus intervention studies and assessing patients in clinical practice.

4.
BMC Health Serv Res ; 20(1): 214, 2020 Mar 14.
Article in English | MEDLINE | ID: mdl-32171314

ABSTRACT

BACKGROUND: Whilst evidence indicates many children experience troublesome tinnitus, specialist services for children are far less established than those available for adults. To date, there is limited understanding of how paediatric tinnitus is managed in the UK, and to what extent current practice reflects what is recommended. This service evaluation aimed to 1) profile how tinnitus in children is managed in UK clinical practice, and assess to what extent care provided by services reflects advice included in the British Society of Audiology (BSA) Tinnitus in Children Practice Guidance, 2) collate clinician opinions on how services may be optimised, and 3) identify common problems experienced by children who present with bothersome tinnitus in clinic. METHODS: As part of a larger survey, eight questions regarding services for paediatric tinnitus were distributed to UK NHS audiology services via email and social media. Representatives from eighty-seven services responded between July and September 2017. RESULTS: Fifty-three percent of respondents reported that their department provided a paediatric tinnitus service. Among these services, there was widespread use of most BSA recommended assessments and treatments. Less widely used practices were the assessment of mental health (42%), and the use of psychological treatment approaches; cognitive behavioural therapy (CBT) (28%), mindfulness (28%), and narrative therapy (14%). There was varied use of measurement tools to assess tinnitus in children, and a minority of respondents reported using adult tinnitus questionnaires with children. Frequently reported tinnitus-related problems presented by children were sleep difficulties, concentration difficulties at school, situation-specific concentration difficulties, and emotional distress. CONCLUSIONS: Approaches used to manage children with troublesome tinnitus in UK NHS services are largely consistent and reflective of the current practice guidance. However, findings from this study indicate specialist staff training, access to child-specific tools, and the treatment and referral of children with tinnitus-related psychological problems represent key areas in need of optimisation.


Subject(s)
Audiology , Child Health Services , State Medicine , Tinnitus/therapy , Child , Health Care Surveys , Health Services Research , Humans , United Kingdom
5.
Int J Pediatr Otorhinolaryngol ; 123: 26-32, 2019 Aug.
Article in English | MEDLINE | ID: mdl-31055204

ABSTRACT

OBJECTIVE: To assess the capacity of two parental report questionnaires, OMQ-14 and ECLiPS, to support clinical-decision making in children affected by Otitis Media with Effusion (OME). DESIGN: OMQ-14 and ECLiPS were administered twice to 90 children aged 2-12 years, three months apart, or 3 months after surgery to insert ventilation tubes (VT). Children were subdivided according to clinical diagnosis into VT (n = 25) and Active Observation (AO; n = 20), and compared with healthy control children (n = 45). Data were analyzed at group level using repeated measures ANOVA, and at individual level using Receiver Operator Characteristics (ROC) curves and confusion matrices. RESULTS: Both OMQ-14 and ECLiPS were sensitive to the presence of OME, and also to improvements in hearing post-surgery. Both were also good at classifying children into their clinically-established diagnostic groups based on score cut-offs determined using Receiver Operator Characteristics (ROC) curves. However, outputs from confusion matrices suggest only around 50% of children after VTs would be indistinguishable from controls following VT surgery. Differences were observed in which children were identified as still having problems according to the questionnaires. OMQ-14 is more sensitive to disease-related hearing loss, while the ECLiPS is more sensitive to developmental difficulties. CONCLUSIONS: Despite being developed with different aims in mind, the OMQ-14 and ECLiPS were similarly sensitive both to symptoms of disease-related hearing difficulty and also to treatment-related improvements in hearing. A significant number of VT children continue to have poor OMQ-14 and ECLiPS scores relative to control children. ECLiPS scores do not always change in a way that hearing improvements would predict, suggesting the ECLiPS is sensitive to wider developmental difficulties. Parental report in the form of narrow or broad-based questionnaires may complement history-taking and audiometry to enhance the quality of discussion between carers and clinicians about OME management.


Subject(s)
Developmental Disabilities/diagnosis , Hearing Loss/diagnosis , Otitis Media with Effusion/diagnosis , Otitis Media with Effusion/therapy , Surveys and Questionnaires , Audiometry , Child , Child, Preschool , Clinical Decision-Making , Decision Support Techniques , Developmental Disabilities/etiology , Female , Hearing Loss/etiology , Humans , Male , Middle Ear Ventilation , Otitis Media with Effusion/complications , Parents , ROC Curve , Watchful Waiting
6.
Int J Pediatr Otorhinolaryngol ; 122: 141-151, 2019 Jul.
Article in English | MEDLINE | ID: mdl-31029948

ABSTRACT

BACKGROUND: The reported prevalence of tinnitus in children is similar to that in adults. However, unlike adults, there is relatively little understanding of the tinnitus-related problems children experience. Knowledge of the problems experienced by adults has led to the development of numerous clinical questionnaires used by health professionals in assessment and treatment practices; to date no child-specific questionnaire measure of tinnitus has been developed. To support development of a questionnaire measure of tinnitus in children, the aim of this scoping review was to catalogue the peer-reviewed and grey scientific literature according to 1) the methods used to identify problems experienced by children with tinnitus, 2) tinnitus-related problems observed in or reported by children, and 3) research recommendations suggested by investigators with regards to tinnitus in children. METHODS: A scoping review was conducted following an established methodological framework. Records were included where a tinnitus-related problem was reported in a child 18 years or younger, and tinnitus was reported as the primary complaint. Tinnitus problems were extracted and categorised into problem themes. RESULTS: Thirty-five records met the inclusion criteria for this review. Methods used to identify tinnitus-related problems in children, and the number and range of problems reported, varied across the records. Symptom impact was summarised according to six problem themes; Physical health, Cognitive health, Hearing and listening, Emotional health, Quality of life, and Feeling different/isolated. Identified research recommendations highlighted a demand for more standardised approaches. CONCLUSIONS: The findings evidence the detrimental impact tinnitus can have on a child's quality of life and emotional wellbeing. The current British Society of Audiology Tinnitus in Children Practice Guidance recommends management practices to address the most broadly reported problems identified in this review; sleep difficulties, emotional difficulties, and concentration and hearing problems at school. Given the finding of this review, we suggest problems relating to the impact of tinnitus on quality of life and feelings of isolation are also important problem domains to consider when managing a child who has tinnitus. Current variability in the approach to identifying children's tinnitus problems underlines the importance of developing a standardised and dedicated measure of tinnitus in children.


Subject(s)
Tinnitus/complications , Child , Child, Preschool , Emotions , Health Status , Hearing , Humans , Quality of Life , Surveys and Questionnaires , Symptom Assessment
7.
Ear Hear ; 40(2): 328-339, 2019.
Article in English | MEDLINE | ID: mdl-29905669

ABSTRACT

OBJECTIVES: The primary aim of this research was to refine and validate the Social Participation Restrictions Questionnaire (SPaRQ). The SPaRQ is a hearing-specific, patient-reported outcome measure that was originally developed through consultation with adults with hearing loss, clinicians, and researchers. This research comprised two studies. Study 1 aimed to assess the psychometric properties of the SPaRQ and to improve these properties by amending the questionnaire (e.g., removing items) as required. Study 2 aimed to validate the refined SPaRQ. DESIGN: In study 1, 279 adults with hearing loss completed a long-form, 53-item SPaRQ. Rasch analysis, a modern psychometric analysis technique, was used to assess a range of psychometric properties for the questionnaire (e.g., unidimensionality, fit to the Rasch model). The properties of the individual items were also assessed (e.g., response dependency, differential item functioning). In study 2, 102 adults with hearing loss completed the refined SPaRQ. In addition, they completed three questionnaires that had been designed to measure related constructs. These were a hearing-specific questionnaire (Hearing Handicap Inventory for the Elderly), a generic health and disability questionnaire (shortened World Health Organization Disability Assessment Schedule 2.0), and a brief depression and anxiety screening questionnaire (Patient Health Questionnaire-4). Traditional psychometric analysis techniques (e.g., Cronbach's alpha) were used to assess the construct validity and internal consistency of the refined SPaRQ. RESULTS: Rasch analysis was used to refine the SPaRQ. The result was a 19-item measure divided into two subscales. The 9-item Social Behaviors subscale measured difficulties with performing actions in a social context due to hearing loss. The 10-item Social Perceptions subscale measured negative thoughts and feelings experienced in a social context due to hearing loss. Both Rasch analysis and the traditional psychometric analysis techniques demonstrated that each subscale had strong psychometric properties. In particular, each subscale passed the test of unidimensionality, displayed good fit to the Rasch model, and had high internal consistency. In addition, it was found that, as predicted, each subscale had strong, positive correlations with the hearing-specific questionnaire and moderate, positive correlations with the generic health and disability questionnaire and the depression and anxiety screening questionnaire. Taken together, these findings support the construct validity of the 19-item SPaRQ. CONCLUSIONS: This was one of the first studies to devise a new hearing-specific outcome measure using Rasch analysis. Rasch analysis proved to be a powerful technique for supporting decisions regarding which items to retain in order to achieve a psychometrically robust questionnaire. Additional support for the robustness of this questionnaire came from the utilization of traditional psychometric analysis techniques. Therefore, this questionnaire has the potential to be used in research and clinical practice to evaluate whether auditory rehabilitation interventions improve social participation in adults with hearing loss. The next stage of this research will be to further validate this questionnaire by assessing its responsiveness in a clinical population. The combined use of modern and traditional psychometric analysis techniques should be considered in future questionnaire development and validation research.


Subject(s)
Hearing Loss/physiopathology , Patient Reported Outcome Measures , Social Participation , Adult , Aged , Aged, 80 and over , Female , Hearing Aids , Hearing Loss/psychology , Hearing Loss/rehabilitation , Humans , Male , Middle Aged , Models, Statistical , Psychometrics , Surveys and Questionnaires , United Kingdom , Young Adult
8.
Ear Hear ; 40(2): 358-367, 2019.
Article in English | MEDLINE | ID: mdl-29965864

ABSTRACT

OBJECTIVES: Musicians appear to have an enhanced ability to perceive speech-in-noise, prompting suggestions that musical training could be used to help people who struggle to communicate in noisy environments. This study assessed the role of sensitivity to beat, rhythm, and melody in supporting speech-in-noise perception. DESIGN: This is an exploratory study based on correlation. The study included 24 normally hearing young adult participants with a wide range of musical training and experience. Formal and informal musical experience was measured with the training subscale of the Goldsmiths' Musical Sophistication Index. Speech reception thresholds (SRT) were measured using the Matrix Sentence Test and three different speech-spectrum-shaped noise maskers: unmodulated and sinusoidally amplitude-modulated (modulation frequency, fm = 8 Hz; modulation depths: 60 and 80%). Primary predictors were measures of sensitivity to beat, rhythm, and melody. Secondary predictors were pure-tone frequency discrimination and auditory working memory (digit span). Any contributions from these two predictors were to be controlled for as appropriate. RESULTS: Participants with more musical experience and greater sensitivity to rhythm, beat, and melody had better SRTs. Sensitivity to beat was more strongly linked with SRT than sensitivity to either rhythm or melody. This relationship remained strong even after factoring out contributions from frequency discrimination and auditory working memory. CONCLUSIONS: Sensitivity to beat predicted SRTs in unmodulated and modulated noise. We propose that this sensitivity maximizes benefit from fluctuations in signal-to-noise ratio through temporal orienting of attention to perceptually salient parts of the signal. Beat perception may be a good candidate for targeted training aimed at enhancing speech perception when listening in noise.


Subject(s)
Music , Noise , Pitch Discrimination/physiology , Speech Perception/physiology , Adult , Audiometry, Pure-Tone , Auditory Perception , Female , Humans , Male , Memory, Short-Term , Speech Reception Threshold Test , Young Adult
9.
Child Youth Serv Rev ; 88: 308-315, 2018 May.
Article in English | MEDLINE | ID: mdl-30323545

ABSTRACT

Formal youth mentoring programs tend to focus on the mentor-mentee dyad as the primary relationship cultivated and supported. The interests and preferences of the parent or caregiver in the mentoring relationship may receive little attention. In this study, semi-structured qualitative interviews were conducted with primary caregivers (N=20) of early adolescent girls participating in a Big Brothers Big Sisters community-based mentoring program to explore reasons why they wanted mentors for their daughters. Thematic analysis revealed that caregivers expected mentors to support their daughters as trusted companions, confidants, and conduits to opportunities and services. In addition, caregivers noted ways in which mentoring offered them respite and reinforced their parenting. The findings highlight the potential value of assessing caregiver perspectives and priorities so that program staff and mentors can partner more effectively with youth and families for successful mentoring experiences.

10.
Sci Rep ; 8(1): 6985, 2018 05 03.
Article in English | MEDLINE | ID: mdl-29725027

ABSTRACT

(Central) auditory processing disorder ((C)APD) is a controversial diagnostic category which may be an artefact of referral route. Yet referral route must, to some extent, be influenced by a child's profile of presenting symptoms. This study tested the hypothesis that parental perception of listening difficulty is associated with weaknesses in ability to sustain attention while listening to speech. Forty-four children (24 with listening difficulties) detected targets embedded in a 16-minute story. The targets were either mispronunciations or nonsense words. Sentence context was modulated to separate out effects due to deficits in language processing from effects due to deficits in attention. Children with listening difficulties missed more targets than children with typical listening abilities. Both groups of children were initially sensitive to sentence context, but this declined over time in the children with listening difficulties. A report-based measure of language abilities captured the majority of variance in a measure capturing time-related changes in sensitivity to context. Overall, the findings suggest parents perceive children to have listening, not language difficulties, because weaknesses in language processing only emerge when stressed by the additional demands associated with attending to, and processing, speech over extended periods of time.


Subject(s)
Attention Deficit Disorder with Hyperactivity/etiology , Attention Deficit Disorder with Hyperactivity/pathology , Auditory Perceptual Disorders/diagnosis , Auditory Perceptual Disorders/pathology , Parents/psychology , Perception , Child , Female , Humans , Male , Time Factors
11.
Hear Res ; 358: 74-85, 2018 Feb.
Article in English | MEDLINE | ID: mdl-29129348

ABSTRACT

OBJECTIVES: The Tinnitus Functional Index (TFI) has been optimised as a diagnostic tool for quantifying the functional impact of tinnitus in US veteran and civilian groups. However, the TFI has not been fully evaluated for use in other English-speaking clinical populations despite its increasingly popular uptake. Here, a prospective multi-site longitudinal validation study was conducted to evaluate psychometric properties relevant to the UK clinical population. Guided by quality criteria for the measurement properties of health-related questionnaires, we specifically evaluated three diagnostic properties relating to the degree to which the TFI (i) covers the eight dimensions proposed to be important for diagnosis, (ii) reliably distinguishes individual differences in severity of tinnitus, and (iii) reliably measures the functional impact of tinnitus. We also examine whether clinically meaningful interpretations of the scores can be produced for the UK population. METHODS: Twelve National Health Service audiology clinics across the UK recruited 255 tinnitus patients to complete questionnaires at four time-intervals, from initial clinical assessment and then over a nine-month period. Patients completed the TFI, the Tinnitus Handicap Inventory (THI), tinnitus case history questions, a Global rating of Perceived Problem with tinnitus and a Clinical Global Impression of perceived change in tinnitus. Baseline TFI data were used to examine the factor structure, construct validity and interpretability of the TFI. Follow-up TFI data were used to examine reliability. RESULTS: Confirmatory factor analysis suggested that of the eight subscales (factors) initially established for the TFI, the 'Auditory' subscale did not contribute to the overall construct 'functional impact of tinnitus', and a modified seven-factor model (TFI-22) better fit the variance in the patient scores. Both the global 25-item TFI and the global TFI-22 scores showed exceptionally high internal consistency (α ≥ 0.95), high construct validity with the THI (r = 0.80) and high test-retest reliability (ICC = 0.87). Test-retest agreement however was only deemed to be borderline acceptable (89%). Receiver Operator Characteristic analysis indicated the 25-item TFI and TFI-22 has excellent ability to distinguish between different levels of impact (Area under the curve > 0.7). CONCLUSION: The TFI was confirmed to cover multiple symptom domains, measuring a multi-domain construct of tinnitus, and satisfies a range of psychometric requirements for a good clinical measure, including having excellent reliability, stability over time and sensitivity to individual differences in tinnitus severity. However, a modified seven-factor structure without the Auditory subscale (TFI-22) is recommended for calculating a global composite score for UK patients. Using patients' experience and Receiver Operator Characteristic analysis, a grading system was presented which identifies the distinct grades of tinnitus impact in the UK clinical population that is broadly comparable to the US-based system.

13.
Int J Pediatr Otorhinolaryngol ; 86: 93-6, 2016 Jul.
Article in English | MEDLINE | ID: mdl-27260589

ABSTRACT

INTRODUCTION: Many different OME treatment trials have been published using different outcomes measures to evaluate the success of particular interventions. We set out to identify the variation in reporting of outcome measures in OME trials that exists at present. This has been achieved by reviewing published trials to determine which outcome measures have been reported. METHOD: The literature review was carried out using PUBMED database (1980 to 2013). Data were collected on the treatment outcomes reported, with particular focus on the methods of assessment and the number of treatment outcomes used in each study. RESULTS: The 171 studies identified used 12 broad treatment outcome measures. The most common outcome measure was OME resolution (48%) followed by hearing level (36%). Only 95 studies used a single outcome measure, with 76 studies using between 2 and 4 outcome measures. The method of assessment varied between studies that used the same treatment outcome measures. CONCLUSION: OME treatment trials report a wide range of measures and comparison across studies is thus difficult. Establishing a core set of outcome measures to be reported by all trials in the future could be useful, and would allow comprehensive comparison of different studies and minimise potential for reporting bias.


Subject(s)
Clinical Trials as Topic , Otitis Media with Effusion/therapy , Outcome Assessment, Health Care , Humans
15.
J Speech Lang Hear Res ; 59(3): 501-10, 2016 06 01.
Article in English | MEDLINE | ID: mdl-27124083

ABSTRACT

PURPOSE: Continuous performance tasks (CPTs) are used to measure individual differences in sustained attention. Many different stimuli have been used as response targets without consideration of their impact on task performance. Here, we compared CPT performance in typically developing adults and children to assess the role of stimulus processing on error rates and reaction times. METHOD: Participants completed a CPT that was based on response to infrequent targets, while monitoring and withholding responses to regular nontargets. Performance on 3 stimulus conditions was compared: visual letters (X and O), their auditory analogs, and auditory pure tones. RESULTS: Adults showed no difference in error propensity across the 3 conditions but had slower reaction times for auditory stimuli. Children had slower overall reaction times. They responded most quickly to the visual target and most slowly to the tone target. They also made more errors in the tone condition than in either the visual or the auditory spoken CPT conditions. CONCLUSIONS: The results suggest error propensity and reaction time variations on CPTs cannot solely be interpreted as evidence of inattention. They also reflect stimulus-specific influences that must be considered when testing hypotheses about modality-specific deficits in sustained attention in populations with different developmental disorders.


Subject(s)
Attention , Auditory Perception , Neuropsychological Tests , Visual Perception , Acoustic Stimulation , Adolescent , Adult , Aging/psychology , Child , Female , Humans , Male , Memory, Short-Term , Middle Aged , Photic Stimulation , Psychology, Child , Reaction Time , Young Adult
16.
Int J Audiol ; 55 Suppl 3: S3-S12, 2016 07.
Article in English | MEDLINE | ID: mdl-26754550

ABSTRACT

OBJECTIVE: This study explored the psychosocial experiences of adults with hearing loss using the self-regulatory model as a theoretical framework. The primary components of the model, namely cognitive representations, emotional representations, and coping responses, were examined. DESIGN: Individual semi-structured interviews were conducted. The data were analysed using an established thematic analysis procedure. STUDY SAMPLE: Twenty-five adults with mild-moderate hearing loss from the UK and nine hearing healthcare professionals from the UK, USA, and Canada were recruited via maximum variation sampling. RESULTS: Cognitive representations: Most participants described their hearing loss as having negative connotations and consequences, although they were not particularly concerned about the progression or controllability/curability of the condition. Opinions differed regarding the benefits of understanding the causes of one's hearing loss in detail. Emotional representations: negative emotions dominated, although some experienced positive emotions or muted emotions. Coping responses: engaged coping (e.g. hearing aids, communication tactics) and disengaged coping (e.g. withdrawal from situations, withdrawal within situations): both had perceived advantages and disadvantages. CONCLUSIONS: This novel application of the self-regulatory model demonstrates that it can be used to capture the key psychosocial experiences (i.e. perceptions, emotions, and coping responses) of adults with mild-moderate hearing loss within a single, unifying framework.


Subject(s)
Auditory Perception , Hearing Loss/psychology , Models, Psychological , Persons With Hearing Impairments/psychology , Psychosocial Deprivation , Self-Control , Adaptation, Psychological , Adult , Aged , Aged, 80 and over , Cognition , Cost of Illness , Emotions , Female , Health Knowledge, Attitudes, Practice , Hearing Loss/diagnosis , Humans , Interviews as Topic , Male , Middle Aged , Qualitative Research , Severity of Illness Index , Young Adult
17.
Hear Res ; 335: 220-235, 2016 05.
Article in English | MEDLINE | ID: mdl-26415998

ABSTRACT

OBJECTIVES: Questionnaires are essential for measuring tinnitus severity and intervention-related change but there is no standard instrument used routinely in research settings. Most tinnitus questionnaires are optimised for measuring severity but not change. However, the Tinnitus Functional Index (TFI) claims to be optimised for both. It has not however been fully validated for research purposes. Here we evaluate the relevant psychometric properties of the TFI, specifically the questionnaire factor structure, reproducibility, validity and responsiveness guided by quality criteria for the measurement properties of health-related questionnaires. METHODS: The study involved a retrospective analysis of data collected for 294 members of the general public who participated in a randomised controlled trial of a novel tinnitus device (ClinicalTrials.gov Identifier: NCT01541969). Participants completed up to eight commonly used assessment questionnaires including the TFI, Tinnitus Handicap Inventory (THI), Tinnitus Handicap Questionnaire (THQ), a Visual Analogue Scale of loudness (VAS-Loudness), Percentage Annoyance question, the Beck's Depression Inventory (BDI), Beck's Anxiety Inventory (BAI), and the World Health Organisation Quality of Life-Bref (WHOQOL-BREF). A series of analyses assessed the study objectives. Forty four participants completed the TFI at a second visit (within 7-21 days and before receiving any intervention) providing data for reproducibility assessments. RESULTS: The 8-factor structure was not fully confirmed for this general (non-clinical) population. Whilst it was acceptable standalone subscale, the 'auditory' factor showed poor loading with the higher order factor 'functional impact of tinnitus'. Reproducibility assessments for the overall TFI indicate high internal consistency (α = 0.80) and extremely high reliability (ICC: 0.91), whilst agreement was borderline acceptable (93%). Construct validity was demonstrated by high correlations between scores on the TFI and THI (r = 0.82) and THQ (r = 0.82), moderate correlations with VAS-L (r = 0.46), PR-A (r = 0.58), BDI (r = 0.57), BAI (r = 0.39) and WHOQOL (r = -0.48). Floor effects were observed for more than 50% of the items. A smallest detectable change score of 22.4 is proposed for the TFI global score. CONCLUSION: Even though the proposed 8-factor structure was not fully confirmed for this population, the TFI appears to cover multiple symptom domains, and to measure the construct of tinnitus with an excellent reliability in distinguishing between patients. While the TFI may discriminate those whose tinnitus is not a problem, floor effects in many items means it is less appropriate as a measure of change in this subgroup. Further investigation is needed to determine whether these effects are relevant in other populations.


Subject(s)
Psychometrics/methods , Tinnitus/diagnosis , Adolescent , Adult , Aged , Aged, 80 and over , Anxiety/complications , Depression/complications , Female , Humans , Male , Middle Aged , Quality of Life , Reproducibility of Results , Research Design , Retrospective Studies , Severity of Illness Index , Surveys and Questionnaires , Tinnitus/psychology , Volunteers , Young Adult
18.
Ear Hear ; 36(6): e300-13, 2015.
Article in English | MEDLINE | ID: mdl-26002277

ABSTRACT

OBJECTIVES: In this study, the authors assessed the potential utility of a recently developed questionnaire (Evaluation of Children's Listening and Processing Skills [ECLiPS]) for supporting the clinical assessment of children referred for auditory processing disorder (APD). DESIGN: A total of 49 children (35 referred for APD assessment and 14 from mainstream schools) were assessed for auditory processing (AP) abilities, cognitive abilities, and symptoms of listening difficulty. Four questionnaires were used to capture the symptoms of listening difficulty from the perspective of parents (ECLiPS and Fisher's auditory problem checklist), teachers (Teacher's Evaluation of Auditory Performance), and children, that is, self-report (Listening Inventory for Education). Correlation analyses tested for convergence between the questionnaires and both cognitive and AP measures. Discriminant analyses were performed to determine the best combination of tests for discriminating between typically developing children and children referred for APD. RESULTS: All questionnaires were sensitive to the presence of difficulty, that is, children referred for assessment had significantly more symptoms of listening difficulty than typically developing children. There was, however, no evidence of more listening difficulty in children meeting the diagnostic criteria for APD. Some AP tests were significantly correlated with ECLiPS factors measuring related abilities providing evidence for construct validity. All questionnaires correlated to a greater or lesser extent with the cognitive measures in the study. Discriminant analysis suggested that the best discrimination between groups was achieved using a combination of ECLiPS factors, together with nonverbal Intelligence Quotient (cognitive) and AP measures (i.e., dichotic digits test and frequency pattern test). CONCLUSIONS: The ECLiPS was particularly sensitive to cognitive difficulties, an important aspect of many children referred for APD, as well as correlating with some AP measures. It can potentially support the preliminary assessment of children referred for APD.


Subject(s)
Auditory Perceptual Disorders/diagnosis , Cognition Disorders/diagnosis , Faculty , Parents , Self Report , Case-Control Studies , Checklist , Child , Cognition , Dichotic Listening Tests , Discriminant Analysis , Female , Hearing Tests , Humans , Intelligence Tests , Male , Surveys and Questionnaires
19.
J Neurophysiol ; 113(10): 3683-91, 2015 Jun 01.
Article in English | MEDLINE | ID: mdl-25787954

ABSTRACT

The speech-evoked auditory brain stem response (speech ABR) is widely considered to provide an index of the quality of neural temporal encoding in the central auditory pathway. The aim of the present study was to evaluate the extent to which the speech ABR is shaped by spectral processing in the cochlea. High-pass noise masking was used to record speech ABRs from delimited octave-wide frequency bands between 0.5 and 8 kHz in normal-hearing young adults. The latency of the frequency-delimited responses decreased from the lowest to the highest frequency band by up to 3.6 ms. The observed frequency-latency function was compatible with model predictions based on wave V of the click ABR. The frequency-delimited speech ABR amplitude was largest in the 2- to 4-kHz frequency band and decreased toward both higher and lower frequency bands despite the predominance of low-frequency energy in the speech stimulus. We argue that the frequency dependence of speech ABR latency and amplitude results from the decrease in cochlear filter width with decreasing frequency. The results suggest that the amplitude and latency of the speech ABR may reflect interindividual differences in cochlear, as well as central, processing. The high-pass noise-masking technique provides a useful tool for differentiating between peripheral and central effects on the speech ABR. It can be used for further elucidating the neural basis of the perceptual speech deficits that have been associated with individual differences in speech ABR characteristics.


Subject(s)
Cochlea/physiology , Evoked Potentials, Auditory, Brain Stem/physiology , Mass Spectrometry , Reaction Time/physiology , Speech , Acoustic Stimulation , Adolescent , Adult , Electroencephalography , Female , Humans , Male , Psychoacoustics , Young Adult
20.
J Interpers Violence ; 30(4): 580-600, 2015 Feb.
Article in English | MEDLINE | ID: mdl-24923891

ABSTRACT

The purpose of this study was to estimate the 6-month incidence rates of sexual assault, physical dating violence (DV), and unwanted pursuit (e.g., stalking) victimization among sexual-minority (i.e., individuals with any same-sex sexual experiences) college students with comparison data from non-sexual-minority (i.e., individuals with only heterosexual sexual experiences) college students. Participants (N = 6,030) were primarily Caucasian (92.7%) and non-sexual-minority (82.3%). Compared with non-sexual-minority students (N-SMS; n = 4,961), sexual-minority students (SMS; n = 1,069) reported significantly higher 6-month incidence rates of physical DV (SMS: 30.3%; N-SMS: 18.5%), sexual assault (SMS: 24.3%; N-SMS: 11.0%), and unwanted pursuit (SMS: 53.1%; N-SMS: 36.0%) victimization. We also explored the moderating role of gender and found that female SMS reported significantly higher rates of physical DV than female N-SMS, whereas male SMS and male N-SMS reported similar rates of physical DV. Gender did not moderate the relationship between sexual-minority status and victimization experiences for either unwanted pursuit or sexual victimization. These findings underscore the alarmingly high rates of interpersonal victimization among SMS and the critical need for research to better understand the explanatory factors that place SMS at increased risk for interpersonal victimization.


Subject(s)
Courtship/psychology , Crime Victims/statistics & numerical data , Heterosexuality/psychology , Homosexuality/psychology , Sex Offenses/statistics & numerical data , Violence/statistics & numerical data , Adolescent , Adult , Female , Humans , Incidence , Male , Young Adult
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