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® 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.

LittlEARS auditory questionnaire as an infant hearing screening in Germany after the newborn hearing screening.

Objective: To investigate the feasibility of using the LittlEARS® Auditory Questionnaire (LEAQ®) as part of the infant hearing screening programme in Germany. Design: LEAQ®s were distributed to 47 paediatric practices and were completed by the parents/guardians of the infants (aged between 9-14 months) involved in the study (= LEAQ® screening). The infants who failed the LEAQ® screening were invited to a LEAQ rescreening. Infants who failed the LEAQ® rescreening were sent to a paediatric ENT specialist. After 3 years, a follow-up was performed on two groups: the first group comprised infants who failed the LEAQ screening; the second group (control group) comprised 200 infants who passed the LEAQ screening. Study Sample: 5316 questionnaires were returned. Results: Six infants with permanent hearing loss were identified using the LEAQ® as a screening tool. Conclusions: An infant hearing screening using the LEAQ® is easily implementable in paediatric practices and may be a good alternative in countries where no objective screening instruments are available. The LEAQ® was suitable for monitoring hearing development in infants in general and could help to identify a late-onset or progressive hearing loss in infants.

Frequency-specific Animal Sound Test (FAST) 4: A valid method for hearing screening.

OBJECTIVES: It is essential to monitor hearing status in children not only as a mandatory requirement during universal newborn hearing screening (UNHS), but also later during preschool and school-age development. The present study considers the appropriateness of the Frequency-specific Animal Sound Test (FAST4) for use in children between the ages of 2.5 and 10 years; the comparability of hearing thresholds determined using FAST4 and those measured by pure tone audiometry (PTA); and the clinical and diagnostic utility of FAST4 in a variety of pediatric settings. METHODS: 322 children aged 2.6-14.1 years and 41 adults were tested with FAST4. Four animal sounds were presented via headphones and a hearing threshold was determined for the high and low frequency range. In addition, the hearing threshold of each child was measured by PTA. RESULTS: Results were analyzed from 156 normal-hearing and hearing-impaired children, mostly above the age of 4 years. In general, FAST4 yielded hearing levels comparable with those from PTA in children and in adults. FAST4 frequently had to be halted prematurely in children under 4 years old. CONCLUSIONS: FAST4 is a strong candidate for use as an instrument for preschool hearing screening and offers several advantages over other hearing tests. FAST4 permits simple, swift and efficient determination of the hearing threshold and the test can be administered by staff without specialist training. A number of improvements have already been integrated into the successor model known as mFAST.

Evaluation of auditory development in infants and toddlers who received cochlear implants under the age of 24 months with the LittlEARS) Auditory Questionnaire.

BACKGROUND AND AIMS: Newborn hearing screening and early intervention for congenital hearing loss have created a need for tools assessing the hearing development of very young children. A multidisciplinary evaluation of children's development is now becoming standard in clinical practice, though not many reliable diagnostic instruments exist. For this reason, the LittlEARS Auditory Questionnaire (LEAQ) was created to assess the auditory skills of a growing population of infants and toddlers who receive hearing instruments. The LEAQ relies on parent report, which has been shown to be a reliable way of assessing child development. Results with this tool in a group of children who received very early cochlear implantation are presented. METHODS: The LEAQ is the first module of the LittlEARS comprehensive test battery for children under the age of two who have normal hearing (NH), cochlear implants (CIs) or hearing aids (HAs). The LEAQ is a parent questionnaire comprised of 35 "yes/no" questions which can be completed by parents in less than 10 min. Sixty-three children who received unilateral CIs at a young age were assessed longitudinally and their performance was compared to that of a NH group. RESULTS: All CI children reached the maximum possible score on the LEAQ on average by 22 months of hearing age, i.e. 38 months of chronological age. In comparison, the NH group reached the maximum score by 24 months of age demonstrating that auditory skills of CI children often develop quicker than those of NH children. In the two comparison groups of children aged (a) younger and older than 12 months, and (b) between 6-9 and 21-24 months at first fitting, the early implanted children reached the highest scores faster than the later implanted children. Furthermore, three children with additional needs were tested. They showed slower growth over time but also received benefits from early implantation. CONCLUSIONS: The LEAQ is a quick and effective tool for assessing auditory skills of very young children with or without hearing loss. In our study, the auditory skills of children with CI progressed very quickly after implantation and were comparable with those of NH peers.