1. Modernising Children’s Hearing Aid Services Evaluation Questionnaires LIFE-UK IHP LSQPEACH MCHAS Modernising Children’s Hearing Aid Services Wave 4 EJB 17/05/04

2. Modernising Children’s Hearing Aid Services Recommended Questionnaires  MCHAS Recommend the following  School age  LIFE (Listening Inventory for Education—UK) (Canning)  ToD/teacher and child  LSQ-P (Listening Situations Questionnaire for Parents) (IHR, Grimshaw)  Parent  Pre-school  PEACH (Parents’ Evaluation of the Aural performance of Children) (NAL)  ToD and parent

3. Modernising Children’s Hearing Aid Services Listening Inventories For Education UK Individual Hearing Profile (LIFE-UK IHP)  Adapted from Dave Canning City University (original version www.hear2learn.com) www.hear2learn.com  Completed by child (with TOD help) Age 5-7+  Designed to isolate issues regarding  Listening in noise and quiet  With/without lipreading  Present version has 18 situations  Used in 1 st wave studies  Identified differences in analogue & DSP HA

4. Modernising Children’s Hearing Aid Services These prompts were added to clarify situation

5. Modernising Children’s Hearing Aid Services

7. 4 3 3 4 3 4 2 4 5 2 2 2 2 3 3 3 4 4 2 11 5 17 77 4 4Comment Always Easy Mostly Easy Sometimes Difficult Mostly Difficult Always Difficult Score12345

8. Modernising Children’s Hearing Aid Services Consider FM if not wearing one If wearing FM, check function/balance Check position in class, room acoustics, counselling with teacher etc Child relies on lip reading, particularly in noise

9. Modernising Children’s Hearing Aid Services LIFE-IHP UK Scoring on a PMS

10. Modernising Children’s Hearing Aid Services Listening Situations Questionnaire (LSQ-P)  Designed by MRC Institute of Hearing Research  Used in 1 st wave studies  Parents were positive  Involves 10 listening situations  Deemed to be most important for HI child  Great deal of validation undertaken  Administered by Teacher (or Health ?)  Completed by parents of children  MCHAS reviewing questions & photos

11. Modernising Children’s Hearing Aid Services

12. Modernising Children’s Hearing Aid Services

13. Modernising Children’s Hearing Aid Services

14. Modernising Children’s Hearing Aid Services LSQ Scoring  Very Important/Very Often/ A great dealScore 4  Important/ Often/ Quite a lotScore 3  Slightly Important/ Sometimes/ A LittleScore 2  Not at all important/ Hardly ever/ None at allScore 1  If answers ‘Never wears an aid’, prompt to see if this is because child experiences ‘A great deal of difficulty’ or ‘No difficulty at all’ and score accordingly  Overall Score Minimum= 30, Maximum=120  Overall Scores over 100 need examination of hearing provision  Difficulty Scores of over 22 need examination of listening situations in which child experiences difficulties, and examination of hearing provision

15. Modernising Children’s Hearing Aid Services LSQ-P Scoring Total Overall Score __________________________________ 35 3423 35+34+23 = 92 Total Difficulty Score __________________________________ 23

16. Modernising Children’s Hearing Aid Services LSQ-P Scoring on PMS

17. Modernising Children’s Hearing Aid Services Parents Evaluation of Aural Performance of Children (PEACH)  Designed by NAL  To be used with children of pre school age  TOD may give parent questionnaire prior to visit  will record responses to questions in an interview style at subsequent visit.  Incorporates questions relevant to  Preschool population  identifying areas of concern listening in noise, quiet, env  hearing aid use  Some normative data available

18. Modernising Children’s Hearing Aid Services PEACH  Probe 1  Goal of probe. How often does the child wear his/her hearing aid/cochlear implant?  * # Examiner instructions. Ask the parent, “Can you tell me about …….. routine for wearing his/her hearing aid/cochlear implant in the last two weeks?“  Scoring_____  0Never. (0%)  1Seldom. (Around 25% of the time)  2Sometimes. (Around 50% of the time)  3Often. (Around 75% of the time)  4Always. (100% of the time)  Examples

19. Modernising Children’s Hearing Aid Services  Probe 2  Goal of Probe. Can the child monitor the proper functioning of the hearing aid/ cochlear implant?  *Examiner instructions. Ask the parent, “Has........ told you if his/her hearing aid/cochlear implant hasn't been working in the last two weeks?” If yes, “Can you give me some examples of the problems he reported?” “Have you ever checked the hearing aid/cochlear implant and found it not switched on or not working properly or has a flat battery?” If the answer to this question is yes, ask for examples that have occurred in the last two weeks.  #OR: Ask the parent, ” In the last two weeks has …….given any indication to show that his/her hearing aid/cochlear implant hasn’t been working? ( e.g. he/she may appear grumpy, agitated, cry, pull at the hearing aids) when the hearing aid /cochlear implant is not functioning If the answer to this question is yes, ask for examples that have occurred in the last two weeks.  This question may not be applicable for infants < 12 months.  Scoring_____  0Never, if no examples can be given. (0%)  1Seldom, if one or two examples can be given. (Around 25% of the time)  2Sometimes, if several examples can be given. (Around 50% of the time)  3Often, if numerous examples can be given. (Around 75% of the time)  4Always. (100% of the time)  Examples

20. Modernising Children’s Hearing Aid Services  Probe 3  Goal of probe. Is the child bothered/upset by any loud sounds?  *Examiner instructions. Ask the parent, “ Has... complained about / or been upset by any some loud sounds in the last two weeks?” If yes, ask the parent to give examples of when and where that occurred.  # OR: Ask the parent, “Has …….shown that he/she has been upset by any loud sounds in the last two weeks?” ( He /she may startle and/or cry, cover his/her ears, pull his/her hearing aids off, or show some other sign of discomfort)." If yes, ask the parent to give examples of when and where that occurred.  Scoring_____  4Never, if no examples can be given. (0%)  3Seldom, if one or two examples can be given. (Around 25% of the time)  2Sometimes, if several examples can be given. (Around 50% of the time)  1Often, if numerous examples can be given. (Around 75% of the time)  0Always. (100% of the time)  Examples

21. Modernising Children’s Hearing Aid Services 3 3 2 8/12 3 3 3 3 2 14/12 2 2 2 3 9/16 1 2 2 1/4 4/8 46 46/60 =76%

22. Modernising Children’s Hearing Aid Services Questionnaire Issues  LIFE-UK  Generally seems good  LSQ-P  Pictures, prompts being reviewed  PEACH  Uptake within MCHAS appears poor, Why ?  Some normative data now available  Work with NAL to revise format  The available tools are not perfect  This is not an excuse to do nothing !

23. Modernising Children’s Hearing Aid Services Questionnaire Summary  Use recommended validated questionnaires  LSQ-P, LIFE-UK, PEACH  Complements/captures informal observations  Extra work or a different way of working ?  Culture ?  Embed in PMS, access by health & education  “Home Grown” questionnaires  Where’s the normative data ?  Are you plagiarising someone else’s work ?  Other future options  ESPP, IT-MAIS