Project Activities
In phase 1 of this project, researchers gathered qualitative data on listening fatigue through focus groups and interviews. In phase 2, they used information gathered in 0phase 1 to create a preliminary version of the VFS-Peds. In phase 3, the team collected data and conducted quantitative psychometric analyses of the preliminary scales to identify high-quality items for inclusion in the final scales. In phase 4, they field tested the final versions of the scales and conducted further psychometric analyses. The final version of the VFS-Peds and an accompanying user guide were made available publicly.
Structured Abstract
Setting
Data were collected from students, parents, and teachers from public and private elementary, middle, and high schools throughout Tennessee as well as a local group of speech and hearing clinics in the state.
Sample
The sample consisted of two groups of children who ranged from 6 to 17 years of age — children with mild to profound hearing loss (CHL), and children with normal hearing (CNH). CHL were categorized into three subtypes, including CHL wearing hearing aids, CHL wearing cochlear implants, and CHL (wearing hearing aids or cochlear implants) exhibiting at least one additional handicapping condition (such as a visual, physical, emotional/behavioral, learning impairment). The sample also included children’s parents and teachers. The phase 1 sample included approximately 88 participants (43 CHL, 17 parents of CHL, and 28 teachers and school professionals who work with CHL and other students with disabilities). The phase 2 sample included 9 CHL, 6 parents, and 7 school professionals who completed cognitive interviews. In addition, 11 professionals (3 speech-language pathologists, 5 audiologists, 2 deaf educators, and 1 hearing scientist) served as expert panel members to evaluate the relevance and clarity of the initial test items. The phase 3 sample included 907 participants, including 211 children (156 CHL), 392 parents (296 parents of CHL), and 304 school professionals (220 who work with CHL). The phase 4 sample included 1,299 participants, including 225 children (119 CHL), 532 parents (305 parents of CHL), and 542 school professionals (368 who work with CHL).
VFS-Peds is designed to assess listening-related fatigue in children ages 6-17, including children who are deaf/hard of hearing as well as other children who may be expected to struggle with listening-related fatigue (such as children with language disorders). There are three versions of the scale—a child self-report (10 items), a parent proxy-report (12 items; 7 that assess mental aspects of fatigue and 5 that assess physical aspects), and a teacher proxy-report (8 items). The VFS-Peds is designed to assess long-term listening-related fatigue; therefore, respondents are asked to answer questions based on experiences/observations from the past week or a typical week. Response options utilize a 5-point Likert frequency scale. While in-person administration is optimal, the VFS-Peds can be administered online to older children, ages 11-17. The VFS-Peds can be scored by either summing item responses or by calculating an Item Response Theory (IRT) scale, or subscale, score.
Research design and methods
In phase 1, researchers gathered qualitative data on fatigue outcomes through focus groups and interviews. In phase 2, these data were used to generate a large pool of potential scale items. Using feedback from an expert panel and cognitive interviews with target respondent groups (CHL, parents, and school professionals), high-quality items were selected to construct three preliminary versions of the VFS-Peds (parent, teacher, and child scales) that measure children’s experiences of fatigue related to hearing loss. In phase 3, researchers ran preliminary tests of VFS-Peds in a large sample of CHL and CNH, their teachers, and parents. Psychometric analyses were conducted to assess scale dimensionality and to identify high-quality items to reduce the length of the final scales. In phase 4, the dimensionality and test-retest reliability of the final versions of the scales were assessed and validated in a large sample of CHL and CNH and their teachers and parents.
Control condition
Although there was no control group due to the nature of the study, there was a comparison group included for each test of the measure consisting of children without hearing impairment or other disabilities.
Key measures
In addition to the measure being developed, the research team utilized two additional measures to assess the construct validity of the VFS-Peds, the Pediatric Quality of Life-Multidimensional Fatigue Scale and the Children’s Depression Inventory-2.
Data analytic strategy
Dimensionality was evaluated using exploratory factor analyses. IRT and differential item functioning analyses were used to identify high-quality items, which were further evaluated and refined to create the final versions of the VFS-Peds.
Key outcomes
The main findings of this project, as reported by the principal investigator, are as follows:
- Listening-related fatigue in children with hearing loss is a complex construct with physical, cognitive, and social-emotional manifestations.
- Important information regarding the listening-related fatigue experienced by children with hearing loss can be obtained from the child’s parents and the teachers who work directly with the child.
- The VFS-Peds is a valid, sensitive, and reliable instrument for assessing listening-related fatigue in CHL and children with other disabilities.
- Results using the VFS-Peds suggest that children with hearing loss and children with other disabilities are more likely to experience severe listening-related fatigue than typically developing children without hearing loss or other disabilities.
People and institutions involved
IES program contact(s)
Products and publications
Project website:
Publications:
ERIC Citations: Find available citations in ERIC for this award here and here.
Select Publications:
Bess, F. H., Davis, H., Camarata, S., & Hornsby, B. W. (2020). Listening-related fatigue in children with unilateral hearing loss. Language, Speech, and Hearing Services in Schools, 51(1), 84-97.
Davis, H., Schlundt, D., Bonnet, K., Camarata, S., Hornsby, B., & Bess, F. H. (2021). Listening-related fatigue in children with hearing loss: Perspectives of children, parents, and school professionals. American Journal of Audiology, 30(4), 929-940.
Hornsby, B. W., Camarata, S., Cho, S. J., Davis, H., McGarrigle, R., & Bess, F. H. (2022). Development and Evaluation of Pediatric Versions of the Vanderbilt Fatigue Scale for Children With Hearing Loss. Journal of Speech, Language, and Hearing Research, 1-21.
Hornsby, B. W., Davis, H., & Bess, F. H. (2021). The Impact and Management of Listening-Related Fatigue in Children with Hearing Loss. Otolaryngologic Clinics of North America, 54(6), 1231-1239.
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