Validation of the LittlEARS((R)) Auditory Questionnaire in children with normal hearing

Int J Pediatr Otorhinolaryngol. 2009 Dec;73(12):1761-8. doi: 10.1016/j.ijporl.2009.09.036. Epub 2009 Oct 17.


Objectives: With more children receiving cochlear implants during infancy, there is a need for validated assessments of pre-verbal and early verbal auditory skills. The LittlEARS Auditory Questionnaire is presented here as the first module of the LittlEARS test battery. The LittlEARS Auditory Questionnaire was developed and piloted to assess the auditory behaviour of normal hearing children and hearing impaired children who receive a cochlear implant or hearing aid prior to 24 months of age. This paper presents results from two studies: one validating the LittlEARS Auditory Questionnaire on children with normal hearing who are German speaking and a second validating the norm curves found after adaptation and administration of the questionnaire to children with normal hearing in 15 different languages.

Methods: Scores from a group of 218 German and Austrian children with normal hearing between 5 days and 24 months of age were used to create a norm curve. The questionnaire was adapted from the German original into English and then 15 other languages to date. Regression curves were found based on parental responses from 3309 normal hearing infants and toddlers. Curves for each language were compared to the original German validation curve.

Results: The results of the first study were a norm curve which reflects the age-dependence of auditory behaviour, reliability and homogeneity as a measure of auditory behaviour, and calculations of expected and critical values as a function of age. Results of the second study show that the regression curves found for all the adapted languages are essentially equal to the German norm curve, as no statistically significant differences were found.

Conclusions: The LittlEARS Auditory Questionnaire is a valid, language-independent tool for assessing the early auditory behaviour of infants and toddlers with normal hearing. The results of this study suggest that the LittlEARS Auditory Questionnaire could also be very useful for documenting children's progress with their current amplification, providing evidence of the need for implantation, or highlighting the need for follow-up in other developmental areas.

Publication types

  • Comparative Study
  • Validation Study

MeSH terms

  • Age Factors
  • Auditory Perception*
  • Austria
  • Child Development / physiology
  • Cohort Studies
  • Cross-Cultural Comparison
  • Female
  • Germany
  • Hearing Loss / diagnosis
  • Hearing Tests
  • Humans
  • Infant
  • Infant, Newborn
  • Language Development*
  • Language Tests*
  • Male
  • Neonatal Screening
  • Reference Values
  • Regression Analysis
  • Sensitivity and Specificity
  • Sex Factors
  • Surveys and Questionnaires*