The tendency toward early diagnosis and intervention for children with hearing loss requires diagnostic tools to assess and monitor early development. When providing intervention to young children with hearing loss, professionals need to be aware not only of speech and language milestones but also to monitor auditory development.
Auditory skills are the basis for spoken communication. For that reason, monitoring auditory development in the early years is key to ensuring that strong foundations for language learning are built.
The LittlEARS® Auditory Questionnaire (LEAQ) was developed to support professionals and caregivers to monitor the auditory skills of young children with hearing loss. It is based on caregivers’ observation of their child’s auditory behavior in daily life. It includes 35 age-dependent questions to be answered with a yes or no (Figure 1). The questions reflect key milestones of auditory development in the first two years of life or up to two years hearing age (for children with hearing devices).
The LEAQ is one of the few questionnaire-based early auditory assessments with normative data.[1,2,3,4,5] It allows professionals to compare a child’s score against previous scores to monitor progress or compare a score with hearing age or age-matched, typically hearing peers (Figure 2). The questionnaire is suitable for children up to 24 months old, or with a hearing age of 24 months.
How to Access the LittlEARS Auditory Questionnaire
The LittlEARS Auditory Questionnaire app is now available for free for tablets on the Apple App Store and the Google Play Store. The app is currently available in English and German.
Alternatively, the LittlEARS Auditory Questionnaire is available in print in more than 40 languages. Contact a MED-EL representative in your area for information on how to purchase a print version of the LittlEARS Auditory Questionnaire.
How to Monitor Auditory Progress With the LittlEARS Auditory Questionnaire
The LEAQ is to be completed with the caregiver. It takes approximately 15 minutes to complete. Responses to the questionnaire are tallied and used (with the child’s chronological or hearing age) to chart the child’s progress and compare it to normative data. The child’s total raw score is marked on the graph at the point where the hearing age and the total score intercept.
The graph in Figure 2 shows the normative curve (black curved line), and the below-average range field (blue shaded area). A child’s scores may be marked on the graph over time to monitor progress.
If using the app, scores will be automatically displayed in the graph once the questionnaire is completed. Professionals can monitor progress, save results, and generate summary reports all in the app (all information is stored locally on the user’s device). If a child’s score falls below the average range, further auditory investigations are recommended.
For more information about LittlEARS® Assessment Battery, including the LittlEARS® Early Speech Production Questionnaire, and LittlEARS® My Diary, see the MED-EL Rehabilitation Catalog.
- Coninx, F., Weichbold, V., Tsiakpini, L., Autrique, E., Bescond, G., Tamas, L., … & Brachmaier, J. (2009). Validation of the LittlEARS® Auditory Questionnaire in children with normal hearing. International Journal of Pediatric Otorhinolaryngology, 73(12), 1761-1768. https://doi.org/10.1016/j.ijporl.2009.09.036
- May-Mederake, B., Kuehn, H., Vogel, A., Keilmann, A., Bohnert, A., Mueller, S., … & Coninx, F. (2010). Evaluation of auditory development in infants and toddlers who received cochlear implants under the age of 24 months with the LittlEARS® Auditory Questionnaire. International Journal of Pediatric Otorhinolaryngology, 74(10), 1149-1155. https://doi.org/10.1016/j.ijporl.2010.07.003
- Liu, H., Jin, X., Zhou, Y., Jing, L. I., Liu, L., & Xin, N. I. (2015). Assessment and Monitoring of the LittlEARS® Auditory Questionnaire Used for Young Hearing Aid Users in Auditory Speech Development. Journal of Audiology and Speech Pathology, (3), 291-294. https://pesquisa.bvsalud.org/portal/resource/pt/wpr-463155
- Obrycka, A., Lorens, A., García, J. L. P., Piotrowska, A., & Skarzynski, H. (2017). Validation of the LittlEARS Auditory Questionnaire in cochlear implanted infants and toddlers. International Journal of Pediatric Otorhinolaryngology, 93, 107-116. https://doi.org/10.1016/j.ijporl.2016.12.024
- Bagatto, M. P., Brown, C. L., Moodie, S. T., & Scollie, S. D. (2011). External validation of the LittlEARS® Auditory Questionnaire with English-speaking families of Canadian children with normal hearing. International Journal of Pediatric Otorhinolaryngology, 75(6), 815-817. https://doi.org/10.1016/j.ijporl.2011.03.014