Karolin Schäfer

Zusammenfassung: Hintergrund: Menschen mit geistiger Behinderung (gB) sind häufig von Hörstörungen betroffen und haben zudem erhöhte Unterstützungsbedarfe bei der Nutzung von Hörgeräten. Ziel der Arbeit: In einer Pilotstudie sollten die spezifischen Unterstützungsbedarfe von Menschen mit gB partizipativ ermittelt werden, um ein passendes Begleitprogramm zur Hörgeräteversorgung zu konzipieren. Die zu Studienbeginn noch offenen Inhalte und die Ausrichtung dieses Begleitprogramms wurden nach der Bedarfserhebung bei der Zielgruppe konkretisiert. Material und Methoden: Mit sechs Proband:innen mit gB, die zuvor Hörgeräte erhalten hatten, wurden problemzentrierte Interviews in Leichter Sprache zu ihren Wünschen und Bedarfen geführt und anschließend mit der qualitativen Inhaltsanalyse ausgewertet. Zusätzlich wurde ein Fragebogen von sechs Mitarbeitenden der jeweiligen Wohneinrichtungen ausgefüllt, in dem ebenfalls Bedarfe für ein spezifisches Begleitprogramm nach einer Hörgeräteversorgung erfragt wurden. Ergebnisse: Umfangreiche Bedarfe wurden vor allem bei der Handhabung der Geräte deutlich. Die Einschätzungen der Mitarbeitenden stimmten in vielen Bereichen mit den Angaben der Proband:innen überein, z. B. im Bereich des Umgangs mit den Geräten. Schlussfolgerungen: Es besteht ein hoher Bedarf an Begleitung von Menschen mit gB nach einer Hörgeräteversorgung, vor allem bei der selbstständigen Handhabung der Hörgeräte. Ein Begleitprogramm zur Hörgeräteversorgung sollte dabei unbedingt auch das Umfeld der betroffenen Person adressieren.

People with intellectual disabilities (ID) are 5–10 times more likely to have hearing loss than the general population, yet it often remains undetected and untreated. To address this gap, the study HörGeist examined the feasibility, outcomes, barriers, and costs of an outreach program with hearing screening, diagnostics, intervention, and monitoring in everyday environments to implement a universal program in Germany. This report outlines ear and hearing care status before and after inclusion in the program and compares outcomes with standard care and a clinic-based invitation model. In a population-based, age-stratified cohort study, 1053 participants with ID (37% female; age 1–90 years) received screening and reference measurements in nurseries, schools, workplaces, and residences. When screening indicated possible hearing loss, on-site diagnostics and therapy were provided or referrals issued. A comparison cohort of 141 individuals with ID was invited to a clinic for identical procedures; none participated. All procedures were repeated after 1 year. Hearing loss was known in 14% of outreach participants at study entry; 8.7% had previously received hearing aids, but fewer than half (4.3%) used them. The program diagnosed hearing loss in 44% of participants, with 70% previously undiagnosed. After screening, 27% received therapy recommendations, but only 37% adhered to them (30% for hearing-aid prescriptions). Undertreated hearing loss declined only slightly, from 43% to 38%, over time. Major barriers included refusal by caregivers (31%) and participants (33%), often appearing to be linked to limited awareness of the treatability and consequences of hearing loss, as well as time and staff shortages. Outreach hearing screening programs are highly necessary, feasible, and effective in detecting hearing loss in people with ID, but substantial care gaps persist. Implementation requires public and professional awareness and rehabilitation strategies that include hearing and communication training and actively involve individuals with ID and their caregivers.

Deaf and hard-of-hearing (DHH) students with cochlear implants (CIs) are increasingly attending mainstream schools but often encounter social barriers with peers. This study explores how environmental factors and individual adaptation strategies shape these social experiences, interviewing 13 CI users (aged 17–27) who attended mainstream education. Thematic content analysis revealed four themes and 12 sub-themes around social barriers: difficulties socializing, sound and built environment barriers, social environment barriers, and adaptive strategies. Findings show participants developed many effective internal and external adaptations to manage barriers, yet often at the cost of their comfort, energy, or social safety, thus requiring additional strategies to maintain balance. This highlights social and emotional aspects of inclusion and asymmetric distributions of responsibility. Findings also highlighted school design choices and cultural/social practices that could shape the cost of adapting, underscoring the need for structural changes in educational environments that facilitate more equitable social access for DHH students.

Age-related hearing loss is highly prevalent among older adults. Long-term care (LTC) residents are an especially vulnerable population, yet hearing accessibility and staff expertise in hearing care often remain insufficient. This study examines (1) the structural and acoustic accessibility conditions in LTC facilities, (2) the hearing-related knowledge and training needs of staff, and (3) staff assessment of feasibility and sustainability of a preventive training program. A mixed-methods study was conducted in 74 LTC facilities in Germany. Data were collected pre- and post-intervention and at one year’s follow-up. Data sources included questionnaires, quantitative surveys, room acoustic measurements, and qualitative interviews. Quantitative data were analyzed descriptively; qualitative data were interpreted via structuring qualitative content analysis. Most facilities (81%) lacked acoustic accessibility concepts. More than half of the staff had limited knowledge on hearing and communication and expressed high training needs on this topic prior to the training program. Post-intervention interviews highlighted organizational barriers, but also a strong increase of awareness. Follow-up findings indicated moderate improvements in hearing-related practices and communication after the training program, though structural acoustic changes remained difficult to implement sustainably. The results show that improving hearing accessibility in LTC requires an integrated approach that strengthens both acoustical conditions in the facilities and staff competencies.

Hearing-related quality of life is a crucial outcome for adults with cochlear implants. The Cochlear Implant Quality of Life (CIQOL)-35 Profile is a patient-reported outcome measure originally developed in English. In a previous study, this instrument was cross-culturally adapted into German to address the need for standardized assessment tools in German-speaking regions. To ensure the adapted instrument meets psychometric criteria, validation is required. The German adaptation of the CIQOL-35 Profile was validated through an online survey including questions on demographics, the German CIQOL-35 Profile, and the German Nijmegen Cochlear Implant Questionnaire (NCIQ). The collected data were analyzed for reliability and validity. A total of 204 adults (aged 19–87 years) with bilateral hearing loss completed the online survey. Cronbach's α between 0.84 and 0.91 demonstrates good internal consistency for all subscales of the CIQOL-35 Profile and the global outcome. Moderate to strong correlations ( r _s = 0.55–0.85) between the CIQOL and NCIQ indicate good convergent validity. Confirmatory factor analysis established construct validity for the German CIQOL instruments. These findings confirm that the adapted German version of the CIQOL instruments is a reliable and valid measure for assessing hearing-related quality of life in adults with cochlear implants and demonstrates higher validity than the NCIQ. The availability of the CIQOL in multiple languages facilitates international comparability of research results and increases clinical application. Implementing quality of life instruments in clinical practice enables a more comprehensive evaluation of patient outcomes and may help identify patient needs that may be addressed in therapy and rehabilitation.

Zusammenfassung: Fragestellung: Die Kommunikation von Eltern mit ihren Kindern über Emotionen spielt eine wichtige Rolle in der sozial-emotionalen Entwicklung von Kindern. Bei hörgeschädigten Kindern kann diese Kommunikation durch die Auswirkungen der Hörschädigung erschwert werden. Es wird untersucht, welche Bedeutung die Emotionskommunikation für die sozial-emotionale Entwicklung hörgeschädigter Kinder und das Stresserleben der Eltern hat. Methodik: Die Eltern von 102 hörgeschädigten Vorschulkindern im Alter von 3;0 bis 6;11 Jahren wurden schriftlich zu elterlicher Emotionskommunikation, elterlicher Responsivität, kommunikativer Kompetenz der Kinder, elterlichem Stress und sozial-emotionaler Entwicklung der Kinder befragt. Die Daten wurden pfadanalytisch ausgewertet. Ergebnisse: Die Ergebnisse zeigen, dass die Emotionskommunikation keine direkten Effekte auf das elterliche Stresserleben und die sozial-emotionale Entwicklung der Kinder hat. Es zeigen sich jedoch indirekte Effekte. Die Emotionskommunikation trägt über die elterliche Responsivität zu einem geringeren elterlichen Stresserleben (β = –.06, p = .04) und zu weniger Verhaltensproblemen der Kinder (β = –.07, p = .04) bei. Über die kommunikative Kompetenz der Kinder trägt sie weiterhin zu besseren sozial-emotionalen Kompetenzen der Kinder bei (β = .08, p = .04). Kinder mit zusätzlichen Beeinträchtigungen und ihre Familien sind besonders gefährdet. Es zeigen sich eine höhere elterliche Belastung (β = .25, p < .001) und geringere sozial-emotionale Kompetenzen bei den Kindern (β = –.18, p = .02). Schlussfolgerungen: Die Ergebnisse stützen die bisher bekannten Befunde zur Rolle der elterlichen Responsivität und der kommunikativen Kompetenz. Im Rahmen einer familienorientierten Förderung sollte neben diesen wichtigen Kompetenzen auch die Unterstützung der Eltern in der Kommunikation über Gefühle mit ihrem Kind als entwicklungsstärkendes Moment berücksichtigt werden.

Background and objective: Currently, there is no universal newborn hearing (UNHS) screening in the Democratic Republic of Congo (DRC), partly due to financial and organizational reasons. The aim of this study was to adapt the LittlEARS^® Auditory Questionnaire (LEAQ) into the Kiswahili and Lingala languages for use as a screening tool for auditory development in children less than two years of age, as objective hearing screening cannot be performed nationwide. Methods: For this purpose, norm data were collected from n = 723 infants (Lingala) and n = 648 infants (Kiswahili) aged between 0 and 24 months in a random selection of four out of seven health zones with pediatric services in the DRC. A non-linear regression model was derived for total scores by age. Pearson correlations were performed to determine whether there were differences between total scores of the questionnaire by region (urban/rural areas). A Mann–Whitney U-test was calculated to determine if there were differences depending on who completed the questionnaire (mother/other caregiver). In addition, a one-way ANOVA was used to determine whether there were differences in the total scores of the questionnaires according to the educational background of the person completing the questionnaire. Results: The Pearson correlation coefficient between total scores and age was 0.81 for Kiswahili and 0.77 for Lingala. There were no significant differences in total scores for all conditions tested (total scores by age, language, region, person who completed the questionnaire, educational background). Conclusions: The LEAQ can be used effectively in a large region such as the DRC, regardless of the region, respondent, and the educational background.

Purpose The aim of this study was to investigate whether the fitting data of children with Cochlear implants (CI) and severe additional disabilities (CAD) differ compared to children with CI but without additional disabilities (CnonAD). Methods In this retrospective analysis, 76 CI cases (fitted ears) from CAD were included and matched with 76 cases from CnonAD. The subjective set values, such as pulse width (PW), threshold (T) and most comfortable (MC) levels were recorded. Additionally, the response threshold values by means of aided soundfield threshold (AST), the values of the intracochlear electrode impedances, the eCAP thresholds and the daily wearing time by using data logging were recorded and analysed. Results The T and MC levels for the Medel implants were significantly lower in the sample than in the control group. A similar trend was evident for Cochlear^® implants. The sample showed a positive correlation between the eCAP thresholds and the T level and MC level in case of the Cochlear implants. The CAD group showed a significantly higher aided soundfield threshold. In contrast to the CnonAD (0%), there was a total of 18% in the CAD with a reduced daily wearing time. When these were excluded, eCAP thresholds were significantly higher in the CAD group. In addition, there was a trend for eCAP thresholds to be higher if the contralateral ear was not also fitted with a CI. Conclusions The significantly higher eCAPs in CAD may be explained by different neural survival but also by different fittings and MC levels. The audiuologist’s subjectivity must be considered as a potential bias but also as potentially valuable input variable contributing to the variance in the fitting parameters and outcomes. Better fitting of T and MC levels focusing on behavioural and developmental responses may lead to a longer wearing time. To support the audiologist and the fitting process, it is necessary to interpret the response thresholds in the aided soundfield threshold against the background of the medical diagnosis and observations from everyday life should be considered. To ensure optimal development of CAD children according to their individual abilities, a multi-professional, family-centred intervention programme including videoanalyses should be implemented at an early stage, ideally from the decision process for a cochlear implant.

This paper presents the results of an online survey on digital participation through the use of social media ofn= 38 German deaf or hard-of-hearing (DHH) adults. In addition, information about the respondents' mental health is collected with four different scales: the Rosenberg Self-Esteem Scale (RSES), the Fear of Missing Out Scale (FoMoS), the Patient-Reported Outcomes Measurement Information System Social Isolation Scale (PRO-MIS SI-S) and the Social Media Disorder Scale (SMDS). Correlation analyses using Pearson correlation and Spearman rank correlation tests were conducted to identify relationships between mental health and use of social media. The results indicate that the DHH adults have 4.13 social media accounts on average and use social media 3.78 h per day. This is consistent with other research findings, so that the DHH individuals in this study do not differ from other DHH adults or hearing adults in the number of their social media accounts and in their media usage time. However, there are differences in usage of social media that concern, for example, the social media platforms that are used and time of usage due to communication modality (spoken language, sign language, bimodal bilingualism, and mixed forms). DHH individuals who use sign language use social media less overall compared to DHH people who use spoken language. In terms of mental health, it was found that, as expected, addictive social media behavior and high usage time are interrelated. Addictive behavior, in turn, is often associated with low self-esteem, a sense of social isolation, and a fear of missing out. In general, many participants in the study score high in scales for self-perception of social isolation and loneliness. Nevertheless, there are also positive effects and opportunities of using social media, especially in terms of digital participation, for DHH people, which are also discussed in the article.

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.