Spatial Hearing Questionnaire Research Articles

Spatial Hearing Questionnaire: Psychometric Properties of Turkish Version and Correlations with Hearing Skills

Objective: Self-report questionnaire is informative to assess general hearing disability. The aims of this study were to investigate the reliability of Turkish version of spatial hearing questionnaire (SHQ) and to analyze the validity of the SHQ by the correlation with speech, spatial, and qualities of hearing questionnaire (SSQ) and Turkish matrix sentence test (TMST). Methods: The first part of the study was the psychometric properties of the SHQ with 192 participants (137 with normal hearing, 55 with hearing loss). In the second and main part of the study, we applied two questionnaires (SHQ and SSQ) and TMST to people other than those included in the first part of the study (88 participants with bilateral sensorineural hearing loss). We compared the results of these two questionnaires and the TMST with the speech discrimination (SD) scores. Results: Turkish spatial hearing questionnaire’s internal consistency was 0.94 and 0.97 for individuals with normal hearing and for individuals with hearing loss, respectively. Moderate, positive, statistically significant correlation was observed between the SHQ and SSQ (r = 0:606, p = 0:001 in individuals with hearing loss who do not wear any hearing aid, and r = 0:627, p = 0:001 in hearing aid users), and SHQ and SD (r = 0:561, p = 0:032 in hearing aid users). According to TMST, moderate, positive, statistically significant correlation was found between SSQ and adaptive TMST in individuals with hearing loss who do not wear any hearing aid (r = 0:330, p = 0:033 for S0N90 and r = 0:364, p = 0:018 for S0N270). Conclusions: Turkish SHQ is a valid and reliable questionnaire for assessing hearing functions. SHQ, SSQ, and TMST are clinically beneficial measuring tools in planning the process of hearing rehabilitation and follow-up.

Validity and Reliability of the Korean Version of the Spatial Hearing Questionnaire in Cochlear Implant Users

Purpose: The Spatial Hearing Questionnaire (SHQ) is a self-report subjective questionnaire that includes eight subscales, including “understanding of male, female, and child’s voice”, “music”, “localization”, “speech understanding in quiet, noise-front, and noise-separate situations”. The aim of this study was to examine the validity and reliability of the Korean version of the SHQ (K-SHQ) in cochlear implant (CI) users. Methods: Fifty-two adult CI users participated in this study. Internal consistency and test-retest reliability of the K-SHQ were evaluated. Concurrent validity was identified by comparing the K-SHQ responses with the “spatial hearing” subscale scores from the Korean version of the Speech, Spatial, and Qualities of Hearing Scale (K-SSQ). We also examined the construct validity of the K-SHQ through an exploratory factor analysis. Results: Overall, the greatest difficulties were obtained from the subscale of “localization”, with the least difficulties in the subscale of “speech in quiet”. Both internal consistency and test-retest reliability were adequate for CI users based on all 24 items and the 8-subscale responses of the K-SHQ. The “localization” subscale responses of the K-SHQ were significantly correlated with the “spatial hearing”subscale responses of the K-SSQ, demonstrating a good concurrent validity in relation to localization performance. The results of the exploratory factor analysis showed that two factors, “speech understanding” and “localization”, explained 73.2% of the variance. Conclusion: The K-SHQ showed satisfactory reliability and validity in evaluating speech understanding as well as spatial hearing abilities in cochlear implant users, especially in complex listening situations.

Cochlear implantation in unilateral hearing loss: impact of short- to medium-term auditory deprivation.

Single sided deafness (SSD) results in profound cortical reorganization that presents clinically with a significant impact on sound localization and speech comprehension. Cochlear implantation (CI) has been approved for two manufacturers' devices in the United States to restore bilateral function in SSD patients with up to 10 years of auditory deprivation. However, there is great variability in auditory performance and it remains unclear how auditory deprivation affects CI benefits within this 10-year window. This prospective study explores how measured auditory performance relates to real-world experience and device use in a cohort of SSD-CI subjects who have between 0 and 10 years of auditory deprivation. Subjects were assessed before implantation and 3-, 6-, and 12-months post-CI activation via Consonant-Nucleus-Consonant (CNC) word recognition and Arizona Biomedical Institute (AzBio) sentence recognition in varying spatial speech and noise presentations that simulate head shadow, squelch, and summation effects (S0N0, SSSDNNH, SNHNSSD; 0 = front, SSD = impacted ear, NH = normal hearing ear). Patient-centered assessments were performed using Tinnitus Handicap Inventory (THI), Spatial Hearing Questionnaire (SHQ), and Health Utility Index Mark 3 (HUI3). Device use data was acquired from manufacturer software. Further subgroup analysis was performed on data stratified by <5 years and 5-10 years duration of deafness. In the SSD ear, median (IQR) CNC word scores pre-implant and at 3-, 6-, and 12-months post-implant were 0% (0-0%), 24% (8-44%), 28% (4-44%), and 18% (7-33%), respectively. At 6 months post-activation, AzBio scores in S0N0 and SSSDNNH configurations (n = 25) demonstrated statistically significant increases in performance by 5% (p = 0.03) and 20% (p = 0.005), respectively. The median HUI3 score was 0.56 pre-implant, lower than scores for common conditions such as anxiety (0.68) and diabetes (0.77), and comparable to stroke (0.58). Scores improved to 0.83 (0.71-0.91) by 3 months post-activation. These audiologic and subjective benefits were observed even in patients with longer durations of deafness. By merging CI-associated changes in objective and patient-centered measures of auditory function, our findings implicate central mechanisms of auditory compensation and adaptation critical in auditory performance after SSD-CI and quantify the extent to which they affect the real-world experience reported by individuals.

Long-term Outcome of Sound Localization with Baha® Attract System.

Spatial hearing is a critical feature in daily life. However, there is quite a range in hearing loss patients regarding the effect of bone conduction device on localization performance. To analyze the localization performance in patients with bilateral conductive or mixed hearing loss fitted with one Baha® Attract system. This prospective study included 12 patients who had followed up for more than one year. The parameters analyzed included (1) audiological results: sound field threshold, speech discrimination scores (SDSs), and sound localization test, and (2) functional results: scores for the Speech, Spatial and Qualities of Hearing Scale (SSQ) and the Chinese translation of the Spatial Hearing Questionnaire (C-SHQ). The audiological assessments showed a reduction of 28.5 dB in the mean sound field thresholds and improvements of 61.7% in the SDSs for disyllabic words. The root mean square error improved slightly with the Baha® Attract system. Patients showed promising results in the functional questionnaire assessments, with significant improvements in the SSQ and C-SHQ scores. Although most patients were not able to localize sound accurately after surgery, the change in the scores of the SSQ and C-SHQ indicated that the Baha® Attract system could improve spatial hearing.

Validation and prospects for the use of the Russian version of the Spatial Hearing Questionnaire (SHQ)

Aim to validate the Russian version of the Spatial Hearing Questionnaire (SHQ) used for clarifying the spatial hearing impairment, translated from English and adapted.&#x0D; Material and methods. After cultural and linguistic adaptation, the reliability of the Russian version of SHQ was validated using the "test - retest" method in 35 people (mean age 51,215,6 years) in two groups: group I - people with normal hearing (17 people), group II - persons with chronic sensorineural hearing loss levels I-IV (18 people).&#x0D; Results. The reliability was assessed by -Cronbach and was equal to 0.981, the total correlation values 0.68 - 0.92. There was a statistically significant difference (p0.05) between mean SHQ scores in the two groups.&#x0D; Conclusion. Based on the results of our study, the Russian version of the SHQ can be used in practice of an otorhinolaryngologist as an additional diagnostic tool for spatial hearing disorders and during the hearing rehabilitation.

The Correlation between Binaural Interaction Component of the Auditory Brainstem Response and Total Score of the Persian Version of the Spatial Hearing Questionnaire

Background and Aim: People with spatial hearing impairment have difficulty perception of speech in the presence of noise, sound localization, and estimating the distance from the sound source. In this study, the comparison between amplitude and latency of the Binaural Interaction Component of the Auditory Brainstem Response (ABR-BIC) with the total score of the Persian version of the Spatial Hearing Questionnaire (SHQ) in adults with normal hearing and moderate sensorineural hearing loss (SNHL) was evaluated.&#x0D; Methods: In this cross-sectional comparative study 55, 18–45-year-old individuals including 35 of normal hearing and 20 moderate SNHL participated. All participants underwent the assessments of medical history, otoscopy, conventional audiometry, tympanometry, SHQ questionnaire, and auditory brainstem response (ABR).&#x0D; Results: There was no significant correlation between the amplitude and latency of the ABR- BIC and the Persian version of the SHQ in normal groups (r=–0.085, r=0.116) and in moderate SNHL groups (r=0.030, r=0.119). The mean value of ABR-BIC range of people with normal hearing and SNHL is statistically significant (p=0.001).&#x0D; Conclusion: The results showed that the amplitude and latency of ABR-BIC were not correlated with the Persian version of the SHQ in people with normal hearing and with moderate SNHL but statistically significant between the mean amplitude and latency of ABR- BIC in people with normal hearing and people with hearing loss.&#x0D; Keywords: Auditory brainstem response; spatial hearing questionnaire; binaural interaction component; spatial hearing; spatial hearing disorder

The benefit of hearing aids in adults with hearing loss during the Covid–19 pandemic

Background/Aim: Hearing aids, cochlear implants, and guidance are highly effective in improving communication skills and the quality of life of individuals with hearing loss. During the Covid-19 pandemic, patients with hearing loss, especially those living far from city centers, faced insufficient device use due to their inability to go to the hospitals and device centers. This study aimed to evaluate the effects of remote monitorization of sound amplification in adults using cochlear implants and/or hearing aids during the lockdown period. Methods: In this cross-sectional study, we recruited 98 individuals with post-lingual cochlear implants (n=38) and hearing aids (n=60). Patients on hearing aids followed before the Covid-19 pandemic were guided with a remote computer connection during the pandemic. All participants filled out the Spatial Hearing Questionnaire (SHQ), the short version of Speech Spatial Quality of Questionnaire (SSQ12), Short Form-36 quality of life questionnaires (SF-36), Satisfaction with Amplification in Daily Life Questionnaire (SADL), and the Coronavirus 19 Phobia Scale (C19P-S) via google questionnaire. Results: During the lockdown period, there were significant increases in the spatial perception scores (SSQ12) of cochlear implant and hearing aid users (P

Spatial hearing and speech understanding in noise in elderly

Objectives The aim of this study was to investigate spatial hearing in elderly with and without complaint about speech understanding in noise. Methods Persian spatial hearing questionnaire (P-SHQ) was investigated in the elderly with and without speech understanding difficulty in noise and in normal young adults. ANOVA test was used for comparing results of the eight sub-characteristics of the P-SHQ among three groups. Results Both elderly groups had lower performance in source localisation, understanding speech in noise with target and noise sources from the front, understanding speech in noise with spatially separate target and noise sources. There was a significant difference between the two elderly groups in understanding speech in noise with target and noise sources from the front. Conclusions It shows that although the elderly have lower spatial performance than young adults, they still can benefit from the spatial separation of sound sources.

The Correlation Analysis Between the Spatial Hearing Questionnaire (SHQ) and the Psychophysical Measurement of Spatial Hearing.

The aim of the present study was examining the relationship between a psychophysical spatial hearing test (spatial word in noise test) and Spatial Hearing Questionnaire. Sixty-six adults (18-40years old) were divided in three groups: normal subjects, subjects with mild and moderate hearing loss. Spatial word in noise test and Persian version of the spatial hearing questionnaire were evaluated and compared among these groups. According to Pearson's test, there was a significant positive correlation between the scores of spatial word in noise test and Persian version of the Spatial Hearing Questionnaire in three groups (r = 0.64-0.89). Hearing loss can deteriorate spatial hearing ability. Both objective and subjective spatial hearing tests are shown to be effective in detecting spatial hearing disorder.

Written Instructions vs. Audiology Service for PSAP Use

Written Instructions vs. Audiology Service for PSAP Use

Development of a Shortened Version of the Spatial Hearing Questionnaire (SHQ-S) for Screening Spatial-Hearing Ability.

The Spatial Hearing Questionnaire (SHQ) was developed to address how to measure spatial-hearing ability in complex listening situations (Tyler, Perreau, & Ji, 2009). It has been translated and validated into various languages, including Chinese, Dutch, French, and Persian. Although the SHQ contains only 24 items, it could be time-consuming in a busy clinic to administer. The purposes of this study were to develop and validate a shortened version of the SHQ (SHQ-S) and to compare self-perceived spatial-hearing ability across adults with normal hearing (NH), hearing loss (HL), and cochlear implants (CIs). This was a retrospective study. The full version of the SHQ was administered to measure self-perceived spatial-hearing ability for 51 adults with NH at Augustana College, 47 adults with essentially mild to moderately severe sensorineural HL at Illinois State University, and 72 adult CI users at the University of Iowa. Exploratory factor analysis was performed for the full version for the data collected from adults with NH and HL. Appropriate items were chosen to develop the SHQ-S from the results of the exploratory factor analysis. Confirmatory factor analysis was then applied to test the factor structure of the SHQ-S for all participants. One-way analysis of variance was used to compare the self-perceived spatial-hearing performance scores between the 3 groups. The exploratory factor analysis revealed scores loaded on 2 factors. Six items from the full version were chosen accordingly. The results of the confirmatory factor analysis indicated that that a shortened version of 6 items is sufficient to measure spatial-hearing ability. The internal consistency reliability of the SHQ-S was high. The main effect of the one-way analysis of variance was significant for the groups, F(2, 167) = 36.0, p < .0001. The comparisons with the Tukey adjustment indicated that the NH group reported significantly better spatial-hearing ability than either the HL or the CI group (both adjusted p values < .05). There was no significant difference between the participants with HL and CI users. The psychometric characteristics of the 6-item SHQ-S were similar to those of the full version of the SHQ. We conclude that the SHQ-S is a reliable and valid tool for measuring spatial-hearing ability and screening for spatial-hearing difficulties. Participants with NH reported better spatial-hearing ability than those with HL or with CIs, whereas the CI users and participants with HL perceived similar spatial-hearing ability in the present study.

Validation of the Korean Version of the Spatial Hearing Questionnaire for Assessing the Severity and Symmetry of Hearing Impairment.

PurposeSpatial hearing refers to the ability to understand speech and identify sounds in various environments. We assessed the validity of the Korean version of the Spatial Hearing Questionnaire (K-SHQ).Materials and MethodsWe performed forward translation of the original English SHQ to Korean and backward translation from the Korean to English. Forty-eight patients who were able to read and understand Korean and received a score of 24 or higher on the Mini-Mental Status Examination were included in the study. Patients underwent pure tone audiometry (PTA) using a standard protocol and completed the K-SHQ. Internal consistency was evaluated using Cronbach's alpha, and factor analysis was performed to prove reliability. Construct validity was tested by comparing K-SHQ scores from patients with normal hearing to those with hearing impairment. Scores were compared between subjects with unilateral or bilateral hearing loss and between symmetrical and asymmetrical hearing impairment.ResultsCronbach's alpha showed good internal consistency (0.982). Two factors were identified by factor analysis: There was a significant difference in K-SHQ scores for patients with normal hearing compared to those with hearing impairment. Patients with asymmetric hearing impairment had higher K-SHQ scores than those with symmetric hearing impairment. This is related to a lower threshold of PTA in the better ear of subjects. The hearing ability of the better ear is correlated with K-SHQ score.ConclusionThe K-SHQ is a reliable and valid tool with which to assess spatial hearing in patients who speak and read Korean. K-SHQ score reflects the severity and symmetry of hearing impairment.

Validation of a French-Language Version of the Spatial Hearing Questionnaire, Cluster Analysis and Comparison with the Speech, Spatial, and Qualities of Hearing Scale.

To validate a French-language version of the spatial hearing questionnaire (SHQ), including investigating its internal structure using cluster analysis and exploring its construct validity on a large population of hearing-impaired (HI) and normal-hearing (NH) subjects, and to compare the SHQ with the speech, spatial, and qualities of hearing scale (SSQ) in the same population. The SHQ was translated in accordance with the principles of the Universalist Model of cross-cultural adaptation of patient-reported outcome instruments. The SSQ and SHQ were then presented in a counterbalanced order, in a self-report mode, in a population of 230 HI subjects (mean age = 54 years and pure-tone audiometry [PTA] on the better ear = 28 dB HL) and 100 NH subjects (mean age = 21 years). The SHQ feasibility, readability, and psychometric properties were systematically investigated using reliability indices, cluster, and factor analyses and multiregression analyses. SHQ characteristics were compared both to different literature data obtained with different language versions and to the SSQ scores obtained in the same population. Internal validity was high and very good reproducibility of scores and intersubject variability were obtained across the 24 items between the English and French SHQ for NH subjects. Factor and cluster analyses concurred in identifying five correlated factors, corresponding to several SHQ subscales: (1) speech in noise (corresponding to SHQ subscales 7 and 8), (2) localization of voice sounds from behind, (3) speech in quiet (corresponding to SHQ subscale 1), (4) localization of everyday sounds, and (5) localization of voices and music (corresponding to parts of the SHQ localization subscale). Correlations between SSQ subscales and SHQ factors identified the greatest correlations between SHQ factors 2, 4, and 5 and SSQ spatial subscales, whereas SHQ factor 1 had the greatest correlation with SSQ_speech. SHQ and SSQ scores were similar, whether in NH subjects (8.5 versus 8.4) or in HI subjects (6.6 for both), sharing more than 80% of variance. The SHQ localization subscale gave similar scores as the SSQ spatial subscale, sharing more than 75% of variance. Construct validity identified better ear PTA and PTA asymmetry as the two main predictors of SHQ scores, to a degree similar to that seen for the SSQ. The SHQ was shorter, easier to read and less sensitive to the number of years of formal education than the SSQ, but this came at a cost of ecological validity, which was rated higher for the SSQ than for the SHQ. A comparison of factor analysis outcomes among the English, Dutch, and French versions of the SHQ confirmed good conceptual equivalence across languages and robustness of the SHQ for use in international settings. In addition, SHQ and SSQ scores showed remarkable similarities, suggesting the possibility of extrapolating the results from one questionnaire to the other. Although the SHQ was originally designed in a population of cochlear implant patients, the present results show that its usefulness could easily be extended to noncochlear-implanted, HI subjects.

Validation of the Chinese Translation of the Spatial Hearing Questionnaire and Its Short Form.

Few questionnaires address how to measure spatial hearing ability in complex listening situations. The purpose of the study was (a) to validate the Chinese translation of the Spatial Hearing Questionnaire (C-SHQ) among Chinese participants and (b) to provide a shortened version for the purpose of clinical screening. This was a cross-sectional study. The C-SHQ was developed from the process of translation and back-translation of the original 24-item, English version (Tyler, Perreau, & Ji, 2009). The C-SHQ was administered to 146 patients at the Department of Otolaryngology Clinic of Sichuan Provincial People's Hospital between October 2013 and May 2014 at Sichuan, China. Exploratory factor analysis and reliability tests were performed for the full version, and confirmatory factor analysis was applied for the shortened version of the C-SHQ. The exploratory factor analysis revealed scores loaded on 3 similar factors compared with the original SHQ. The internal consistency reliability was high (Cronbach's α = 0.99). The confirmatory factor analysis indicated that a shortened version of 12 items is sufficient to measure spatial hearing abilities. The C-SHQ and its short form are both reliable and valid questionnaires, which are suitable for both research and clinical settings to measure spatial hearing ability in the Chinese population.

Speech, Spatial and Qualities of Hearing Scale (SSQ) and Spatial Hearing Questionnaire (SHQ) Changes Over Time in Adults With Simultaneous Cochlear Implants.

The purpose of the present study is to evaluate the changes over time of the Spatial Hearing Questionnaire (SHQ; Tyler, Perreau, & Ji, 2009) and the Speech, Spatial and Qualities of Hearing Scale (SSQ; Gatehouse & Noble, 2004) in adults with simultaneous bilateral cochlear implants by collecting data for 2 years after implantation. Nineteen postlingual subjects participated in this study. Average age at implant was 63 years. The subjects' data were included in this retrospective analysis only if they completed both questionnaires. We compared subjects' SSQ and SHQ scores to word recognition and sound localization performances. The study showed SHQ and SSQ scores continuously improved up to 1 year postimplantation, with the most improvement occurring within the first 6 months of implantation. After 1 year, the scores reached a plateau. This is consistent with laboratory tests from the same 19 subjects, and they showed high correlations (p < .05). The present study also showed a high degree of correlation between SHQ and SSQ scores. Both the SSQ and SHQ scores improved up to 12 months postimplantation, with the most improvement during the first 6 months of implantation. Both were consistent with laboratory tests. There was a high degree of correlation between SHQ and SSQ scores.

Self-reported spatial hearing abilities across different cochlear implant profiles.

The goal of this study was to determine how self-reported spatial hearing abilities differ across various cochlear implant (CI) profiles and to examine the degree of subjective benefit following cochlear implantation across different groups of CI users. This was a retrospective study of subjective spatial hearing ability of CI recipients. The subjects consisted of 99 unilateral CI users, 49 bilateral CI users, 32 subjects with a CI and contralateral hearing aid (bimodal users), and 37 short-electrode CI users. All subjects completed the Spatial Hearing Questionnaire (Tyler, Perreau, & Ji, 2009), a questionnaire assessing spatial hearing ability, after implantation, and a subset of the subjects completed the questionnaire pre- and postimplantation. Subjective spatial hearing ability was rated higher for the bilateral and short electrode CI users compared to the unilateral and bimodal users. There was no significant difference in subjective spatial hearing performance between the bilateral and short electrode CI users and the unilateral CI and bimodal users. A separate analysis of pre- and postimplant performance revealed that all CI groups reported significant improvements in spatial hearing ability after implantation. This study suggests that there are substantial differences in perceived spatial hearing ability among unilateral and bimodal CI users compared with bilateral and short electrode CI users.

The Spatial Hearing Questionnaire: Data From Individuals With Normal Hearing

Although a number of questionnaires are available to assess hearing aid benefit and general hearing disability, relatively few investigate spatial hearing ability in more complex listening situations. The aim of this study was to document the performance of individuals with normal hearing using the Spatial Hearing Questionnaire (SHQ; Tyler, Perreau, & Ji, 2009) and to compare performance with published data from cochlear implant (CI) users. Fifty-one participants with normal hearing participated. All participants completed the 24-item SHQ. Also, a factor analysis and reliability tests were performed. Performance on the SHQ was high (87%) for the participants with normal hearing. Subjective ratings varied across different listening situations: Understanding speech in quiet (98%) was rated higher than sound localization (84%) and understanding speech in a background of noise (85%). Compared with previously published data (Tyler, Perreau, & Ji, 2009), listeners with normal hearing rated their spatial hearing ability significantly better than bilateral and unilateral CI users. Results confirmed that the SHQ is a reliable measure of spatial hearing ability for listeners with normal hearing. Overall, results indicated that the SHQ is able to capture expected differences between individuals with normal hearing and CI users. These new data can be used as targets following the provision of hearing devices.

Comparison of 2 Implantable Bone Conduction Devices in Patients With Single-Sided Deafness Using a Daily Alternating Method

Comparison of the auditory and subjective capabilities of 2 implantable bone conduction devices BAHA Divino sound processor (Divino) and the BAHA BP100 sound processor (BP100) using a daily alternating method. Open prospective comparative trial. Tertiary referral otology and neurotology center. Ten patients with single-sided deafness (SSD) using a Divino for more than 1 year. The patients with SSD changed to the BP100 for 1 week, and then underwent an evaluation period of 18 days switching between BP100 and Divino on a daily alternating basis. On a scale from 0 to 10, patients rated their quality of hearing daily with both devices concerning overall satisfaction, clearness of sound, and effort of listening in background noise. For the total duration of the trial, the spatial hearing questionnaire (SHQ) and the abbreviated profile of hearing aid benefit (APHAB) were administered. In the unaided condition and with Divino at baseline and aided with BP100 after the evaluation period, adaptive speech in quiet and in noise testing was performed with speech and noise coming from different azimuth angles. Subjective rating in a diary, APHAB, SHQ, and aided speech in quiet and speech in noise. The diary shows significant improvement on all subscales with BP100 in comparison with Divino. These differences did not change significantly during 18 days. On the APHAB, listening in background noise and in reverberant conditions was rated significantly better with the BP100. The SHQ shows a significant difference between both devices on all subscales except for source localization and speech understanding in quiet. Speech audiometry showed a significant head shadow benefit with both implantable bone conduction devices (median [Q1, Q3]: Divino = 2.67 dB [0.33, 1.51], BP100 = 2.83 dB [4.08, 3.83]). There was no significant difference found between both devices. Both the Divino and the BP100 reduce the handicap experienced by patients with SSD. Subjective assessment using a daily alternating method shows higher overall hearing capabilities with BP100. Results of the questionnaires are similar. Speech audiometry in noise does not reveal a statistically significant difference between both devices. A daily alternating method can provide useful information for both the patient and the audiologist because objective measurements do not show any statistically significant differences between patients. In our opinion, daily alternation of devices is a useful method to compare different devices.

Validation of the Spatial Hearing Questionnaire

Subjective questionnaires are informative in understanding the difficulties faced by patients with hearing loss. Our intent was to establish and validate a new questionnaire that encompasses situations emphasizing binaural hearing. The Spatial Hearing Questionnaire is a self-report assessment tool with eight subscales representing questions; pertaining to the perception of male, female, and children's voices; music in quiet; source localization; understanding speech in quiet; and understanding speech in noise. The Spatial Hearing Questionnaire, composed of 24 items, is scored from 0 to 100. It was administered to 142 subjects using one or two cochlear implants. Speech perception and localization abilities were measured, and the Speech, Spatial, and Other Qualities questionnaire was completed to evaluate validity of the questionnaire. Psychometric tests were performed to test the reliability and factor structure of the Spatial Hearing Questionnaire. Results showed high internal consistency reliability (Cronbach's alpha = 0.98) and good construct validity (correlations between the Spatial Hearing Questionnaire and other test measures, including the Speech, Spatial, and Other Qualities, were significant). A preliminary factor analysis revealed scores loaded on three factors, representing the following conditions: localization, speech in noise and music in quiet, and speech in quiet, explaining 64.9, 13.0, and 5.3% of the variance, respectively. Most of the questionnaire items (12/24) loaded onto the first factor that represents the subscale related to source localization. Mean scores on the Spatial Hearing Questionnaire were higher for subjects with bilateral cochlear implants than for subjects with a unilateral cochlear implant, consistent with other research and supporting construct validity. The Spatial Hearing Questionnaire is a reliable and valid questionnaire that can be completed independently by most patients in about 10 minutes. It is likely to be a valuable tool for clinicians and researchers to measure spatial hearing abilities.