Objectives: To adapt the LittlEARS^® Auditory Questionnaire into the Maltese language and evaluate the psychometric properties of the Maltese version of the questionnaire for hearing children. Methods: The English version of LittlEARS^® Auditory Questionnaire was adapted into Maltese using a translation/back translation procedure. In this cross-sectional study, a total of 398 parents of normal hearing children aged between 5 days and 36 months completed the Maltese version of LittlEARS^®. Psychometric validation was performed through scale analysis, item analysis, and analysis of reliability and validity. A non-linear regression model was derived to obtain normative data for expected and minimum values of total scores from the questionnaire according to age. Results: Predictive accuracy (Guttman’s lambda) was 0.921, the Cronbach’s alpha coefficient value was 0.921, and the split-half reliability coefficient was 0.949. The Pearson correlation coefficient between scores and age was 0.903. The regression analysis showed that 82% of the variance in the total scores can be explained by age. Norm curves were comparable to the original German data. Conclusion: This study confirmed that the Maltese version of LittlEARS^® is a valid and reliable tool to evaluate auditory development in children less than two years of age.

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.

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.