Objective: To investigate the feasibility of using the LittlEARS (R) Auditory Questionnaire (LEAQ (R)) as part of the infant hearing screening programme in Germany. Design: LEAQ (R) s were distributed to 47 paediatric practices and were completed by the parents/guardians of the infants (aged between 9-14 months) involved in the study (= LEAQA (R) screening). The infants who failed the LEAQA (R) screening were invited to a LEAQ rescreening. Infants who failed the LEAQA (R) rescreening were sent to a paediatric ENT specialist. After 3 years, a follow-up was performed on two groups: the first group comprised infants who failed the LEAQ screening; the second group (control group) comprised 200 infants who passed the LEAQ screening. Study Sample: 5316 questionnaires were returned. Results: Six infants with permanent hearing loss were identified using the LEAQA (R) as a screening tool. Conclusions: An infant hearing screening using the LEAQA (R) is easily implementable in paediatric practices and may be a good alternative in countries where no objective screening instruments are available. The LEAQA (R) was suitable for monitoring hearing development in infants in general and could help to identify a late-onset or progressive hearing loss in infants.

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.

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.

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.

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.

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.