Ira M. Ventry

The Hearing Handicap Inventory for the Elderly: a New Tool

This report describes the development and standardization of the Hearing Handicap Inventory for the Elderly (HHIE). This self-assessment tool is designed to assess the effects of hearing impairment on the emotional and social adjustment of elderly people. The inventory is comprised of two subscales: a 13-item subscale explores the emotional consequences of hearing impairment; a 12-item subscale explores both social and situational effects. The inventory was administered to 100 elderly subjects (mean age = 75 years) with hearing threshold levels in the better ear ranging from normal to severe. The reliability of the HHIE was evaluated by assessing its internal consistency through the computation of Chronbachs alpha. Alpha values ranged from 0.88 (social/situational subscale) to 0.95 for the entire inventory. Split-half reliabilities were equally high. The validity of the HHIE was not directly evaluated. Certain aspects of the data, however, support the construct validity of the instrument, while analysis of the questions themselves appears to attest to its content validity. Possible uses of the inventory were described and suggestions were made regarding future research on the instrument. The reliability and validity of the HHIE as well as its brevity, simplicity, and ease of administration and interpretation all recommend its use in assessing hearing handicap in the elderly.

Test-retest reliability of the hearing handicap inventory for the elderly

The Hearing Handicap Inventory for the Elderly (HHIE) is a self-assessment tool, composed of emotional and social/situational subscales and designed to measure the perceived effects of hearing impairment in the noninstitutionalized elderly. Previous study has indicated that the HHIE has a high internal consistency, as well as high split-half reliability. The present study was undertaken to examine test-retest reliability associated with the HHIE, as the latter information is prerequisite to the application of the HHIE as a measure of change in perception of handicap which may result from audiologic intervention. Forty-seven noninstitutionalized elderly individuals with sensorineural hearing loss were sampled, using two measurement techniques: face-to-face (N = 20) and paper-and-pencil (N = 27) administration. Test-retest reliability was high for both the face-to-face and paper-and-pencil administration, suggesting that the HHIE has potential as a measure of change resulting from rehabilitation.

Effect of ascending and descending measurement methods on comfortable loudness levels for pure tones

The effect of ascending and descending measurement methods on comfortable loudness (MCL) levels for continuous and interrupted 1000‐Hz pure tones was studied using Bekesy audiometry and 20 normal‐hearing adults. Ascending pure‐tone MCLs were significantly lower than descending MCLs for both types of pure‐tone stimuli with differences ranging from 12 to 30 dB. The relationship between MCLs obtained with continuous and interrupted stimuli was unaffected by measurement method.

The contribution of the acoustic reflex to the ascending-descending most comfortable loudness gap

The contribution of the acoustic reflex (AR) contraction to the ascending-descending (A-D) gap was explored. 15 normal listeners traced ascending and descending most comfortable loudness (MCL) levels for continuous (C) and interrupted (I) tones at 250, 1000 and 4000 Hz. Reflex thresholds were obtained for each subject at the test frequencies. No evidence was found to implicate the AR as the causative agent in the A-D gap. Two important trends emerged: (1) an ordering of MCL conditions occurred which was consistent across frequencies and (2) there was a consistent difference between AR level and MCL for a given stimulus condition which was constant across frequencies. The findings suggest that a predictive relationship may exist between AR and pure-tone MCL.

The relationship of continuous (C) and interrupted (I) tones at threshold and most comfortable loudness (MCL) in hearing-impaired ears.

Differences in the Bekesy tracking levels of continuous (C) and interrupted (I) tones at both threshold and most comfortable loudness (MCL) were determined in a large clinical sample of persons with hearing loss. Results indicate small but significant C-I differences not only at the two levels separately but also in the tracking of C and I tones at threshold relative to MCL, regardless of frequency or hearing loss severity. Such results may have implications for both diagnostic and rehabilitative audiology.