Listening effort and downstream effects due to hearing loss in children & young people: An online quantitative questionnaire-based observational study

Callum Shields, Mark Sladen, Azita Rajai, Hannah Guest, Iain Bruce, Karolina Kluk-De Kort, Jaya Nichani

Research output: Contribution to journalArticlepeer-review


The clinical application of listening effort (LE) is challenging due to the lack of consensus regarding measuring the concept. Correlational analysis between different measuring instruments shows conditional and weak relationships, indicating they capture different dimensions of LE. Current research has suggested possible links between LE and downstream consequences such as fatigue, stress, and confidence. One way to clinically measure LE would be to focus on its corollaries. Further research is needed to explore whether tools used to measure these downstream effects can be applied to capture LE.
This study explores using existing questionnaire-based outcome instruments to evaluate LE and its associated consequences in children and young people (CYP), with and without hearing loss.

One hundred CYP aged 12-17 years with normal hearing and a range of hearing loss levels will be invited to complete a series of online questionnaires (Speech, Spatial and Qualities, Vanderbilt Fatigue Scale – Child, Perceived Stress Scale, and Rosenberg Self-Esteem Scale) and a hearing test (Digits in Noise). They will complete the questionnaires at two-time points 1: at the end of a REST day; 2: at the end of a WORK day. Standard demographic and hearing health information will be collected. The sample size was determined pragmatically due to a lack of comparable published data to power the study. Tests are exploratory and for generating hypotheses; therefore, the standard criterium of p < 0.05 will be used.

This study has been reviewed within the funding organisation (Cochlear Research and Development Limited) by an independent and relevant peer reviewer/committee. This study has had a favourable ethics committee review by both NHS ethics and University of Manchester ethics. The study will be disseminated through newsletters, publication and presentations at conferences. The results will be made available to participants upon request.

- Records data at two time points to allow within-subject comparison.
- Relatively large sample size (n = 100).
- Entirely remote to avoid unnecessary expense/time commitments for the participants.
- Technology bias – This study is limited to the recruitment of participants with access to an internet-enabled device.
- Those with severe/profound hearing loss may not be able to complete the digits in noise test unaided.
Original languageEnglish
Article numbere069719
JournalBMJ Open
Publication statusPublished - 20 Feb 2023


  • audiology
  • paediatric otolaryngology
  • neurotology
  • otolaryngology


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