Background: The Ling 6(HL) test offers a calibrated version of naturally produced speech sounds
in dB HL for evaluation of detection thresholds. Aided performance has been previously
characterized in adults.
Purpose: The purpose of this work was to evaluate and refine the Ling 6(HL) test for use in
pediatric hearing aid outcome measurement.
Research Design: This work is presented across two studies incorporating an integrated knowledge translation
approach in the characterization of normative and typical performance, and in the
evaluation of clinical feasibility, utility, acceptability, and implementation.
Study Sample: A total of 57 children, 28 normally hearing and 29 with binaural sensorineural hearing
loss, were included in Study 1. Children wore their own hearing aids fitted using
Desired Sensation Level v5.0. Nine clinicians from The Network of Pediatric Audiologists
participated in Study 2.
Data Collection and Analysis: A CD-based test format was used in the collection of unaided and aided detection
thresholds in laboratory and clinical settings; thresholds were measured clinically
as part of routine clinical care. Confidence intervals were derived to characterize
normal performance and typical aided performance according to hearing loss severity.
Unaided-aided performance was analyzed using a repeated-measures analysis of variance.
The audiologists completed an online questionnaire evaluating the quality, feasibility/executability,
utility/comparative value/relative advantage, acceptability/applicability, and interpretability,
in addition to recommendation and general comments sections.
Results: Ling 6(HL) thresholds were reliably measured with children 3–18 yr old. Normative
and typical performance ranges were translated into a scoring tool for use in pediatric
outcome measurement. In general, questionnaire respondents generally agreed that the
Ling 6(HL) test was a high-quality outcome evaluation tool that can be implemented
successfully in clinical settings.
Conclusions: By actively collaborating with pediatric audiologists and using an integrated knowledge
translation framework, this work supported the creation of an evidence-based clinical
tool that has the potential to be implemented in, and useful to, clinical practice.
More research is needed to characterize performance in alternative listening conditions
to facilitate use with infants, for example. Future efforts focused on monitoring
the use of the Ling 6(HL) test in daily clinical practice may help describe whether
clinical use has been maintained across time and if any additional adaptations are
necessary to facilitate clinical uptake.
Key Words
Aided thresholds - children, hearing aids - Ling 6(HL) test - outcome measurement
