Development of the Screening Test for Hearing Problems

Purpose: The goal of this study was to develop a brief self-assessment instrument to screen for communication problems and psychosocial adjustment to hearing impairment as part of a rehabilitative needs assessment. Method: A pseudorandom sample of 1,000 cases was drawn from a large, heterogeneous clinical database containing audiometric data and responses to the Communication Profile for the Hearing Impaired (CPHI; Erdman & Demorest, 1998a). Item response theory was used to derive item-characteristic curves, and item selection was based primarily on item discrimination. Internal consistency, factor structure, sensitivity, and specificity of 2 scales, Communication and Adjustment, were evaluated in a holdout sample of 319 cases from the same database. Results: A 9-item Communication scale and an 11-item Adjustment scale both showed satisfactory internal consistency, and the 20-item test presented a clear 2-factor structure. Sensitivity and specificity functions and positive and negative predictive values indicated that the 2 scales could be used to identify the bottom 2 quartiles of the clinical population, as defined by factor scores on the CPHI. Conclusion: The 2 scales of the Screening Test for Hearing Problems can be used to screen for communication and adjustment problems that warrant a comprehensive rehabilitative assessment.