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The translation and validation of the LittlEARS auditory questionnaire in isiZulu

Hearing loss is a significant contributor to years lived with disability worldwide, affecting approximately 34 million children whose daily lives are substantially impaired. To mitigate the detrimental effects of untreated hearing impairment, paediatric audiologists aim to identify hearing loss as e...

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Main Author: Nefolovhodwe, Thendo Faith
Other Authors: Petersen, Lucretia
Format: Thesis
Language:English
English
Published: Division of Communication Sciences and Disorders 2025
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access_status_str Open Access
author Nefolovhodwe, Thendo Faith
author2 Petersen, Lucretia
author_browse Nefolovhodwe, Thendo Faith
Petersen, Lucretia
author_facet Petersen, Lucretia
Nefolovhodwe, Thendo Faith
author_sort Nefolovhodwe, Thendo Faith
collection Thesis
description Hearing loss is a significant contributor to years lived with disability worldwide, affecting approximately 34 million children whose daily lives are substantially impaired. To mitigate the detrimental effects of untreated hearing impairment, paediatric audiologists aim to identify hearing loss as early as possible. This proactive approach enables them to implement timely interventions, ensuring that infants and young children receive the support they need to develop communication skills and overall well-being. Early detection is crucial for optimizing developmental outcomes and enhancing quality of life for these individuals. However, most existing audiological diagnostic tools were developed for older children and are not suitable for assessing auditory development of infants and young children who are not yet verbal. In South Africa, the lack of contextually relevant assessment tools hinders the provision comprehensive audiological rehabilitation. The LittlEARS Auditory Questionnaire (LEAQ) is a parent/caregiver questionnaire that evaluates age-dependent auditory behaviours in the prelingual stage (0-2 years). It screens the auditory development of children with normal hearing as well as those with hearing loss who are fitted with hearing aids or cochlear implants. The responses obtained from the questionnaire are derived from observations made by caregivers or parents since assessing auditory behaviours in paediatric populations is often more complex than in adults. This reliance on caregiver insights is crucial, as formal testing methods may not capture the nuances of a child's auditory experiences. The LEAQ contains questions tailored to specific age groups with the auditory response complexity increasing as the child progresses through different developmental stages. Originally developed in Germany, the LEAQ has been translated into at least 21 languages. Therefore, translating and validating this tool for South Africa's multilingual and multicultural context is essential. This study aimed to (1) translate the English version of the LEAQ into isiZulu, and (2) validate the isiZulu translation. Methods: The study aimed to (1) translate the English version of the LEAQ into isiXhosa and (2) validate the isiZulu translation. Translation Process: (1) Forward translation from English to isiZulu, (2) back translation from isiZulu to English, and (3) an expert committeereview. Validation process: An expert panel (n=6) used acontent validity questionnaire to evaluate the appropriateness and relevance of LEAQ items. 57 isiZulu-speaking parent/caregiver participants completed both the isiZulu version of the LEAQ and a face validity questionnaire. The reliability of the translated LEAQ was assessed through item and scale analysis. Results: Item Content Validity Index (I-CVI) results (0.8-1) indicated relevance across all items of the LEAQ. ScaleContent Validity Index (S-CVI) (0.914) indicated a high content validity of the isiZulu LEAQ. Face validity analysis indicated that all items on the LEAQ achieved an agreement score of ≥80%. The indices of difficulty (0.71-1), signifying that all items on the isiZulu LEAQ were easily comprehensible. All items presented with strong discrimination power ≥0.2. The Cronbach's alpha results indicated good internal consistency with α = 0.86. Conclusion: The findings indicated that following a rigorous translation procedure is useful, as it allows for the identification of any inaccuracies or discrepancies during the translation phases to attain the best quality translation. The statistical analysis indicated that the translated isiZulu LEAQ is valid. Therefore, the questionnaire is appropriate for the use amongst isiZulu speakers.
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spelling oai:open.uct.ac.za:11427/42002 The translation and validation of the LittlEARS auditory questionnaire in isiZulu Nefolovhodwe, Thendo Faith Petersen, Lucretia LittlEARS auditory questionnaire auditory development isiZulu self-evaluation scale translation scale development, cochlear implants hearing aids infants and toddlers Hearing loss is a significant contributor to years lived with disability worldwide, affecting approximately 34 million children whose daily lives are substantially impaired. To mitigate the detrimental effects of untreated hearing impairment, paediatric audiologists aim to identify hearing loss as early as possible. This proactive approach enables them to implement timely interventions, ensuring that infants and young children receive the support they need to develop communication skills and overall well-being. Early detection is crucial for optimizing developmental outcomes and enhancing quality of life for these individuals. However, most existing audiological diagnostic tools were developed for older children and are not suitable for assessing auditory development of infants and young children who are not yet verbal. In South Africa, the lack of contextually relevant assessment tools hinders the provision comprehensive audiological rehabilitation. The LittlEARS Auditory Questionnaire (LEAQ) is a parent/caregiver questionnaire that evaluates age-dependent auditory behaviours in the prelingual stage (0-2 years). It screens the auditory development of children with normal hearing as well as those with hearing loss who are fitted with hearing aids or cochlear implants. The responses obtained from the questionnaire are derived from observations made by caregivers or parents since assessing auditory behaviours in paediatric populations is often more complex than in adults. This reliance on caregiver insights is crucial, as formal testing methods may not capture the nuances of a child's auditory experiences. The LEAQ contains questions tailored to specific age groups with the auditory response complexity increasing as the child progresses through different developmental stages. Originally developed in Germany, the LEAQ has been translated into at least 21 languages. Therefore, translating and validating this tool for South Africa's multilingual and multicultural context is essential. This study aimed to (1) translate the English version of the LEAQ into isiZulu, and (2) validate the isiZulu translation. Methods: The study aimed to (1) translate the English version of the LEAQ into isiXhosa and (2) validate the isiZulu translation. Translation Process: (1) Forward translation from English to isiZulu, (2) back translation from isiZulu to English, and (3) an expert committeereview. Validation process: An expert panel (n=6) used acontent validity questionnaire to evaluate the appropriateness and relevance of LEAQ items. 57 isiZulu-speaking parent/caregiver participants completed both the isiZulu version of the LEAQ and a face validity questionnaire. The reliability of the translated LEAQ was assessed through item and scale analysis. Results: Item Content Validity Index (I-CVI) results (0.8-1) indicated relevance across all items of the LEAQ. ScaleContent Validity Index (S-CVI) (0.914) indicated a high content validity of the isiZulu LEAQ. Face validity analysis indicated that all items on the LEAQ achieved an agreement score of ≥80%. The indices of difficulty (0.71-1), signifying that all items on the isiZulu LEAQ were easily comprehensible. All items presented with strong discrimination power ≥0.2. The Cronbach's alpha results indicated good internal consistency with α = 0.86. Conclusion: The findings indicated that following a rigorous translation procedure is useful, as it allows for the identification of any inaccuracies or discrepancies during the translation phases to attain the best quality translation. The statistical analysis indicated that the translated isiZulu LEAQ is valid. Therefore, the questionnaire is appropriate for the use amongst isiZulu speakers. 2025-10-13T13:34:20Z 2025-10-13T13:34:20Z 2025 2025-10-13T13:08:44Z Thesis / Dissertation Masters MSc http://hdl.handle.net/11427/42002 en eng application/pdf Division of Communication Sciences and Disorders Faculty of Health Sciences Universiy of Cape Town
spellingShingle LittlEARS auditory questionnaire
auditory development
isiZulu
self-evaluation scale
translation
scale development, cochlear implants
hearing aids
infants and toddlers
Nefolovhodwe, Thendo Faith
The translation and validation of the LittlEARS auditory questionnaire in isiZulu
thesis_degree_str Master's
title The translation and validation of the LittlEARS auditory questionnaire in isiZulu
title_full The translation and validation of the LittlEARS auditory questionnaire in isiZulu
title_fullStr The translation and validation of the LittlEARS auditory questionnaire in isiZulu
title_full_unstemmed The translation and validation of the LittlEARS auditory questionnaire in isiZulu
title_short The translation and validation of the LittlEARS auditory questionnaire in isiZulu
title_sort translation and validation of the littlears auditory questionnaire in isizulu
topic LittlEARS auditory questionnaire
auditory development
isiZulu
self-evaluation scale
translation
scale development, cochlear implants
hearing aids
infants and toddlers
url http://hdl.handle.net/11427/42002
work_keys_str_mv AT nefolovhodwethendofaith thetranslationandvalidationofthelittlearsauditoryquestionnaireinisizulu
AT nefolovhodwethendofaith translationandvalidationofthelittlearsauditoryquestionnaireinisizulu