title: The Ling 6(HL) test: typical pediatric performance data and clinical use evaluation.
abstract: 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.
  
  
  OBJECTIVE
  The purpose of this work was to evaluate and refine the Ling 6(HL) test for use in pediatric hearing aid outcome measurement.
  
  
  METHODS
  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.
  
  
  METHODS
  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.
  
  
  METHODS
  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.
authors.affiliation: National Centre for Audiology and School of Communications Sciences and Disorders, Western University, London, ON Canada.
authors.forename: Danielle
authors.initials: D
authors.lastname: Glista
authors.affiliation: National Centre for Audiology and School of Communications Sciences and Disorders, Western University, London, ON Canada.
authors.forename: Susan
authors.initials: S
authors.lastname: Scollie
authors.affiliation: National Centre for Audiology and School of Communications Sciences and Disorders, Western University, London, ON Canada.
authors.forename: Sheila
authors.initials: S
authors.lastname: Moodie
authors.affiliation: National Centre for Audiology and School of Health and Rehabilitation Sciences, Western University, London, ON Canada.
authors.forename: Vijayalakshmi
authors.initials: V
authors.lastname: Easwar
mesh_terms: D000293:Adolescent; D000328:Adult; D001309:Auditory Threshold; D002648:Child; D002675:Child, Preschool; D005260:Female; D006310:Hearing Aids; D006319:Hearing Loss, Sensorineural / Q000175:diagnosis*; D006320:Hearing Tests / Q000379:methods*; D006801:Humans; D008297:Male; D013067:Speech Perception; D011795:Surveys and Questionnaires