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Updated: Jan 7, 2026

Systematic Hearing Performance Evaluation Process for Adolescents with Cochlear Implantation at Early Ages
Published on: March 24, 2023
Factors Associated With Hearing-Related Quality of Life in Children and Adolescents With Hearing Loss
Christina Batthyany1, Marc van der Schroeff1, Bernd Kremer1
1Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus Medical Centre, Rotterdam, the Netherlands.
Objective:
As the impact of hearing loss extends beyond auditory function, patient-reported outcome measures (PROMs) measuring quality of life (QOL) are increasingly incorporated in the management and follow-up of children with hearing loss. The Hearing Environments and Reflection on Quality of Life (HEAR-QL) is a hearing-specific QOL tool, providing insight into the impact of hearing loss on daily life. This study aims to identify factors associated with hearing-related QOL in children and adolescents with hearing loss.
Method:
Clinical data of 136 subjects (84 children and 52 adolescents) aged 7-18 years with unilateral and bilateral hearing loss, attending our audiology outpatient clinic at the Erasmus MC Sophia Children's Hospital in Rotterdam, the Netherlands, were used. The Dutch HEAR-QL questionnaires for children and adolescents were used to assess hearing-related QOL. Characteristics of hearing rehabilitation; hearing status; and the demographic factors gender, age, and education type were explored as potential factors associated with hearing-related QOL, using group comparisons, Spearman's correlation coefficient, and multiple linear regression analysis.
Results:
Univariate analysis showed that children in regular education scored significantly higher on hearing-specific QOL for the Activities subscale compared to those attending education for the deaf and hard of hearing. Adolescents with hearing aids had higher HEAR-QL scores compared to those with cochlear implants. Furthermore, speech recognition in both quiet and noise was significantly associated with hearing-related QOL in the adolescent age group. Multiple linear regression analysis confirmed higher QOL in adolescents with hearing aids and identified speech recognition in quiet at 45 dB SPL as a significant predictor of hearing-related QOL in adolescents. In children, univariate analyses revealed no significant associations with hearing device characteristics or auditory performance.
Conclusions:
The main finding of this study was that the type of hearing device and aided speech recognition scores were associated with hearing-specific QOL in adolescents, illustrating the vital contribution of hearing rehabilitation to daily life functioning. The increasing use of QOL PROMs in children and adolescents with hearing loss will facilitate further exploration of potential associated factors and could increase our insight into this vulnerable population group.
Supplemental Material:
https://doi.org/10.23641/asha.30795119.
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