Development and Validation of a Psychometric Tool for Disability Assessment in Auditory Neuropathy Spectrum Disorder

Individuals with auditory neuropathy spectrum disorder (ANSD) often demonstrate disproportionately poor speech understanding in noise relative to their pure-tone thresholds. Conventional disability assessments based on pure-tone averages (PTAs) fail to capture these functional limitations, leading to an underestimation of disability. This study aimed to develop and validate the Auditory Neuropathy Perceived Disability Questionnaire (ANPDQ), a condition-specific psychometric tool that assesses functional disability in ANSD.

The study involved 116 individuals aged ≥ 15 years with a confirmed diagnosis of ANSD. The study was conducted in two phases: (1) development and validation of the ANDPQ to assess disability in individuals with ANSD and (2) administration of the questionnaire to evaluate functional disability. The ANPDQ was developed through literature review, patient interviews, and expert input. The final 59-item questionnaire covered functional, psychosocial, and audiological domains.

The ANPDQ demonstrated robust psychometric properties. Eight interpretable components emerged, explaining 74.1% of the total variance. High internal consistency was observed in domains related to speech-in-noise communication, listening effort, and psychological impact. ANPDQ scores showed weak-to-moderate correlations with traditional audiometric measures, highlighting the distinct contribution of self-perceived disability.

The ANPDQ is a valid, reliable tool for assessing functional disability in ANSD. This study proposes a novel composite formula combining PTA and ANPDQ scores to more accurately estimate total hearing disability, for advancing equitable disability certification. The ANPDQ may also serve as a valuable tool for guiding individualized rehabilitation strategies to the unique communicative and psychosocial needs of individuals with ANSD. Grounded in the ICF framework, ANPDQ also holds potential for cross-cultural adaptation and application in global contexts.