Assessment of Self-Perceived Hearing Disability Using the Arabic Speech, Spatial, and Qualities of Hearing Scale-12...

Unilateral hearing loss (UHL), single-sided deafness (SSD), and asymmetric hearing loss (AHL) impair speech understanding in noise, sound localization, and overall communication. These conditions are commonly managed with contralateral routing of signal (CROS) or bilateral CROS (BiCROS) hearing aids. Culturally appropriate, psychometrically sound patient-reported outcome measures are needed to characterize self-perceived hearing disability in Arabic-speaking populations prior to fitting.

To characterize self-perceived hearing disability and evaluate the psychometric properties (internal consistency, floor/ceiling effects, and subscale intercorrelations) of the Arabic Speech, Spatial, and Qualities of Hearing Scale, 12-item version (SSQ-12), among adults referred for CROS/BiCROS evaluation.

In this cross-sectional observational study, 54 adults referred for CROS/BiCROS evaluation at the Audiology Department, Security Forces Hospital Program, General Directorate of Medical Services, Ministry of Interior, Riyadh, Saudi Arabia, were recruited via consecutive convenience sampling. Eligible participants were aged ≥18 years, had confirmed UHL, SSD, or AHL, and had no cognitive, psychiatric, or communication disorders precluding reliable self-report. Participants completed the Arabic SSQ-12, a 12-item patient-reported outcome measure rated on an 11-point scale from 1 (poorest) to 10 (best), with a not applicable (N/A) option, covering speech perception (items 1-5), spatial hearing (items 6-9), and sound quality (items 10-12). The questionnaire was completed independently or with the assistance of an audiologist before hearing aid fitting. Descriptive statistics (frequencies/percentages, mean ± SD), item- and subscale-level floor/ceiling effects (>15% scoring 1 or 10), internal consistency (Cronbach's α), and subscale intercorrelations (Pearson's r) were computed.

The total SSQ-12 score was 3.82 ± 2.17 (scale 1-10), with subscale means ranging from 3.54 ± 2.28 (speech perception) to 4.43 ± 2.64 (sound quality); all fell below the scale midpoint. Item SSQ6 (locating sound source direction) had the lowest mean (3.15), and 11 of 12 items showed floor effects exceeding 15%. The total SSQ-12 demonstrated excellent internal consistency (α = 0.944), and the speech perception (α = 0.885) and spatial hearing (α = 0.901) subscales showed good-to-excellent reliability, whereas the three-item sound quality subscale showed lower reliability (α = 0.548). Speech perception and spatial hearing were strongly correlated (r = 0.756, p < 0.001).

Adults referred for CROS/BiCROS evaluation report substantial self-perceived hearing disability across speech, spatial, and sound-quality domains. The Arabic SSQ-12 total scale shows excellent internal consistency and captures this disability profile, supporting its use as a routine outcome measure in Arabic-speaking CROS/BiCROS candidates, while the brief sound quality subscale warrants cautious interpretation.