PP114 - Listening-Related Fatigue in Children with Hearing Loss: Perspectives from Children, Parents, and Teachers Using the VFS-Peds-BP

Abstract:
This study examines listening-related fatigue in children with hearing loss using the Brazilian Portuguese Pediatric Vanderbilt Fatigue Scales (VFS-Peds-BP). Reports from children, parents, and teachers reveal varying fatigue levels and significant correlations within each group. For children and parents, fatigue was linked to hearing device type, remote microphone system use, and duration of device use, highlighting the benefits of assistive technology over time. Teachers identified correlations between observed student fatigue and factors such as their own educational level, professional qualifications, institution type, and the number of students with hearing loss. The VFS-Peds-BP is an valuable tool for developing targeted interventions.

Summary:
Objective
This study aimed to evaluate listening-related fatigue in children and adolescents with hearing loss using the Brazilian Portuguese versions of the Pediatric Vanderbilt Fatigue Scales (VFS-Peds-BP). Fatigue perceptions were assessed separately for children/adolescents (VFS-C-BP), parents (VFS-P-BP), and teachers (VFS-T-BP). The study also examined correlations between fatigue levels and select demographic and audiological factors within each group.

Rationale
Listening-related fatigue impacts children with hearing loss in high-demand listening environments, such as classrooms, where increased cognitive load leads to fatigue, potentially affecting academic performance and social interactions. Identifying influencing factors is essential for developing effective interventions.

Methods
The study included 89 participants across three groups: 24 children/adolescents with hearing loss, 41 parents, and 24 teachers. Recruitment was conducted using convenience sampling via social media and direct contact with parents and teachers.

Nominal variables, such as type of hearing device (hearing aid or cochlear implant) and RMS (remote microphone system) use (e.g., no use, intermittent use, or consistent use), were transformed into ordinal scales for correlation analysis. Analyses were conducted separately for each group to explore associations between fatigue levels and relevant factors. Normality testing guided correlation method selection.

For the VFS-C-BP group, the Shapiro-Wilk test confirmed normality (W = 0.956, p = 0.363), allowing Pearson’s correlation to analyze associations with variables such as age, degree of hearing loss, and therapy duration. For the VFS-P-BP and VFS-T-BP groups, Spearman’s correlation was used due to the non-parametric nature of the data, small sample size, and ordinal transformation of variables. Analyses for the VFS-C-BP and VFS-P-BP groups focused on device-specific factors, including the type of hearing device, RMS use, and their duration of use. The VFS-T-BP group analyses examined associations between fatigue and teacher-related factors, including educational level, professional qualifications, institution type, and number of students with hearing loss supported.

Results
Significant associations were found between listening-related fatigue and several factors. For children, moderate negative correlations were observed between fatigue levels and cochlear implant use (r = -0.536) and duration of device use (r = -0.255), indicating that prolonged use reduced fatigue. Similarly, RMS use showed a moderate negative correlation with fatigue (r = -0.274), suggesting its effectiveness in reducing listening effort.

In the teacher group, weak positive correlations were found between observed student fatigue and variables such as educational level and academic grade taught (rs = 0.22 and rs = 0.25, respectively), suggesting advanced educational settings may contribute to higher fatigue levels in children.

Conclusion
Listening-related fatigue in children with hearing loss is influenced by factors such as hearing device type, duration of cochlear implant use, and RMS use. Longer use and consistent RMS implementation were associated with reduced fatigue in children. However, teachers observed higher fatigue in children in advanced academic settings and among those taught by highly educated teachers. These findings highlight the multifaceted nature of listening-related fatigue and the importance of tailored strategies to address influencing factors. Small sample size affects generalizability, and convenience sampling may limit representativeness. Future research should include larger, more diverse samples to validate these findings.