Synchronising audiology measurement and listening-based communication ability in adults with hearing loss: a scoping review of clinical measures

Hearing loss in adults has a pervasive impact on health and well-being, however these impacts are poorly assessed within clinical settings. Improving our understanding of the different constructs of listening and communication within existing measures could facilitate discussions around the appraisal and utility of such measures. Therefore, this systematic scoping review aimed to: (i) provide a descriptive analysis of current measures used to evaluate listening skills needed for oral communication in adults with hearing loss; and (ii) contrast the content of these assessments and their underlying constructs with broader features of functional listening and communication. Methods: Systematic database searches were conducted to retrieve peer-reviewed articles that used one or more linguistic-based measure necessary to oral communication in adults with hearing loss. Results: 2505 articles met the inclusion criteria and were included in the scoping review. Data synthesis indicated that the primary linguistic-based measure used in these studies was word or sentence identification presented in quiet (65.8%). In contrast, discourse-based measures that are the foundation of social communication were used in 2.7% of the articles included. The self-reported measures’ item analysis included over 2400 questions. The content analysis of these questions demonstrated that external auditory elements were present in 37.3% of the items. Pragmatic and linguistic constructs central to interactional communication were represented in only 13.5% and 7.5% respectively of the pool of items. Discussion: Overall, the results suggest that current measures used in clinical studies to assess listening abilities relevant to oral communication target only a narrow set of domains that are part of the listening and communication construct. This narrow scope may, in part, explain the poor relationship of existing measurement and individual’s perception of their communication abilities, as shown in the literature. Without considering the broader linguistic, cognitive and interactive elements of communication, existing measures of listening abilities may have limited clinical application to everyday situations, as experienced by an adult with hearing loss.