Development and Evaluation of Pediatric Versions of the Vanderbilt Fatigue Scale (VFS-Peds) for Children with Hearing Loss

Abstract

Growing evidence suggests that fatigue associated with listening difficulties is particularly problematic for children with hearing loss (CHL). However, sensitive, reliable, and valid measures of listening-related fatigue do not exist. To address this gap, this paper describes the development, psychometric evaluation, and preliminary validation of a suite of scales designed to assess listening-related fatigue in CHL- the pediatric Vanderbilt Fatigue Scales (VFS-Peds).

Test development employed best practices, including operationalizing the construct of listening-related fatigue from the perspective of target respondents (i.e., children, their parents, and teachers). Test items were developed based on input from these groups. Dimensionality was evaluated using exploratory factor analyses. Item response theory (IRT) and differential item functioning (DIF) analyses were used to identify high-quality items which were further evaluated and refined to create the final versions of the VFS-Peds.

The VFS-Peds is appropriate for use with children aged 6-17 years and consists of a child self-report scale (VFS-C), parent proxy- (VFS-P), and teacher proxy-report (VFS-T) scales. Exploratory factor analyses of child self-report and teacher proxy data suggested listening-related fatigue was unidimensional in nature. In contrast, parent data suggested a multidimensional construct, comprised of mental (cognitive, social, and emotional) and physical domains. IRT analyses suggested items were of good quality, with high information and good discriminability. DIF analyses revealed the scales provided a stable measure of fatigue regardless of the child’s gender, age, or hearing status. Test information was acceptable over a wide range of fatigue severities and all scales yielded acceptable reliability and validity.

This paper describes the development, psychometric evaluation, and validation of the VFS-Peds. Results suggest the VFS-Peds provide a sensitive, reliable, and valid measure of listening-related fatigue in children that may be appropriate for clinical use. Such scales could be used to identify those children most affected by listening-related fatigue; and given their apparent sensitivity, the scales may also be useful for examining the effectiveness of potential interventions targeting listening-related fatigue in children.