Psychometric properties of the Inventory of Life Quality in children and adolescents in Norwegian Sign Language

Abstract

Background Several studies have assessed the Quality of Life (QoL) in Deaf and hard-of-hearing (DHH) children and adolescents. The findings from these studies, however, vary from DHH children reporting lower QoL than their typically hearing (TH) peers to similar QoL and even higher QoL. These differences have been attributed to contextual and individual factors such as degree of access to communication, the participants’ age as well as measurement error. Using written instead of sign language measures has been shown to underestimate mental health symptoms in DHH children and adolescents. It is expected that translating generic QoL measures into sign language will help gain more accurate reports from DHH children and adolescents, thus eliminating one of the sources for the observed differences in research conclusions. Hence, the aim of the current study is to translate the Inventory of Life Quality in Children and Adolescents into Norwegian Sign Language (ILC-NSL) and to evaluate the psychometric properties of the self-report of the ILC-NSL and the written Norwegian version (ILC-NOR) for DHH children and adolescents. The parent report was included for comparison. Associations between child self-report and parent-report are also provided. Methods Fifty-six DHH children completed the ILC-NSL and ILC-NOR in randomized order while their parents completed the parent-report of the ILC-NOR and a questionnaire on hearing- and language-related information. Internal consistency was examined using Dillon-Goldstein’s rho and Cronbach’s alpha, ILC-NSL and ILC-NOR were compared using intraclass correlation coefficients. Construct validity was examined by partial least squares structural equation modeling (PLS-SEM). Results Regarding reliability, the internal consistency was established as acceptable to good, whereas the comparison of the ILC-NSL with the ILC-NOR demonstrated closer correspondence for the adolescent version of the ILC than for the child version. The construct validity, as evaluated by PLS-SEM, resulted in an acceptable fit for the proposed one-factor model for both language versions for adolescents as well as the complete sample. Conclusion The reliability and validity of the ILC-NSL seem promising, especially for the adolescent version, even though the validation was based on a small sample of DHH children and adolescents.

Deaf and hard-of-hearing children and adolescents’ mental health, Quality of Life and communication

“…[ 30 , 32 ]. We administered both the parent and the self-report versions of the ILC in written Norwegian (ILC-NOR) and NSL (ILC-NSL; [ 22 ]) for this study.…”

“…DHH children responded to the written and the NSL versions of the ILC and SDQ. A more detailed description of the DHH group can be found here: [ 22 , 69 ]. The HH children and their parents recruited through the ENT department received information about the study by mail.…”

“…Another systematic review [ 21 ] finds that (D)HH children score significantly lower on validated QoL measures. Methodological issues with this systematic review, including misinterpretation of the results of two of the included studies, have been discussed by Aanondsen, Jozefiak, Heiling et al [ 22 ]. Some studies report no significant differences between TH and (D)HH children in QoL [ 23 – 25 ], whereas recent Norwegian studies on (D)HH children [ 3 ] and children with CI [ 26 , 27 ] report significantly lower overall QoL (parent and self-report).…”

“…Some studies report no significant differences between TH and (D)HH children in QoL [ 23 – 25 ], whereas recent Norwegian studies on (D)HH children [ 3 ] and children with CI [ 26 , 27 ] report significantly lower overall QoL (parent and self-report). The subjectiveness of QoL as a concept [ 28 ], differences between parent- and self-report, and the importance of multiple perspectives have been described [ 21 , 22 , 29 – 34 ]. Age [ 31 , 35 ], degree of HL [ 23 – 25 ], and communication [ 26 , 27 , 36 ] have all been associated with QoL in (D)HH children.…”

“…Among these are the low prevalence of moderate to profound HL [ 54 ], resulting in small sample sizes, heterogeneity in outcomes for mental health, QoL [ 20 ] and communication due to differences in aetiology of HL [ 55 ], access to newborn hearing screening, early intervention as well as the likelihood of other disabilities [ 4 , 9 ]. In addition, mode and level of communication [ 1 , 11 ], differences in services between countries, choice of instruments (generic vs ad hoc [ 20 ], written vs sign language measures [ 14 , 56 ]) as well as methodological issues such as those reported here previously [ 22 ] also contribute to the heterogeneity in findings. Assessing DHH children is challenging, as few validated assessment tools are available in sign language, but necessary as studies have shown that DHH children report more symptoms on measures in Sign Language than on written ones [ 14 , 56 ].…”