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Pediatric Vanderbilt Fatigue Scale (Hornsby et al., 2022)

online resource
posted on 2022-05-27, 22:26 authored by Benjamin W. Y. Hornsby, Stephen Camarata, Sun-Joo Cho, Hilary Davis, Ronan McGarrigle, Fred H. Bess

Purpose: 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 article describes the development, psychometric evaluation, and preliminary validation of a suite of scales designed to assess listening-related fatigue in CHL: the pediatric versions of the Vanderbilt Fatigue Scale (VFS-Peds).

Method: 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 (EFAs). 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.

Results: The VFS-Peds is appropriate for use with children aged 6–17 years and consists of child self-report (VFS-C), parent proxy–report (VFS-P), and teacher proxy–report (VFS-T) scales. EFA of child self-report and teacher proxy data suggested that listening-related fatigue was unidimensional in nature. In contrast, parent data suggested a multidimensional construct, composed of mental (cognitive, social, and emotional) and physical domains. IRT analyses suggested that items were of good quality, with high information and good discriminability. DIF analyses revealed the scales provided a comparable 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.

Conclusions: This article describes the development, psychometric evaluation, and validation of the VFS-Peds. Results suggest that 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.

Supplemental Material S1. Construct Map showing domains and severity levels of listening-related fatigue in CHL. This map was used to guide development of the VFS-Peds items.

Supplemental Material S2. Vanderbilt Fatigue Scale- Child self-report version (VFS-C).

Supplemental Material S3. Vanderbilt Fatigue Scale- Parent proxy-report version (VFS-P).

Supplemental Material S4. Vanderbilt Fatigue Scale- Teacher proxy-report version (VFS-T).

Supplemental Material S5. VFS-Peds item parameter estimates.

Supplemental Material S6. Tables for converting VFS-Peds summed scores to IRT scale scores.

Hornsby, B. W. Y., Camarata, S., Cho, S.-J., Davis, H., McGarrigle, R., & Bess, F. H. (2022). Development and evaluation of Pediatric Versions of the Vanderbilt Fatigue Scale for Children With Hearing Loss. Journal of Speech, Language, and Hearing Research. Advance online publication.


The primary support for this work was provided by a grant from the Institute for Education Sciences (R324A160300; PI: Bess). Additional support was provided by a Vanderbilt Institute for Clinical and Translational Research Grant (UL1 TR000445 from NCATS/ NIH) to the Vanderbilt University Medical Center. Graphic services were supported in part by EKS NICHD Grant 1P50HD103537-01 to the Vanderbilt Kennedy Center.