Abstract
A self-administered questionnaire concerning auditory disability and handicap was completed by 1691 subjects who were part of a two-stage random sample of the UK adult population. A principal components analysis of questionnaire replies identified four components. They were interpreted as (a) disability for everyday speech, (b) disability for speech-in-quiet, (c) localisation, and (d) hearing handicap. Components (a) and (d) were the strongest, accounting for 68% of the variance. Subjects also performed pure-tone audiometry amongst other tests. Audiometric information was well described by a two-parameter model characterised by low-to-mid-frequency loss and high-frequency slope. All four components increased progressively with increasing low-to-mid-frequency loss, independent of high-frequency slope. They were best correlated with a binaural average over 0.5,1 and 2 kHz weighted 4:1 in favour of the better ear, out of several audiometric descriptors examined. Sex and socio-economic group did not generally affect disability or handicap, but people of similar hearing impairment reported less disability and handicap as age increased. This is interpreted as over-compensation for the effects of age in self-report. There were three unexpected findings which may entail some changes in current thinking on the relationship between auditory impairment and self-perceived disability/handicap, (a) Hearing losses incorporating a conductive component in the better ear were more disabling and handicapping than sensorineural losses of equal magnitude, (b) Localisation ability and, to a lesser extent, general hearing handicap were more highly correlated with measures of impairment in the worse ear than in the better ear. (c) There was little evidence for the concept of a ‘low fence’ in the relationship between impairment and either disability or handicap.
