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Int J Pediatr Otorhinolaryngol. 2017 Mar;94:23-29. doi: 10.1016/j.ijporl.2017.01.007. Epub 2017 Jan 9.

Development and evaluation of the LittlEARS® Early Speech Production Questionnaire - LEESPQ.

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Catholic University of Applied Sciences, Department of Health Care and Nursing, Saarstr. 3, 55122 Mainz, Germany. Electronic address:
MED-EL, MED-EL Worldwide Headquarters, Fürstenweg 77a, 6020 Innsbruck, Austria.
MED-EL, MED-EL Deutschland, Moosstraße 7, 82319 Starnberg, Germany.
Voice Care Center Bad Rappenau, Salinenstr. 43, 74906 Bad Rappenau, Germany.



Universal Newborn Hearing Screening programs, now instituted throughout the German-speaking countries, allow hearing loss to be detected and treated much earlier than ever before. With this earlier detection, arises the need for tools fit for assessing the very early speech and language production development of today's younger (0-18 month old) children. We have created the LittlEARS® Early Speech Production Questionnaire, with the aim of meeting this need.


600 questionnaires of the pilot version of the LittlEARS® Early Speech Production Questionnaire were distributed to parents via pediatricians' practices, day care centers, and personal contact. The completed questionnaires were statistically analyzed to determine their reliability, predictive accuracy, internal consistency, and to what extent gender or unilingualism influenced a child's score. Further, a norm curve was generated to plot the children's increased expected speech production ability with age.


Analysis of the data from the 352/600 returned questionnaires revealed that scores on LittlEARS® Early Speech Production Questionnaire correlate positively with a child's age, with older children scoring higher than do younger children. Further, the questionnaire has a high measuring reliability, high predictability, high unidemensionality of scale, and is not significantly gender or uni-/multilingually biased. A norm curve for expected development with age was created.


The LittlEARS® Early Speech Production Questionnaire (LEESPQ) is a valid tool for assessing the most important milestones in very early development of speech and language production of German language children with normal hearing aged 0-18 months old. The questionnaire is a potentially useful tool for long-term infant screening and follow-up testing and for children with normal hearing and those who would benefit from or use hearing devices.


Early speech and language production; Infant vocalization; LEESPQ; Language development; Prelexical vocalization; Speech development

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