Integrating the ICF Framework for Comprehensive Hearing and Functioning Assessment Using the HEAR-COMMAND Tool to Enhance Clinical Practice

Authors: Tahereh Afghah1,2, Razan Al Fakir3, Markus Meis4, Mahmoud Hammady5, Mostafa Youssif5, Sophia E. Kramer6, Kirsten Wagener1,2

1Hörzentrum Oldenburg gGmbH
2Cluster of Excellence Hearing4all
3Department of Speech-Language and Hearing Sciences, ABILITY Research Lab, Auburn University
4Research Department, Cochlear Deutschland GmbH & Co. KG
5Department of Otolaryngology, Head and Neck Surgery, Audiovestibular Medicine Division, Sohag University Hospital
6Department of Otolaryngology, Head and Neck Surgery, Amsterdam University Medical Center

Background: A thorough evaluation of Hearing Loss (HL) requires a broad overview of hearing impairment and its impacts on quality of life. Laboratory measurements are insufficient for revealing a wide range of daily-life difficulties caused by HL. The World Health Organization’s (WHO) International Classification of Functioning, Disability, and Health Framework (ICF) Core Sets for Hearing Loss were developed to address numerous factors regarding the causes and consequences of HL. HEAR-COMMAND tool is a questionnaire developed and validated in Germany, the USA, the Netherlands, and Egypt to integrate the ICF framework into clinical practice and facilitate broad HL screening. The tool contains 90 ICF-based items and 30 items regarding HL and personal factors. The current validation includes normal-hearing (NH) subjects and hearing-impaired (HI) patients with mild to moderately severe HL.

Method: The tool was completed by 215 subjects in their native language: English, German, or Arabic. To summarize the outcome, three scores were defined: “Hearing-related score”, “Speech perception score”, and “Non-hearing-related score”.

Results: The tool was found to have a high internal consistency. NH subjects had significantly lower hearing-related and speech perception scores compared to HI patients. Factor analysis revealed the following seven constructs: “Interpersonal interaction functionality and infrastructure accessibility”, “Social determinants and infrastructure compatibility”, “Other sensory integration functionality”, “Cognitive functionality”, “Auditory processing functionality”, “Sound quality compatibility”, and “Listening and communication functionality”.

Conclusion: The tool is adequately capable of creating a comprehensive profile of an individual’s hearing impairment, making it a practical resource to represent HL-related daily life challenges. Healthcare professionals can use it to encounter a wide range of factors in rehabilitation and treatment planning.