Introduction
The Communication Profile for the Hearing Impaired (CPHI) is a 145-item self-assessment inventory that provides a systematic, comprehensive picture of communication problems and rehabilitation needs in adults with hearing loss. Marilyn E. Demorest and Sue Ann Erdman reported the full instrument in 1987 in the Journal of Speech and Hearing Disorders. It has received more than 400 citations.
The CPHI is especially relevant to aural rehabilitation. This guide explains its scales, its profile-based scoring, its reliability and how clinicians use it.
Key Features of the CPHI
Purpose and Use
The CPHI assesses communication problems and rehabilitative needs in hearing-impaired adults. Clinicians use it mainly for comprehensive assessment and treatment planning in audiological rehabilitation.
Target Population
The CPHI targets adults aged 18 and older with hearing loss, particularly those undergoing rehabilitation.
Structure
The CPHI contains 145 items scored into 25 scales across several domains:
Communication PerformanceCommunication EnvironmentCommunication StrategiesPersonal AdjustmentCommunication ImportanceProblem Awareness and DenialThe items fall into three parts. The first asks how often the person communicates effectively in everyday situations, such as conversation while driving or using the phone at work, and how important each situation is. The second describes communication experiences and behaviors, for example asking others to repeat themselves. The third presents statements about feelings, attitudes and beliefs regarding hearing loss.
Scoring Method
The CPHI uses three 5-point response scales:
Frequency: 1 (rarely or almost never) to 5 (usually or almost always)Agreement: 1 (strongly disagree) to 5 (strongly agree)Importance: 1 (not important) to 5 (essential)Scale scores are computed by summing or averaging the items in each scale. The profile yields 25 scores: 22 plotted scales plus 3 Communication Importance scales. Thirteen scales are reverse-scored, so that lower scores on the 22 profile scales point to potential problem areas. Communication Importance scores are interpreted separately, with higher scores meaning greater importance.
There is no overall cut-off; interpretation is profile-based.
Administration Format
Patients complete the CPHI themselves in about 15–30 minutes, on paper, online or in an in-person interview. However, the authors stress that experience working with hearing-impaired people, and a thorough understanding of each scale, are important for clinical interpretation.
Applications of the CPHI
The CPHI supports several uses in audiology:
Screening: identifying communication handicap.Treatment planning: guiding audiological rehabilitation based on the patient's profile.Monitoring: tracking change in communication problems over time.Research: studying communication and psychosocial adjustment in hearing loss.Languages and availability
The original version is in English. Other adaptations include:
German: a pilot studySwedish: the communication strategies scaleNorwegian: the communication strategies scaleDutch: seven scales of the CPHIOfficial use generally requires permission or purchase through ASHA or the authors; the current cost is not confirmed.
Reliability and Validity
The CPHI is considered highly reliable and valid. Cronbach's alpha ranged from 0.67 to 0.89 across the 25 scales. In addition, factor analyses during development supported the intended scale structure, and content validity is high.
Validation studies:
Development of the Communication Profile for the Hearing Impaired (1987): study linkScale composition and item analysis of the CPHI (1986): study linkLimitations and Considerations
Keep these points in mind:
Length: with 145 items and many scores, it suits specialized rehabilitation and research better than a quick clinic screen.Original sample: the sample was mostly middle-aged, male and military, which limits generalizability.Limited validation: few large normative studies exist beyond the initial work.Self-report biases: responses may be affected by cultural and social desirability bias.Other Versions And Related Questionnaires
No other versions of the CPHI exist. The Screening Test for Hearing Problems (STHP) was derived from the CPHI's structure, but it is not a short version of the CPHI.
These questionnaires are related:
Hearing Handicap Scale and Hearing Measurement ScaleDenver Scale of Communication FunctionHearing Problem Inventory–AtlantaHearing Handicap Inventory for the Elderly; see also the ResRef HHIA guideFor deaf adults, see the ResRef guide to the Communication Self-Assessment Scale for Deaf Adults (CSDA)Additional Resources
The original article (ASHA): linkFor inquiries, contact Marilyn E. Demorest, PhD, Department of Psychology, University of Maryland, Baltimore County, or Sue Ann Erdman, PhD, Walter Reed Army Medical Center. ASHA (Rockville, MD) handles rights for its publications.Browse more ENT questionnaires in the ResRef database.Frequently Asked Questions (FAQ)
What does the CPHI measure?The CPHI measures communication problems and rehabilitation needs in adults with hearing loss, across communication performance, environment, strategies, personal adjustment, importance, awareness and denial.
How is the CPHI scored?Items use 5-point frequency, agreement or importance scales. Items are summed or averaged into 25 scale scores, and lower scores on the 22 profile scales indicate potential problem areas.
How long does the CPHI take?The CPHI takes about 15 to 30 minutes. Because of its length, it suits specialized rehabilitation and research better than quick screening.
Is the CPHI free to use?No. Official use generally requires permission or purchase through ASHA or the authors, although the current cost is not confirmed.
A Word from ResRef About the CPHI
The CPHI is a comprehensive self-assessment inventory for hearing-impaired adults, particularly relevant to aural rehabilitation and assessment of communication-related and psychosocial adjustment problems.
References
Demorest, M. E., & Erdman, S. A. (1987). Development of the communication profile for the hearing impaired. The Journal of Speech and Hearing Disorders, 52(2), 129–43. https://doi.org/10.1044/jshd.5202.129Demorest, M. E., & Erdman, S. A. (1986). Scale composition and item analysis of the Communication Profile for the Hearing Impaired. Journal of Speech and Hearing Research, 29(4), 515–35. https://doi.org/10.1044/jshr.2904.535Hallberg, L. R., Eriksson-Mangold, M., & Carlsson, S. G. (1992). Psychometric evaluation of a Swedish version of the communication strategies scale of the communication profile for the hearing impaired. Journal of Speech and Hearing Research, 35(3), 666–74. https://doi.org/10.1044/jshr.3503.666Helvik, A. S., Thürmer, H., Jacobsen, G. W., Bratt, M., & Hallberg, L. R. (2007). Psychometric evaluation of a Norwegian version of the Communication Strategies Scale of the Communication Profile for the Hearing Impaired. Disability and Rehabilitation, 29(6), 513–20. https://doi.org/10.1080/09638280600902596Mokkink, L. B., Knol, D. L., Zekveld, A. A., Goverts, S. T., & Kramer, S. E. (2009). Factor structure and reliability of the Dutch version of seven scales of the Communication Profile for the Hearing Impaired (CPHI). Journal of Speech, Language, and Hearing Research: JSLHR, 52(2), 454–64. https://doi.org/10.1044/1092-4388(2008/08-0036)