Translation, Cross-Cultural Adaptation and Preliminary Validation of the Italian Version of the Early Cognitive and Listening Links (EarlyCaLL) Framework

Background/Objectives: Children with severe-to-profound hearing loss and additional disabilities, receiving cochlear implant (CI), require multidimensional outcome measures that extend beyond conventional assessments of auditory perception and spoken language. The Early Cognitive and Listening Links (EarlyCaLL) framework was originally developed by the Nottingham Auditory Implant Programme team, in the United Kingdom, led by Datta and colleagues, to support expectation counselling and to monitor post-cochlear implantation progress in children with CI and associated complex needs. The framework was designed to capture broader developmental outcomes, including cognition, social and emotional engagement, listening and understanding, vocalisations and early talk, and augmentative and alternative communication (AAC), alongside CI equipment use and signal tolerance. However, to date, no validated Italian version of the Framework has been available. This study aims to translate, culturally adapt, and perform a preliminary psychometric validation of the Italian version of the EarlyCaLL. Methods: A methodological study was conducted following international guidelines for translation and cross-cultural adaptation. The development phase included forward translation, expert committee review, back-translation, developer review, and pre-validation refinement. The validation phase involved 20 experienced professionals. Results: The expert panel demonstrated extensive clinical experience, with a 100% response rate. Face validity was excellent across all six domains (≥90% adequate ratings; Gwet’s AC1 = 0.82). Ninety percent of experts considered the questionnaire acceptable without substantial modifications, and 10% recommended only minor revisions. All 25 descriptors achieved perfect content validity, while the overall scale indices also indicated unanimous agreement regarding the relevance and adequacy of the instrument. Conclusions: Our results support the face and content validity of the Italian version of the EarlyCaLL, supporting further clinical validation as a culturally adapted multidimensional observational instrument for evaluating rehabilitation outcomes in children with CI and additional disabilities. The framework provides a comprehensive assessment of functional development and may facilitate individualized rehabilitation, multidisciplinary collaboration, and family-centred care in pediatric CI.