JMIR Publications

ABSTRACT

Background:

Auditory spatial attention can be impaired in clinical populations and affects everyday activities, yet it remains understudied and lacks practical assessment tools for clinical use. However, recent technological advances now enable the development of rich auditory environments that can engage attention networks with equipment designed for clinical implementation.

Objective:

This study aims to validate a newly developed approach for assessing auditory spatial attention designed for clinical implementation. The study will first evaluate face and content validity with expert clinicians. If these aspects are established, construct validity will be examined in both clinicians and healthy adults, including response-mode validity (eye and head responses relative to sound location), coherence between response modalities, and sensitivity to background-noise effects. Feasibility will also be investigated, including usability and intention to use, technological and procedural quality, and the quality of pupil-dilation data.

Methods:

This within-subject methodological validation pilot study will include two successive groups: (1) 15 expert clinicians (neuropsychologists or speech therapists with ≥1 year of experience in attention assessment and ≥6 months in spatial-neglect evaluation) and (2) 40 healthy adults aged 20–40 and 60–80 years. Participants will complete five auditory spatial-attention task phases alternating habituation and measurement, using eye-tracking and head-tracking as response modalities. Vocal targets will be presented with or without background sound in a dynamic binaural environment integrating Unity, MaxMSP, and IRCAM SPAT, combined with Supperware inertial head-tracking and Tobii eye-tracking. Primary outcomes include face and content validity, assessed through expert ratings of relevance, clarity, and comprehensiveness, and their alignment with the underlying construct of auditory spatial attention. Secondary outcomes include construct validity through analyses of eye position, head position, and pupil size; as well as feasibility through usability (SUS), intention-to-use measures, ratings of technological and procedural quality, and quality analysis of pupillometry data.

Results:

The study has received ethical approval from the Institutional Research Ethics Committee of the University of Caen (Reference: 2025060606545200000310000391). Recruitment of clinicians began in October 2025 and is ongoing. Recruitment of healthy participants is planned from January to October 2026. The end of the study is expected in late 2026.

Conclusions:

This validation study represents the first step toward developing a clinically applicable tool for assessing auditory spatial attention. The approach combines immersive auditory technology and clinically feasible hardware to enable fast, systematic, and ecologically valid evaluation. Future studies will focus on building a normative database and testing the tool in patients populations. Ultimately, this assessment could improve diagnostic precision and guide targeted interventions for neurological and neurodevelopmental disorders.