Gestational age and birth weight variations in young children with language impairment at an early communication intervention clinic

Background: South Africa presents with high preterm birth (PTB) and low birth weight (LBW) rates (14.17%). Numerous conditions characterised by language impairment are associated with LBW and/or PTB. Speech-language therapists may fail to identify older children whose language impairment may have originated from LBW and/or PTB. Objective: To describe the frequency of LBW and/or PTB, in comparison with full-term birth, and associated conditions in children at an early communication intervention (ECI) clinic. Methods: Retrospective data of 530 children aged 3–74 months were analysed, with 91.9% presenting with language impairment. Results: Almost 40% had LBW and/or PTB, and late PTB was the largest category. Factors associated with LBW and/or PTB were prenatal risks, including small-for-gestational age, perinatal risks, including caesarean section, and primary developmental conditions. Secondary language impairment was prevalent, associated with genetic conditions and global developmental delay. Conclusion: The frequency of LBW and/or PTB was unexpectedly high, drawing attention to the origins of language impairment in almost 40% of the caseload at the ECI clinic

Why parents refuse newborn hearing screening in South Africa?

No abstract available.http://www.elsevier.com/locate/ijporlhb201

Children with conductive hearing loss fitted with hearing aids : outcomes and caregiver experiences in South Africa

INTRODUCTION : Hearing aids are a frequent management option for children with conductive hearing loss (CHL) and it is necessary to determine the efficacy of outcomes. Limited information regarding caregivers' perceptions and experiences are available to examine outcomes in this population. OBJECTIVES : To describe hearing aid outcomes and caregivers' experiences for children with CHL who wear behind-the-ear (BTE) hearing aids. METHODS : Retrospective review of clinical data from 19 children between 0 and 13 years of age with CHL, who were fitted with BTE hearing aids between January 2017 and March 2020. Hearing aid outcomes were documented at one month post-hearing aid fitting, via average daily use and caregiver and teacher reports obtained through the Parents' Evaluation of Aural/oral performance of Children (PEACH) and the Teachers' Evaluation of Aural/oral performance of Children (TEACH). Telephonic surveys were conducted with 13 caregivers to explore their experiences. Qualitative data from open-ended questions were analyzed thematically. RESULTS : The average hearing aid use was 6.5 hours/day (2.0 standard deviation, SD; range 4.1–10.3) for bilateral hearing aid users. Questionnaire results indicated that most children (PEACH – 83.3% and TEACH – 92.3%) used their hearing aids more than 75% of the time. Participants performed better in quiet environments with limited sensitivity to loud sounds at home and at school. Reported challenges included stigma and device compliance. CONCLUSIONS : Children with CHL used their hearing aids for comparable hours (5–8 hours/day), as reported for children with sensorineural hearing loss, but less than the recommended 10 hours/day required for adequate language development. Caregivers reported benefits equivalent to expectations, with challenges similar to those reported in high-income countries.https://www.thieme-connect.com/products/ejournals/journal/10.1055/s-00025477am2023Speech-Language Pathology and Audiolog

Why parents refuse newborn hearing screening and default on follow-up rescreening : a South African perspective

OBJECTIVES : This study describes screen refusal and follow-up default characteristics together with caregiver reasons for screen refusal and follow-up default in two South African universal newborn hearing screening programs. METHODS : A retrospective record review of universal newborn hearing screening conducted at two hospitals (Hospital A n = 954 infants; Hospital B n = 2135) over a 31–33 month period. Otoacoustic emission screening was conducted with rescreen recommended within six weeks for a uni- or bilateral refer. Program efficacy was described according to coverage, referral and follow-up rates. A prospective telephonic interview with caregivers who declined the initial screen (n = 25) and who defaulted on follow-up (n = 25) constituted the next study component. Caregivers were randomly selected from the screening programs for a survey related to reasons for newborn hearing screening refusal and follow-up default. RESULTS : Screening coverage (89.3% Hospital A; 57.4% Hospital B), initial referral rates (11.6% Hospital A; 21.2% Hospital B) and follow-up return rates (56.1% Hospital A; 35.8% Hospital B) differed significantly between hospitals and were below benchmarks. The most frequent reasons for screen refusal were related to costs (72%), caregiver knowledge of newborn hearing screening (64%) and health care professional knowledge and team collaboration (16%). Almost all caregivers (96%) indicated that if costs had been included in the birthing package or covered by medical insurance they would have agreed to newborn hearing screening. Reasons for follow-up default were most commonly related to caregiver knowledge of newborn hearing screening (32%) and costs (28%). One in four caregivers (24%) defaulted on follow-up because they forgot to bring their infant for a rescreen. Only half of caregivers (48%) who defaulted on follow-up reported being aware of initial screen results while 60% reported being aware of the recommended follow-up rescreen. CONCLUSION : Caregivers most commonly refused screening due to associated costs and mostly defaulted on follow-up due to an apparent lack of knowledge regarding initial screen outcome and recommendations made for follow-up. Including NHS as a mandated birthing service is essential if coverage is to be increased, while reducing follow-up defaults requires proactive reminders and improved communication with caregivershttp://www.elsevier.com/locate/ijporlhb201

National survey of paediatric audiological services for diagnosis and intervention in the South African private health care sector

OBJECTIVE : A national survey of early hearing detection and intervention services was undertaken to describe the current status of diagnostic and intervention services in the South African private health care sector. METHODS : All private hospitals with obstetric units (n = 166) were surveyed telephonically. The data was integrated with data collected from self-administered questionnaires subsequently distributed nationally to private audiology practices providing hearing screening at the respective hospitals reporting hearing screening services (n = 87). Data was analysed descriptively to yield national percentages and frequency distributions. RESULTS : Average reported age at diagnosis was 11 months. Most participants (74%) indicated that less than 20% of infants fitted with hearing aids received amplification before the age of 6 months. Most (64%) participants indicated that the average period between confirmed diagnosis and hearing aid fitting was 1 month, on par with international benchmarks. Only 16%–23% of participants included all diagnostic procedures recommended by the Health Professions Council of South Africa’s 2007 position statement for minimum diagnostic test batteries for infants and young children. CONCLUSIONS : Diagnosis of hearing loss, hearing aid fitting and audiological intervention is delayed significantly in the South African private health care sector. Improved services should include integrated systematic hospital-based screening as part of birthing packages with diagnostic referral to specialist paediatric audiologists for accurate assessment and management of patients in a timely manner.http://www.sajcd.org.zaam201

Neonatal hearing screening using a smartphone-based otoacoustic emission device : a comparative study

OBJECTIVE : Increasing options are becoming available for clinicians and healthcare professionals who use smartphone-based applications (apps) to identify hearing loss. The use of smartphone-based apps for newborn hearing screening (NHS) has been proposed as an alternative screening method in NHS programs. This study aims to compare the screening outcomes of a smartphone-based otoacoustic emission (OAE) screening device to a commercially available OAE screening device. METHODS : NHS was conducted in the post-natal maternity ward and neonatal intensive care unit (NICU) of two tertiary public healthcare hospitals over a period of 8 months. Within participant DPOAE and TEOAE screening outcomes of a smartphone-based OAE device (hearOAE) were compared to that of the Otodynamics ILO V6. RESULTS : A total of 176 infants (n = 352 ears; 48.9 % female) underwent NHS (DPOAE n = 176; TEOAE n = 176). The mean age at was 4.5 days (SD 11.3). Signal-to-noise ratio (SNR) were higher with the hearOAE with TEOAE NHS, and equivalent or higher SNR at four out of six frequencies with DPOAEs. Mean and total noise levels were significantly lower for the hearOAE compared to the Otodynamics with DPOAEs noise levels of five out of six frequencies being equivalent to, or lower than the Otodynamics (p 0.05), and in 20 ears for TEOAEs, with the hearOAE demonstrating a higher TEOAE pass rate (p = 0.009). The hearOAE did, however, demonstrate lower noise levels at three out five frequencies, which may have impacted the pass rate. No statistically significant correlation was found between the independent variables and the screening outcome (pass/refer) for TEOAEs using either device (p = 0.105 to 0.810). A high concordance of NHS outcomes within-participants of 89.7 % and 85.0 % for DPOAE and TEOAE respectively, was measured. CONCLUSIONS : The mHealth based OAE device demonstrated good agreement in NHS outcomes compared to a commercially available device. This verifies the performance of the novel smartphone based OAE device, and may facilitate increased accessibility of decentralised NHS service in resource constrained populations.The HearX Group who supplied the hearOAE and Otodynamics devices free of charge.https://www.elsevier.com/locate/ijporlhj2024Speech-Language Pathology and AudiologySDG-03:Good heatlh and well-bein

Tele-intervention for children with hearing loss : a comparative pilot study

INTRODUCTION : This pilot study compared tele-intervention to conventional intervention for children with hearing loss in terms of communication performance, parental perceptions and clinician perceptions. METHODS : A within-subject design was employed, including 10 children with hearing loss and their parents who each received a structurally similar tele-intervention and conventional intervention session in a counterbalanced manner. Quality of communication performance was analysed using a modified Tait video analysis method. Parent and clinician perceptions were collected through rating-scale surveys and thematic analysis of qualitative responses. RESULTS : No significant difference (p > 0.05) was found between tele-intervention and conventional intervention in terms of communication performance of children. Parent perceptions were not significantly different (p > 0.05) between conventional and tele-intervention in terms of facilitating meaningful communication interaction. Significant differences were evident for parents’ comfort level during the session, whether they found it to be a beneficial experience and whether they would like to continue receiving intervention through this method. Clinician perceptions of conventional and tele-intervention were not significantly different (p > 0.05) and tele-intervention was deemed a valuable method of service delivery for clients. DISCUSSION : This study provides preliminary evidence that teleintervention is effective for communication intervention and can be a valuable solution to typical barriers such as distance and the shortage of trained interventionists.http://jtt.sagepub.comhb2017Speech-Language Pathology and Audiolog

Predictors of hearing technology use in children

OBJECTIVE : To identify and describe predictors of daily hearing technology (HT) use in children. DESIGN : Retrospective review of clinical records. Multiple regression analyses were performed to identify predictors. STUDY SAMPLE : The sample included 505 children (<11 years of age) using hearing aids (HAs), cochlear implants (CIs), and bone conduction hearing devices (BCHDs). RESULTS : Average HT use was 9.4 h a day. Bivariate analyses yielded 31 potential predictors from the 42 variables included. The general linear model (p < 0.01, R2 = 0.605) identified 10 interacting factors that significantly associated with increased HT use. Intrinsic predictors of increased HT use included older chronological age, more severe degrees of hearing loss and older ages at diagnosis and initial HA fitting. Extrinsic predictors included the child’s ability to independently use HT, at least one CI as part of the HT fitting, coordinated onsite audiological management, self-procured batteries, auditory-oral communication mode and regular caregiver intervention attendance. CONCLUSIONS : Average HT use was high, approximating hearing hours of peers with normal hearing. CI recipients demonstrated higher HT use compared to children using other HT. The newly identified factors can predict and increase HT use in children while contributing to evidence-based intervention services that promote optimal auditory-based outcomes.https://www.tandfonline.com/loi/iija20hj2022Speech-Language Pathology and AudiologyStatistic

Cochlear implantation in South Africa (Part 1)

Cochlear implantation is a timeous and cost-effective solution for severe-profound sensorineural hearing loss, and has transformed the lives of many individuals with significant hearing loss. The advent of cochlear implantation has meant that, for the first time, one of the senses (hearing), having been entirely lost, can be restored. This, the first of a two-part series on cochlear implantation in South Africa (SA) puts global (and especially SA) hearing loss in perspective, sets out the principles of cochlear implantation and briefly sketches the history of this world-changing technology.The Andrew W Mellon Foundation.http://www.samj.org.zadm2022Speech-Language Pathology and Audiolog

Cochlear implantation in South Africa (Part 2)

Cochlear implantation is a timeous and cost-effective solution for severe-to-profound sensorineural hearing loss (SNHL) and has transformed the lives of many individuals with significant hearing loss. The advent of cochlear implantation has meant that, for the first time, one of the senses (hearing), having been entirely lost, can be restored. The previous article in this series sketched the problem of severe-toprofound SNHL, and how cochlear implantation can overcome this, how a cochlear implant (CI) works, the history of cochlear implantation and the principles of the multidisciplinary CI team. The current status of cochlear implantation in South Africa (SA) is the subject of discussion in this article, the second of this two-part series on cochlear implantation. It comprises a study of the best available current data on the status of CI in SA.The Andrew W Mellon Foundation.http://www.samj.org.zadm2022Speech-Language Pathology and Audiolog