KNOWLEDGE AND ATTITUDES OF EARLY CHILDHOOD DEVELOPMENT PRACTITIONERS TOWARDS HEARING HEALTH IN POOR COMMUNITIES

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Diagnostic audiometry

The KUDUwave audiometer (GeoAxon, South Africa) was used to obtain hearing thresholds in children seen for follow-up testing at clinics. The KUDUwave audiometer is a computer-based device. Circumaural ear cups are placed over insert earphones for additional attenuation. This allowed for hearing assessments to be conducted outside a soundproof booth. A microphone on the outside of the circumaural ear cups provides monitoring of background noise. The audiometer hardware is contained within the circumaural ear cups that plugs into a Dell laptop via a USB cable. Additionally, an electronic patient response button is connected to the headset software interface that controls the KUDUwave audiometer.
In July 2016, the hearTestTM smartphone application was loaded onto the smartphones used for hearing screenings as an additional tool at clinics to obtain hearing thresholds. The hearTestTM smartphone application is also operated on Samsung J2 Galaxy smartphones (Andriod OS, 5.1) connected to supra-aural Sennheiser HD202 II headphones (Sennheiser, Wedemark Germany) and can be calibrated according to prescribed standards. Noise levels were monitored by the hearTestTM application throughout the test procedure in order to ensure for reliable testing. Data collected by the smartphone was uploaded to a secure cloud-based server at the end of each test day and was stored electronically.

CHAPTER 1: INTRODUCTION
CHAPTER 2: PROPOSED METHODOLOGY
2.1. Research objectives and design
2.1.1. Study I: Community-based hearing screening young children using an mHealth service-delivery model
2.1.2. Study II: Knowledge and attitudes of early childhood development practitioners towards hearing health in poor communities
2.1.3. Study III: Hearing loss in preschool children from a low-income South African community
2.2. Research context
2.3. Research participants
2.4. Materials and apparatus for data collection
2.4.1. Hearing screening
2.4.2. Otoscopy
2.4.3. Tympanometry
2.4.4. Diagnostic audiometry
2.4.5. Questionnaire
2.5. Procedure for data collection
2.5.1. Phase I: Community mapping
2.5.2. Phase II: Pilot Implementation Phase
2.5.3. Phase III: Implementation Phase
2.6. Procedure for data processing and analysis
2.7. Ethical considerations
2.7.1. Confidentiality and Anonymity
2.7.2. Protection from harm
2.7.3. Permission
2.7.4. Informed consent
2.8. Feasibility
2.8.1. ECD’s openness and willingness to partner with this initiative
2.8.2. Consent from parents/caregivers for screening
2.8.3. Absence of learners for screening on specific dates
2.8.4. Language barrier
2.8.5. Non-attendance of follow-up appointments
CHAPTER 3: COMMUNITY-BASED HEARING SCREENING FOR YOUNG CHILDREN USING AN MHEALTH SERVICE-DELIVERY MODEL
3.1. Abstract
3.2. Background
3.3. Method
3.3.1. Context
3.3.2. Participants
3.3.3. Equipment
3.3.4. Procedures
3.3.5. Data analysis
3.4. Results
3.5. Discussion
3.6. Conclusion
CHAPTER 4: KNOWLEDGE AND ATTITUDES OF EARLY CHILDHOOD DEVELOPMENT PRACTITIONERS TOWARDS HEARING HEALTH IN POOR COMMUNITIES
4.1. Abstract
4.2. Introduction
4.3. Method
4.3.1. Context
4.3.2. Subjects
4.3.3. Questionnaire
4.3.4. Procedure and analysis
4.4. Results
4.5. Discussion
4.6. Conclusion
CHAPTER 5: HEARING LOSS IN PRESCHOOL CHILDREN FROM A LOWINCOME
SOUTH AFRICAN COMMUNITY
CHAPTER 6: DISCUSSION, CLINICAL IMPLICATIONS AND CONCLUSIONS
REFERENCES
APPENDIXES