And the research offers an exciting glimpse of a future in which teachers using portable audiometry could quickly and reliably identify children at risk of hearing loss as part of sustainable hearing referral programmes.

US researchers run field study in Africa

An exploration of how teachers might efficiently prescreen children for hearing loss in countries with limited hearing healthcare provision was published in this October's Ear, Nose and Throat Journal. The work of these researchers, who tested their hypothesis in a number of semirural schools outside Malindi, Kenya, was then positively highlighted in a follow-up article in The Hearing Journal, which quoted both the main authors of the study: James L. Netterville, director of the Department of Otolaryngology – Head and Neck Surgery at the Vanderbilt University Medical Center in Tennessee; Justin R. Shinn, Department of Otolaryngology at University of Texas Southwestern; and Asitha Jayawardena, Department of Otolaryngology at Children’s Minnesota.

Teachers with no formal training in hearing loss (HL) screening were asked to pre-identify children whom they perceived as having trouble hearing among a group of 2- to 16-year-olds. The Kenyan school educators were focused on “subjective concerns of HL, inattention, difficulty learning, poor classroom participation, poor speech, and disobedience.” They identified forty children as at risk of HL.

Portable audiometry tools were used to compare the hearing of these pre-identified children with that of children thought to have normal hearing. Eight children were found to have hearing loss, all of them from the group pre-identified by the teachers. So, the prescreening had a 100-percent hearing loss identification rate, and a 20-percent referral rate.

The problem of screening efficiency in developing countries

In low- and middle-income countries, the limited number of hearing healthcare providers is one obstacle to those at risk of HL receiving proper attention, although, in recent years, tablet and smartphone audiometry apps have provided greater means for screening. But the efficiency of screening is low in such areas.

Teachers "can immediately intervene through implementation of appropriate classroom positioning and development of alternate educational models,” the new study states. “Furthermore, teacher identification and awareness of HL in the classroom is likely to produce a favorable response to include and educate these children at risk of intellectual delay and poor performance.”

“Of course, there are still challenges to [the teacher prescreening] approach,” one of the authors, Jayawardena, told The Hearing Journal. “Although teachers have unique insight into the communication abilities of their students, they are already heavily taxed for their time—particularly in the developing world where children of all ages and grades may share a single classroom.”

Repeating the study on a wider population sample is the next step towards screening becoming commonplace in the schools of developing countries. But could schools in wealthier countries also play a greater hands-on role in screening kids for hearing loss?

Source: The Hearing Journal