Narrative review of EHDI in South Africa

Exploration of parental perspectives and involvement in therapeutic communication approaches for deaf and/or hard-of-hearing children at special schools in South Africa

Family-centred intervention optimises the development of communication abilities and academic outcomes in children with hearing loss. Cognisance of family values, respect for family differences and adaptations to cultural and linguistic diversity ensure the collaboration of parent-professional relationships. This study investigated the parental involvement and parental perceptions regarding the communication intervention approaches implemented (i.e., traditional speech-language therapy and listening and spoken language-South Africa-adapted Auditory Verbal Therapy) for children with profound hearing loss. The study was conducted at special schools for children with hearing loss across four provinces in South Africa, where grade-level core skills are taught using a mainstream curriculum complemented by specialised instruction. Data were collected through a parental self-administered survey and a retrospective record review. An inductive analysis of transcripts was conducted, and the Fisher's exact test assessed associations between data sets. Findings demonstrated limited informational counselling provided to parents regarding communication intervention options. Following the initiation of the communication intervention process, findings indicate parental buy-in, fuelled by their aspirations for their child with a hearing loss. Although results suggest that parents prefer a listening and spoken language therapeutic communication modality, this approach is hindered by the lack of culturally sensitive and linguistically appropriate care. This is an important finding, particularly in multilingual and multicultural contexts like South Africa. These context-specific outcomes emphasise that communication interventionists must be cognizant of parental-informed decision-making, cultural contexts and linguistic sensitivity for effective parent-professional collaborations.

Risk factors and hearing outcomes in infants and young children in KwaZulu-Natal, South Africa

BACKGROUND

 Targeted new-born hearing screening, based on high risk factors is recommended in the absence of universal new-born hearing screening in resource-constrained settings. The relevance of risk factors listed in the guidelines of high-income countries and used by low-middle income countries remains relatively unknown. Risk factors consistent with the epidemiological profile, evolution of risks and disease burden in these countries need to be considered.

OBJECTIVES

 This study aimed to profile the frequency of risk factors and their manifestation in hearing outcomes of young children in the KwaZulu-Natal province of South Africa.

METHOD

 A chart review of N = 1433 patients' archival audiology records was conducted, conveniently sampled from a single tertiary hospital (n = 351), a provincial assessment and therapy centre (n = 649), a university clinic (n = 291), and two schools for the deaf (n = 142).

RESULTS

 Overall, 56% of the participants presented with either a conductive, sensorineural or a mixed hearing loss; 62% of the children had between 1 and 2 risk factors present (Mean [M] = 1.1; standard deviation [s.d.] = 0.98). Admission to neonatal intensive care unit, maternal infections, bacterial and viral infections and chemotherapy, from the Joint Committee on Infant Hearing list of high risk factors were significantly associated with hearing loss (p  0.05). Known non-JCIH risks, emerging risks and other statistically significant contextually relevant risk factors were also noted.

CONCLUSION

 Understanding the profile of high risk factors in a given context has implications for prevention, early hearing identification and intervention services.Contribution: Targeted new-born hearing screening needs to be based on risk factors that are contextually relevant. This study is one of the first profiling high risk factors for hearing loss in children in KZN, the province with the second highest population in South Africa.