INTRODUCTION
METHODS
RESULTS
DISCUSSION
ACKNOWLEDGEMENT
REFERENCES
 

IMPACT OF USING HEARING AID AND ITS BENEFITS: SURVEY OF INSTITUTES FOR THE DEAF CHILDREN
Khayria A. Al-Abduljawad, PhD.

From the College of Applied Medical Sciences, King Saud University, Riyadh, Kingdom of Saudi Arabia. Address reprint requests to: Dr. Khayria A. Al-Abduljawad, P.O. Box 271512, Riyadh 11352, Kingdom of Saudi Arabia, Telefax: 966-1-4455293, E-mail: khayria_audio@hotmail.com

Hearing impaired children from Al-Amal boys and girls institutes for the deaf and girls integrated classes in the public school in Riyadh city, were approached to study the benefits of using hearing aids. A questionnaire was designed in Arabic and sent to parents of 900 hearing impaired students. The questionnaire contained in addition to name, age, time of discovering hearing loss - the use of hearing aid, benefits of amplification, the impact on verbal communication, repair and satisfaction by students and parents. 400 of 450 (88.9%) responses were obtained from the girls' institutes while 300 responses (66.7%) were obtained from the boys' institutes. 85.43% of the students were using hearing aids which were either provided by institutes or bought by the parents.
63.14% were benefitted from using the hearing aids. 50% girls and 51.3% boys received amplification before entering the institutes, and 76.57% of the parents reported positive attitude towards using the aids. 59.85% (N=700) of the parents reported improvement / increased verbal vocalization of their children, after speech therapy as part of their rehabilitation program. There are several issues related to hearing aids such as the type, cost, maintenance, cleaning and changing of batteries.

Key Words: Hearing loss, Hearing aids, Children, Rehabilitation

INTRODUCTION :
          The term "hearing loss" in the medical and social senses has served to mean "an impairment of hearing", and it has also been used to mean a change for the worse or shift of threshold from one level to another. When a sound has to be increased in intensity for a person to hear it, that is when the threshold of hearing is elevated, then, this is also called hearing impairment^1,2.
          Types of hearing loss (HL) can by categorized by site of the auditory system damaged. There are three basic types of hearing impairment (HI): conductive HI, sensorineural HI and mixed HI³.
          Many surveys show that one out of ten people suffer from hearing loss (HL) and nobody knows the exact number of hearing-impaired people in the world, but experts estimate that the figure is about 500 million⁴.
          Hearing Aids (HA) are sound amplifiers, their function is to amplify sound to a level such that a hearing impaired person can both detect and make effective use of the acoustic signals⁵.
          Most people with HL could be helped medically, surgically or with hearing aids⁶.
          According to "Sergei Kochkin"⁷ about 90-95% of the hearing impaired population have correctable HL, and 5-10% can be helped medically or surgically. It should be noted that, HA cannot totally restore hearing, but they can make a big difference in improving the quality of life for people with HL^5,7.
          There are currently six major styles of HA available. These include body aid - eyeglass aid - behind the ear (BTE) aid, in the ear aid (ITE), in the canal (ITC) aid, completely in the canal (CIC) aid^8,9.

The Purpose of this Study

• To determine the benefits of HA used by the hearing impaired children and find out issues related to HA.

• To identify the causes, degree and time of diagnosing the HL.

• To investigate HA impact on the hearing - impaired verbal communication, and

• To obtain the opinion of parents and children regarding the usefulness of HA.

METHODS :
          This study was conducted during the period Sep. 2000 to Nov. 2001 at Al-Amal institutes for the deaf (girls and boys) and girls integrated classes in the public school. Their age ranged from 6.3 - 16.7 years.
          900 confidential questionnaires were sent to the parents of the hearing impaired children, studying in Al-Amal (Girls and boys) institutes for the deaf in Riyadh. 400 out of 450 returned the completed questionnaires from the girls institutes, and 300 out of 450 returned questionnaires from the boys institutes. The questionnaire used was in Arabic. Pure tone audiograms and/or Auditory Brainstem Response (ABR) were reviewed from their files.

Data collection
          Parents of all the subjects included in this study were asked to fill up a questionnaire about the use and benefits of HA used by their children and its impact on their verbal communication.
          Information concerning the following were obtained from the questionnaires :
          Causes of hearing loss, degree of HL, time of diagnosing HL, does he/she wear a HA, age at which HA was prescribed, type of HA used, provision of HA, improvement after using HA, complaints of children using HA, children's attitude, parent's attitude, cost of HA, maintenance and repair of HA, period required for cleaning the HA, period required for changing the battery, improvement after HA usage and improvement in speech after speech therapy with HA.
          The data was collected from the questionnaire and translated into English.

RESULTS :
          The studied population was 700 Saudi children, 57.1 percent (N=400) were girls and 42.9 percent (N=300) were boys. The age distribution of those children ranged from 6.3 years to 16.7 years with a medain age of 11.5 years.

 

4 - Types of HA:

 

5 - Provisions of HA:

 

6 - Complaints of Children using HA:

 

7 - Children's attitude towards HA:

 

9 - Cost of HA:

 

10 - Maintenance of HA:

 

11 - Period required for cleaning HA:

 

12 - Period required for changing the battery:

 

13 - Benefits of using HA:

DISCUSSION :
          The prevalence of hearing impairment in Riyadh was reported to be 7.7%¹⁰. WHO also reported that the number of hearing impaired people is around 250 millions¹¹. It appears likely that the absolute numbers and prevalence of deafness and hearing impairment are increasing especially in developing countries¹².Ê In this study, hereditary hearing impairment constitutes 44.6%.
          A hereditary cause of deafness was found to be 66.07% in a study survey of 6421 Saudi infants and children in Riyadh¹³. This high prevalence rate of hereditary causes may be attributed to consanguinity which is widely practiced in Saudi community due to social customs, arranged marriage within the families and unawareness of the public about the adverse genetic effects of such practice. In this study there was a prevalence of girls with hearing impairment who had hearing levels in the better ear within the 41 - 55 dB range. Study conducted by "Eagles and Coworkers"¹⁴ showed that the majority of the children with hearing impairment had hearing levels in the better ear within 40 - 70 dB range. About (64.9%) (N=454) of children were diagnosed as having hearing impairment between the age of 0-2 years. This high prevalence could be due to increased awareness of the parents about HL and the level of parent's education. Availability of the facilities like: new techniques and instrument, increasing number of Audiologists in health care setting, and developing new programs for screening infants, all these play a great role in early detection of HL which leads to intervention.
          For many Hearing impaired persons, HA provides a re-entry into the hearing world¹⁵. The majority of children are using HA as shown in this study (85.43%) (N=598). The prevalence of girls and boys who do not use HA should not be over looked, because their percentage (14.57%) (N=102) is considerably high.
          This study showed that about half of hearing impaired children (50.86%) (N=356) received amplification before entering institute, while others (49.14%) (N=344) after their admission in the institute. In a research conducted to find out the issue related to HA, in special schools in Karachi, Pakistan, the age of amplification was less than 5 years in 55% children and above 5 years in 45% cases¹⁶.
          Comparing the high prevalence of the children diagnosed early, the number of children using HA after entering institute was considered high. This is because majority of them obtain HA from the institute because they cannot afford it due to financial problems, or limited awareness of parents about the benefits of early usage of HA. While the other half of children were using HA before entering institute, the majority of them obtained HA from medical rehabilitation center (35.7%) (N=250) and (30.5%) (N=214) from hospitals.
          (72.2%) (N=289) of girls gained significant benefit from HA, whereas, (27.8%) (N=111) did not get any benefit. Among boys, (51%) (N=153) obtained benefit from using HA whilst, (49%) (N=147) did not get any benefit. To achieve the benefit from HA, many factors should be considered such as appropriate fitting of HA, the understanding that the HA, will enable him/her to communicate better.
          In this study, majority of children (girls and boys) who used HA had no complaints and in those who had complaints, environmental noise topped the list of complaints (21.4%) (N=136) followed by HA whistle (20.7%) (N=132). Since several HA users reported considerable improvement in speech with little or no complaints from the use of their HA , it could therefore be taken as an evidence of appropriate diagnostic appraisal and good fitting.

ACKNOWLEDGEMENT :
          We would like to thank:
                  -   Al-Amal institutes for the deaf, boys and girls integrated classes (public school) for girls.
                  -   All parents and children who gave us all the assistance we needed in answering the questionnaire.

REFERENCES :

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16. Razi MS, Jaffer S, Zaide SH, Newton VE: Hearing Aid and its use among hearing impaired children. Pakistan journal of otolaryngology 1996.