Best practice in early screening for deaf children in Mumbai - A study by The Stephen High School for the Deaf

22.03.2019

This article has been submitted by The Stephen High School for the Deaf and Montfort Care.

Problem

Sixty children are born with deafness in India everyday. Many cases go undetected until long after which the normal language acquisition is no longer possible. It is a fact that half of all the ‘deafness’ is preventable or treatable. Nearly one of every 1,000 children are born with a permanent hearing loss and another two or three in 1,000 will develop hearing loss later . By identifying a hearing loss early in a child’s life, families can help ensure age-appropriate overall development.

Solution
Montfort Care is working to ensure that all children get identified before the age of three years, so that they can learn a language, study in regular schools and lead a normal life.

People with hearing loss can benefit from assistive devices such as hearing aids and cochlear implants. These innovations have been positively impactful and have been a boon in allowing their users to communicate and conduct themselves socially. But communication can be exhausting even for a hearing-impaired person, despite having a hearing aid or cochlear implant due the period of adjustment for installation and follow-up for each device.

Montfort’s major activities involve awareness drives around deafness and the need for early intervention to the general public and to parents in particular, screening children for hearing impairments and give rehabilitation services to children with hearing loss with the aim to integrate them in mainstream schools.

Our most recent Hearing Screening Camp involved outreach to children from neighbouring municipal schools, registration of 100 parents and children at the screening camp. The screening test involved a 1-minute Otoacoustic Emissions Test (OAE) by an audiologist, after which a pathology report detailed the need for a follow-up ENT consultation if required. Each participant parent was also given a brief about looking out for signs of hearing impairments among children in early childhood, while being given handouts on this for their respective community outreach efforts.

Outcomes

Firstly, the Hearing Screening Camp demonstrated the potential of early screening for hearing impairment. In a sample of 100 school children, reports revealed that 81% of children presented with bilateral hearings sensitivity within normal limits, 17% of the children with bilateral impacted cerumen (wax) resulting in minimal conductive hearing loss, and 2% children with ear discharge resulting in peripheral hearing abnormality. One child was found to diagnosed with autism spectrum disorder in this sample. High prevalence of earwax impaction can lead to conductive hearing impairment which can affect negatively affect learning skills among students. Secondly and in the long term, poor academic performance is often accompanied by inattention and sometimes poor behaviour, children with hearing reduced hearing are often misidentified as having learning disabilities such as ADD and ADHD.

Why this works

Public and private entities are not coordinating support. Medical screenings for deaf children are the onus of the Brihanmumbai Municipal Corporation (BMC). However, lack of follow-up mechanism prevents beneficiaries from making the most of early screening. Instead, school-driven initiatives (such as Montfort) that drive community awareness through screening increases access to support services for disability management, and preventing deafness.

In the long-term, early screening and provision of inclusive supports to students allow them to be mainstreamed in regular schools. Overall, we estimate that the cost of educating a student in a segregated school is five times that of including them in a mainstream classroom. Research supports that inclusive education offers improved social development and academic outcomes for all students.