Accepted for/Published in: JMIR Formative Research
Date Submitted: Oct 9, 2023
Date Accepted: Oct 10, 2024
Development and beta validation of an mHealth based hearing screener (SRESHT) for young children in resource-limiting countries: A pilot study
ABSTRACT
Background:
The prevalence of hearing loss in neonates, babies, and children in India varies between 5% and 16%. Objective-based Oto Acoustic Emissions and Auditory Brainstem Response have been utilised in many High Income Countries for establishing early hearing screening and intervention programmes. Nevertheless, the use of screening tests in low middle income countries (LMICs) such as India is not feasible. mHealth solutions have been demonstrated to be a viable option for hearing screening in various LMICs.
Objective:
The current study aimed to develop a low cost solution for hearing screening in neonates, infants and children below 6 years in India to identify moderate or higher degree of hearing losses.
Methods:
The method included two phases. During the initial phase, a Tablet-based Hearing Screening (SRESHT) device was developed using a single board computer. This device used wireless commercial headphones and speakers as transducers. These transducers were calibrated according to the standard procedure. Three hearing screening modules were conceptualised and developed, each tailored to be suitable for different age groups. It comprised three hearing screening modules: i) Behavioural observation based screening (BOA) for infants from birth to one year old; ii) Speech spectrum awareness task (SSAT) based screening for children one to three years old; and iii) Speech recognition task (SRT) based screening for children from three to six years old. Auditory stimuli for each of the screening modules were developed, which included noise makers, animal sounds, and environmental sounds at 500Hz, 1 kHz, 2 kHz, and 4 kHz for infants aged birth to one year; Animal sounds and non sense syllables for children aged one to three years; Eighteen picturable spondee words for children between 3 and 6 years of age. In the second phase, the SRESHT device was beta validated in to establish the accuracy of hearing screening modules in comparison to the gold standard process in identifying moderate hearing losses.
Results:
As transducers, Sony WHCH510 headphones and JBL go 2 pro speakers were selected and calibrated. The auditory stimuli for each of the modules were finalised based on stimuli validation on children. The results showed that noise makers for the BOA module, animal-like sounds for the SSAT module, and 12 spondee words for the SRT module were the most effective. A total of fifty-five children underwent screening, and the beta validation results indicated that the SRESHT screener was accurate to identify moderate or higher degree of hearing loss.
Conclusions:
The development and beta validation of a hearing screening device using the selected auditory stimuli shown that the stimuli were suitable for identifying children with moderate hearing loss. The clinical validation of the SRESHT screening device against the gold standard test technique is presently underway in order to assess the screening device's sensitivity and specificity.
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