Reliability of Tablet-Based Hearing Testing in Nicaraguan Schoolchildren
Hearing loss affects an estimated 4 in 1000 children, yet meeting demand is challenging due to the shortage of audiologists and a growing need for access to hearing healthcare. Fortunately, tablet-based hearing assessments and boothless audiometry are exciting new technologies that offer more expansive access to hearing screening to help address this problem. Results from a recent field application were both accurate and cost-effective, demonstrating promising results.
Childhood Hearing Loss and Access to Health Care
Hearing loss affects millions of people worldwide, and those who come from low socioeconomic status (SES) are disproportionately at risk. Children, in particular, are more vulnerable to the long-term effects of untreated hearing loss, which can include difficulty with language development, social skills, and academic performance.
Identifying and diagnosing hearing loss early is a crucial step to help children get the treatment and support they need to help them learn speech and language at the same rate as their normal-hearing peers.
Effects of Hearing Loss in Low-Income Households
One of the primary reasons children from low-income households are more likely to suffer from hearing loss is due to a lack of access to regular and preventative health care. Without regular checkups, hearing loss may go undiagnosed for years until it has caused other effects on overall health, educational setbacks, or other impacts. In addition, other common health issues among children from lower socioeconomic backgrounds – such as middle ear infections, lead poisoning, and malnutrition – can all contribute to hearing problems that need attention and treatment.
Untreated hearing loss can impact more than just academic performance. Hearing loss can also profoundly affect children’s mental development, isolating them from conversations with their peers. Additionally, children may miss out on incidental learning opportunities in the classroom and the formal school educational experience. The impact on socioeconomic outcomes and academic performance can be severe if left untreated for extended periods of time.
Understanding the Disparity of Hearing Loss in Low-Income Communities
It’s essential to understand why children from low socioeconomic environments are more vulnerable to untreated hearing loss and its long-term effects on physical, mental, social, and academic performance.
Lack of access to health care and limited resources within underfunded school systems are two major contributing factors that leave these populations at a considerable disadvantage when providing necessary support and intervention. With greater accessibility, we can create and offer better solutions so that every child has equal access to quality healthcare services in a time-sensitive manner regardless of their socio-economic background or other factors beyond their control.
Low-income caregivers are sometimes overburdened with multiple employment engagements, challenging work schedules, literacy levels, and other external factors. Providing innovative solutions in the community, such as for the school-age population, can help identify and start the process of diagnosis and intervention for families who need it.
What is the WAHTS Solution?
The Wireless Audiometric Hearing Test System (WAHTS) is a boothless and portable audiological tool that can perform tablet-based hearing assessments. This technology is conveniently transported and easily set up, making it an excellent option for conducting hearing testing in the field.
WAHTS is composed of a headset with a built-in audiometer that communicates with a tablet and mobile application. The system is ideal for group hearing assessment, and allows up to seven people to take a hearing test simultaneously.
This solution offers the perfect opportunity to bridge the gap between a shortage of providers and a large population in need of services.
What are the Advantages of Boothless Audiometry?
Boothless audiometry provides the instruments to assess hearing using portable devices for testing instead of traditional booths or soundproof rooms, as well as enabling greater accessibility to underserved populations. This technology first appeared in the early 2000s, but has become increasingly popular due to its convenience and portability.
With boothless audiometry, audiologists and hearing professionals can assess patients in natural settings like their homes or classrooms without using expensive equipment or difficult-to-transport soundproof booths. This makes it easier for hearing care professionals to reach people needing access to traditional audiology services.
WAHTS communicates with a bluetooth sound level meter for easy external noise monitoring throughout the hearing test. When testing multiple people, the test administrator can connect wirelessly to the test taker tablets for live progress monitoring.
How Accurate is WAHTS Technology?
A recent field assessment of Nicaraguan second and third-grade children demonstrated that a combination of automated and manual hearing testing is effective at identifying hearing loss. While automated testing alone showed a 76% specificity, a two-step protocol had a 99% specificity. The two-step protocol uses a combination of an initial automated screening with a manual follow-up test by an audiologist to ensure a proper diagnosis of hearing loss.
Convenience of Hearing Testing
In addition, this approach to field testing offers convenience for both patients and practitioners alike by eliminating the need for travel time or scheduling appointments at inconvenient times due to the limited availability of traditional services. This makes it easier for those with busy schedules or those living in rural areas who may not have access to conventional audiology services to get their hearing tested remotely with minimal effort or inconvenience on their part.
Cost of WAHTS Testing
Finally, due to the highly attenuating earcups, WAHTS replaces the need for a traditional sound booth. This makes WAHTS incredibly cost-effective when compared to systems that require expensive soundproof rooms. WAHTS can be thought of as including both an audiometer and sound booth in one compact device!
Additionally, WAHTS technology enables a single clinician to complete testing on multiple individuals simultaneously, making it more efficient than conventional testing. These advantages make WAHTS an ideal solution for those looking for affordable ways to test hearing in a large population.
WAHTS as a Unique Solution: Inventing the Future of Hearing Health
WAHTS assessments and boothless audiometry offer an exciting opportunity to revolutionize hearing testing.
Imagine the possibility of making hearing assessment more accessible to everyone, regardless of location or availability of traditional audiology services.
This innovative solution maximizes what a single clinician can do in the field, meaning that we can do more with fewer resources. As these technologies and new advancements become more available, more field studies will be conducted using these technologies, which will continue to influence the way we identify and treat hearing loss in the future.
Conclusion:
Tablet-based hearing assessments & boothless audiometry are revolutionizing wireless hearing testing by providing broader access and greater convenience than ever before—with a recent application among school-aged children from low socio-economic status as an example of practical use. By utilizing these innovative technologies, hearing professionals can now offer accurate assessments via tablet computers or smartphones while still providing quality service at an affordable price point-making high quality care accessible to individuals everywhere. WAHTS technology is positioned perfectly to benefit both patients and clinicians with this innovative technology.
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References
Magro, Isabelle∗; Clavier, Odile†; Mojica, Karen‡; Rieke, Catherine§; Eisen, Eric§; Fried, Debra||; Stein-Meyers, Anita¶; Fellows, Abigail∗; Buckey, Jay∗; Saunders, James§. Reliability of Tablet-based Hearing Testing in Nicaraguan Schoolchildren: A Detailed Analysis. Otology & Neurotology 41(3):p 299-307, March 2020. | DOI: 10.1097/MAO.0000000000002534