Search results for: deafness and hearing impairment

Authors: Akanle Florence Foluso

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Access to health care and people’s ability to have a responsible, satisfying and safe sexual life is clearly a defined human right of people with hearing impairment and others with disabilities. This paper investigates the extent to which the hearing impaired have a satisfying, safe sexual life and whether their human right in regard to information and education is violated. The study population consists of all hearing-impaired adolescents and young adults aged 10-24 years who are currently enrolled in primary and secondary schools in Nigeria. A sample of 389 hearing-impaired adolescents was selected, and an adapted version of the illustrative questionnaire for interview - survey by John Cleland was used to collect the data. A correlation of 0.80 was obtained at a P<0.05 level of significance. Teachers in the school of the deaf who used sign language were used in the administration of the questionnaire. The data generated were analyzed using Frequency counts. Summary of responses on access to information, education, voluntary testing, counseling and reproductive services. This is to be violated or protected. Findings show that a gap exists in the level of knowledge of SRH services and voluntary counseling because more than half the respondents are not aware of these services in their community. Access to information, education and health services are rights denied to the hearing impaired. So, their rights are violated.

Keywords: sexuality, gender, reproductive health, human right

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Authors: Fink Nir

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Soldiers within armored vehicles are exposed to continuous noise reaching levels as high as 120 dB. The use of hearing protection devices (HPD) may attenuate noise by as 25 dB, but attenuated noise reaching the ear is still harmful and may result in hearing loss. Hearing conservation programs in the military suggest methods to manage the harmful effects of noise. These include noise absorption within vehicles, evaluating HPD's performance, limiting time exposure, and providing guidance.

Keywords: armored vehicle noise, hearing loss, hearing protection devices, military noise, noise attenuation

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Authors: Doctor Akanle Florence Foluso

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Access to health care and people’s ability to having a responsible, satisfying and safe sexual life is clearly a defined human right of people with hearing impairment and others with disabilities this paper looks at disability and sexuality: a human right approach to sexual and reproductive health of the hearing impaired adolescents in developing countries. This paper investigates the extent to which the hearing impaired has a satisfying, safe sexual life and whether their human right in regards to information education is violated. The study population consists of all hearing impaired adolescents and young adults aged 10-24 years who are currently enrolled in the primary and secondary schools in Nigeria. A sample of 389 hearing impaired adolescents was selected, an adapted version of the illustrative questionnaire for interview – survey by Johncleland was used to collect the data. A correlation of 0.80 was obtained at p<0.05 level of significance. Teachers in the schools of the deaf who used sign language were used in the administration of the questionnaire. The data generated were analyzed using Frequency Counts, Percentages, Means and Standard Deviation to give a Summary on responses on access to information, education, voluntary testing and counselling and other reproductive services. This is to investigate if the sexual and reproductive right violated or protected. Findings show that a gap exists in the level of knowledge of SRH services, voluntary counselling because more than half the respondents are not aware of these services in their community. Access to information, education and health services are rights denied the hearing impaired. So their SRH rights are violated.

Keywords: sexual right diability, family planning, pregnancy, diability

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Authors: Paris Binos

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The present work investigates developmental aspects of the duration of isolated vowels in infants with normal hearing compared to those who received cochlear implants (CIs) before two years of age. Infants with normal hearing produced shorter vowel duration since this find related with more mature production abilities. First isolated vowels are transparent during the protophonic stage as evidence of an increased motor and linguistic control. Vowel duration is a crucial factor for the transition of prelexical speech to normal adult speech. Despite current knowledge of data for infants with normal hearing more research is needed to unravel productions skills in early implanted children. Thus, isolated vowel productions by two congenitally hearing-impaired Greek infants (implantation ages 1:4-1:11; post-implant ages 0:6-1:3) were recorded and sampled for six months after implantation with a Nucleus-24. The results compared with the productions of three normal hearing infants (chronological ages 0:8-1:1). Vegetative data and vocalizations masked by external noise or sounds were excluded. Participants had no other disabilities and had unknown deafness etiology. Prior to implantation the infants had an average unaided hearing loss of 95-110 dB HL while the post-implantation PTA decreased to 10-38 dB HL. The current research offers a methodology for the processing of the prelinguistic productions based on a combination of acoustical and auditory analyses. Based on the current methodological framework, duration measured through spectrograms based on wideband analysis, from the voicing onset to the end of the vowel. The end marked by two co-occurring events: 1) The onset of aperiodicity with a rapid change in amplitude in the waveform and 2) a loss in formant’s energy. Cut-off levels of significance were set at 0.05 for all tests. Bonferroni post hoc tests indicated that difference was significant between the mean duration of vowels of infants wearing CIs and their normal hearing peers. Thus, the mean vowel duration of CIs measured longer compared to the normal hearing peers (0.000). The current longitudinal findings contribute to the existing data for the performance of children wearing CIs at a very young age and enrich also the data of the Greek language. The above described weakness for CI’s performance is a challenge for future work in speech processing and CI’s processing strategies.

Keywords: cochlear implant, duration, spectrogram, vowel

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Authors: Sehmus Aslan, Sibel Karacaoglu, Cengiz Sevgin, Ummuhan Bas Aslan

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Objective: Anger expression style is an important moderator of the effects on the person and person’s environment. Anger and anger expression have become important constructs in identifying individuals at high risk for psychological difficulties. To our knowledge, there is no information about anger and anger expression of adolescents with visual impairment. The aim of this study was to compare anger and anger expression among adolescents with and without visual impairment. Methods: Thirty-eight adolescents with visual impairment (18 female, 20 male) and 44 adolescents without visual impairment (22 female, 24 male), in totally 84 adolescents aged between 12 to 15 years, participated in the study. Anger and anger expression of the participants assessed with The State-Trait Anger Scale (STAS). STAS, a self-report questionnaire, is designed to measure the experience and expression of anger. STAS has four subtitles including continuous anger, anger in, anger out and anger control. Reliability and validity of the STAS have been well established among adolescents. Mann-Whitney U Test was used for statistical analysis. Results: No significant differences were found in the scores of continuous anger and anger out between adolescents with and without visual impairment (p < 0.05). On the other hand, there were differences in scores of anger control and anger in between adolescents with and without visual impairment (p>0.05). The score of anger control in adolescents with visual impairment were higher compared with adolescents without visual impairment. Meanwhile, the adolescents with visual impairment had lower score for anger in compared with adolescents without visual impairment. Conclusions: The results of this study suggest that there is no difference in anger level among adolescents with and without visual impairment meanwhile there is difference in anger expression.

Keywords: adolescent, anger, impaired, visual

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Authors: M. Mokhtarzadeh, M. Taheri Qomi, M. Nikafrooz, A. Atashafrooz

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The purpose of the present study was to investigate the effectiveness of using motion graphics as a learning medium on training hearing aids maintenance skills to hearing-impaired children. The statistical population of this study consisted of all children with hearing loss in Ahvaz city, at age 4 to 7 years old. As the sample, 60, whom were selected by multistage random sampling, were randomly assigned to two groups; experimental (30 children) and control (30 children) groups. The research method was experimental and the design was pretest-posttest with the control group. The intervention consisted of a 2-minute motion graphics clip to train hearing aids maintenance skills. Data were collected using a 9-question researcher-made questionnaire. The data were analyzed by using one-way analysis of covariance. Results showed that the training of hearing aids maintenance skills with motion graphics was significantly effective for those children. The results of this study can be used by educators, teachers, professionals, and parents to train children with disabilities or normal students.

Keywords: hearing aids, hearing aids maintenance skill, hearing impaired children, motion graphics

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Authors: Jentel Van Havermaet, Geert Van Hove, Elisabeth De Schauwer

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This study re-conceptualizes visual impairment in the interdependent context of James, his family, and allies. Living with a visual impairment is understood as an entanglement of assemblages, dynamics, disablism, systems… We narrated this diffractively into two meaningful events: decisions and processes on (inclusive) education and hinderances in connecting with others. We entangled and (un)raveled lived experiences in assemblages in which the contextualized meaning of visual impairment became more clearly. The contextualized narrative of James interwove complex intra-actions; showed the complexity and contextualization of entangled relationalities.

Keywords: disability studies, contextualization, visual impairment, assemblage, entanglement, lived experiences

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Authors: D. Estrella, A. Silva, R. Zapata, H. Rubio

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A total of 100 primary caregivers (mothers, fathers, grandparents) with at least one child or grandchild with a diagnosis of congenital bilateral profound deafness were assessed in order to evaluate the functionality of families with a deaf member, who was evaluated by specialists in audiology, molecular biology, genetics and psychology. After confirmation of the clinical diagnosis, DNA from the patients and parents were analyzed in search of the 35delG deletion of the GJB2 gene to determine who possessed the mutation. All primary caregivers were provided psychological support, regardless of whether or not they had the mutation, and prior and subsequent, the family APGAR test was applied. All parents, grandparents were informed of the results of the genetic analysis during the psychological intervention. The family APGAR, after psychological and genetic counseling, showed that 14% perceived their families as functional, 62% moderately functional and 24% dysfunctional. This shows the importance of psychological support in family functionality that has a direct impact on the quality of life of these families.

Keywords: deafness, psychological support, family, adaptation to disability

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Authors: Jonathan A. Mikhail, Arsenio Paez

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It is not uncommon for a viral infection to cause hearing loss. Many viral infections are associated with sudden-onset, often unilateral, idiopathic sensorineural hearing loss. We conducted an exploratory study with thirty patients with pre-existing hearing loss between 50 and 64 to evaluate if COVID-19 was associated with exacerbated hearing loss. We hypothesized that hearing loss would be exacerbated by COVID-19 infection in patients with pre-existing hearing loss. A statistically significant paired T-test between pure tone averages (PTAs) at the patient’s original diagnosis and a current, updated audiometric assessment indicated a regression in hearing (p-value < .001) sensitivity following the contraction of COVID-19. Speech reception thresholds (SRTs) and word recognition scores (WRSs) were also considered, as well as the participants' gender. SRTs between each ear exhibited a statistically significant change (p-value of .002 and p-value < .001). WRSs did not show statistically significant differences (p-value of .290 and p-value of .098). A non-statistically significant Two-Way ANOVA was performed to evaluate gender’s potential role in exacerbated hearing loss and proved to be statistically insignificant (p-value of .214). This study discusses practical implications for clinical and educational pursuits in understanding COVID-19's effect on the auditory system and the need to evaluate the deadly virus further.

Keywords: audiology, COVID-19, sensorineural hearing loss, otology, auditory research

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Authors: Marzieh Amiri, Zahra Iranpour Mobarakeh, Fatemeh Mehrbakhsh, Mehran Amiri

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Introduction: Early diagnosis and intervention of congenital hearing loss is necessary to minimize the adverse effects of hearing loss. The aim of the present study was to report the results of newborn hearing screening in a centerin the south part of Iran, Fasa. Material and methods: In this study, the data related to 6,144 newbornsduring September 2018 up to September2021, was analyzed. Hearing screening was performed using transient evoked otoacoustic emissions (TEOAEs) and automated auditory brainstem response (AABR) tests. Results: From all 6144 newborns,3752 and 2392referred to the center from urban and rural part of Fasa, respectively. There were 2958 female and 3186 male in this study. Of 6144 newborns, 6098 ones passed the screening tests, and 46 neonates were referred to a diagnostic audiology clinic. Finally, nine neonates were diagnosed with congenital hearing loss (seven with sensorineural hearing loss and two with conductive hearing loss). The severity of all the hearing impaired neonates was moderate and above. The most important risk factors were family history of hearing loss, low gestational age, NICU hospitalization, and hyperbilirubinemia. Conclusion: Our results showed that the prevalence of hearing loss was 1.46 per 1000 infants. Boosting public knowledge by providing families with proper education appears to be helpful in preventing the negative effects of delayed implementation of health screening programs.

Keywords: newborn hearing screening, hearing loss, risk factor, prevalence

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Authors: F. Forouharmajd, S. Pourabdian, N. Ziayi Ghahnavieh

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For many years, the ear protectors have been used to preventing the audio and non-audio effects of received noise from occupation environments. Despite performing hearing protection programs, there are many people which still suffer from noise-induced hearing loss. This study was conducted with the aim of determination of human hearing system response to received noise and the effectiveness of ear protectors on preventing of noise-induced hearing loss. Sound pressure microphones were placed in a simulated ear canal. The severity of noise measured inside and outside of ear canal. The noise reduction values due to installing ear protectors were calculated in the octave band frequencies and LabVIEW programmer. The results of noise measurement inside and outside of ear canal showed a different in received sound levels by ear canal. The effectiveness of ear protectors has been considerably reduced for the low frequency limits. A change in resonance frequency also was observed after using ear protectors. The study indicated the ear canal structure may affect the received noise and it may lead a difference between the received sound from the measured sound by a sound level meter, and hearing system. It means the human hearing system may probably respond different from a sound level meter. Hearing protectors’ efficiency declines by increasing the noise levels, and thus, they are not suitable to protect workers against industrial noise particularly low frequency noise. Hearing protectors may be solely a reason to damaging of hearing system in a special frequency via changing of human hearing system acoustical structure. We need developing the subjective method of hearing protectors testing, because their evaluation is not designed based on industrial noise or in the field.

Keywords: ear protector, hearing system, occupational noise, workers

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Authors: Bushra Akram, Amina Tariq

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Objective: This cross-sectional descriptive study aimed to compare the level of resilience among children with and without hearing loss. Methodology: In this descriptive cross sectional study total 500 children (with hearing loss = 250 and without hearing loss = 250) were recruited conveniently. Children with hearing loss were recruited from the special schools whereas children without hearing loss were selected from regular schools located in cities of Gujrat and Jhelum of Pakistan. Respondents’ age ranged from 9-14 years. Resiliency scale named RSCA (Resiliency Scales for children and adolescents) developed by Sandra Prince Embury (2006) was used. RSCA consist of three core theoretical areas: MAS (Sense of Mastery Scale), REL (Sense of Relatedness Scale) and REA (Emotional Reactivity Scale). Results: Findings indicated that there was a significant difference in the resilience level of participants with and without hearing loss. The mean comparison showed that the children with hearing loss showed lower scores on MAS (X̅ = 43.32, SD = 7.55) as well as on REL (X̅ = 49.96, SD = 7.65) as compared to their counterparts on MAS (X̅ = 53.96, SD = 9.90, t= -7.31***) and on REL (X̅ = 68.43, SD = 14.57,t= -10.18***). However children with hearing loss showed higher scores on REA (X̅ = 42.12, SD = 5.84) as compared to hearing participants (X̅ = 28.84, SD = 13.97, t = -8.20***). The findings revealed no significance difference in the resilience level of hearing and deaf children on the basis of their gender and age. Research Outcomes and Future Scope: Children with hearing loss showed a lower level of resilience, therefore, needs a program to develop resilience for better social-emotional adjustment and enhancement of their psychological well-being. In the end, the researcher gave recommendations for future research.

Keywords: children with hearing loss, psychological Wellbeing, resiliency scales for children and adolescents, resilience

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Authors: Irfana M., Priyandi Kabasi

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Children with specific language impairment (SLI) have difficulty acquiring and using language despite having all the requirements of cognitive skills to support language acquisition. These children have normal non-verbal intelligence, hearing, and oral-motor skills, with no history of social/emotional problems or significant neurological impairment. Nevertheless, their language acquisition lags behind their peers. Phonological complexity can be considered to be the major factor that causes the inaccurate production of speech in this population. However, the implementation of various ranges of complex phonological stimuli in the treatment session of SLI should be followed for a better prognosis of speech accuracy. Hence there is a need to study the levels of phonological complexity. The present study consisted of 7 individuals who were diagnosed with SLI and 10 developmentally normal children. All of them were Hindi speakers with both genders and their age ranged from 4 to 5 years. There were 4 sets of stimuli; among them were minimal contrast vs maximal contrast nonwords, minimal coarticulation vs maximal coarticulation nonwords, minimal contrast vs maximal contrast words and minimal coarticulation vs maximal coarticulation words. Each set contained 10 stimuli and participants were asked to repeat each stimulus. Results showed that production of maximal contrast was significantly accurate, followed by minimal coarticulation, minimal contrast and maximal coarticulation. A similar trend was shown for both word and non-word categories of stimuli. The phonological complexity effect was evident in the study for each participant group. Moreover, present study findings can be implemented for the management of SLI, specifically for the selection of stimuli.

Keywords: coarticulation, minimal contrast, phonological complexity, specific language impairment

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Authors: Hanh Thi My Nguyen

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The purpose of this research is to examine the experiences of parents of children who are deaf or hard of hearing in supporting their children to access education in Vietnam. Parents play a crucial role in supporting their children to gain full access to education. It was widely reported that parents of those children confronted a range of problems to support their children to access education. To author’s best knowledge, there has been a lack of research exploring the experiences of those parents in literature. This research examines factors affecting those parents in supporting their children to access education. To conduct the study, qualitative approach using a phenomenological research design was chosen to explore the central phenomena. Ten parents of children who were diagnosed as deaf or hard of hearing and aged 6-9 years were recruited through the support of the Association of Parents of Children with Hearing Impairment. Participants were interviewed via telephone with a mix of open and closed questions; interviews were audio recorded, transcribed and thematically analysed. The research results show that there are nine main factors that affected the parents in this study in making decisions relating to education for their children including: lack of information resources, perspectives of those parents on communication approaches, the families’ financial capacity, the psychological impact on the participants after their children’ diagnosis, the attitude of family members, attitude of school administrators, lack of local schools and qualified teachers, and current education system for the deaf in Vietnam. Apart from those factors, the lack of knowledge of the participants’ partners about deaf education and the partners’ employment are barriers to educational access and successful communication with their child.

Keywords: access to education, deaf, hard of hearing, parents experience

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Authors: H. Weigelt-Marom

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Over the years and up to the arousal of the COVID-19 pandemic, deaf or hard of hearing students studying in higher education institutions, participated lectures on campus using hearing aids and strategies adapted for frontal learning in a classroom. Usually, these aids were well known to them from their earlier study experience in school. However, the transition to online lessons, due to the latest pandemic, led deaf or hard of hearing students to study outside of their physical, well known learning environment. The change of learning environment and structure rose new challenges for these students. The present study examined the learning experience, limitations, challenges and benefits regarding learning online with lecture and classmates via the “Zoom” video conference program, among deaf or hard of hearing students in academia setting. In addition, emotional and social aspects related to learning in general versus the “Zoom” were examined. The study included 18 students diagnosed as deaf or hard of hearing, studying in various higher education institutions in Israel. All students had experienced lessons on the “Zoom”. Following allocation of the group study by the deaf and hard of hearing non-profit organization “Ma’agalei Shema”, and receiving the participants inform of consent, students were requested to answer a google form questioner and participate in an interview. The questioner included background information (e.g., age, year of studying, faculty etc.), level of computer literacy, and level of hearing and forms of communication (e.g., lip reading, sign language etc.). The interviews included a one on one, semi-structured, in-depth interview, conducted by the main researcher of the study (interview duration: up to 60 minutes). The interviews were held on “ZOOM” using specific adaptations for each interviewee: clear face screen of the interviewer for lip and face reading, and/ or professional sign language or live text transcript of the conversation. Additionally, interviewees used their audio devices if needed. Questions regarded: learning experience, difficulties and advantages studying using “Zoom”, learning in a classroom versus on “Zoom”, and questions concerning emotional and social aspects related to learning. Thematic analysis of the interviews revealed severe difficulties regarding the ability of deaf or hard of hearing students to comprehend during ”Zoom“ lessons without adoptive aids. For example, interviewees indicated difficulties understanding “Zoom” lessons due to their inability to use hearing devices commonly used by them in the classroom (e.g., FM systems). 80% indicated that they could not comprehend “Zoom” lessons since they could not see the lectures face, either because lectures did not agree to open their cameras or, either because they did not keep a straight forward clear face appearance while teaching. However, not all descriptions regarded learning via the “zoom” were negative. For example, 20% reported the recording of “Zoom” lessons as a main advantage. Enabling then to repeatedly watch the lessons at their own pace, mostly assisted by friends and family to translate the audio output into an accessible input. These finding and others regarding the learning experience of the group study on the “Zoom”, as well as their recommendation to enable deaf or hard of hearing students to study inclusively online, will be presented at the conference.

Keywords: deaf or hard of hearing, learning experience, Zoom, qualitative research

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Authors: Melissa Angus Baboun

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Utilizing a Critical Discourse Analysis (CDA) methodology and a theoretical framework based on disability studies, how Jamaican and Trinidadian newspapers discussed issues relating to the Deaf community were examined. The term deaf was inputted into the search engine tool of the online website for the Jamaica Observer and the Trinidad & Tobago Guardian. All 27 articles that contained the term deaf in its content and were written between August 1, 2017 and November 15, 2017 were chosen for the study. The data analysis was divided into three steps: (1) listing and analysis instances of metaphorical deafness (e.g. fall on deaf ears), (2) categorization of the content of the articles into the models of disability discourse (the medical, socio-cultural, and superscrip models of disability narratives), and (3) the analysis of any additional data found. A total of 42% of the articles pulled for this study did not deal with the Deaf community in any capacity, but rather instances of the use of idiomatic expressions that use deafness as a metaphor for a non-physical, undesirable trait. The most common idiomatic expression found was fall on deaf ears. Regarding the models of disability discourse, eight articles were found to follow the socio-cultural model, two were found to follow the medical model, and two were found to follow the superscrip model. The additional data found in these articles include two instances of the term deaf and mute, an overwhelming use of lower case d for the term deaf, and the misuse of the term translator (to mean interpreter).

Keywords: deafness, disability, news coverage, Caribbean newspapers

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Authors: Estrella C. Damaris, Ingrid A. Olais, Gloria P. Uicab

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This study explores the relationship between the level of functionality and cognitive impairment in older adult women from the south-east of Mexico. It is a descriptive, cross-sectional study; performed with 172 participants in total who attended a health institute and live in Merida, Yucatan Mexico. After a non-probabilistic sampling, Barthel and Pfeiffer scales were applied. The results show statistically significant correlation between the cognitive impairment (Pfeiffer) and the levels of independence and function (Barthel) (r =0.489; p =0.001). Both determine a dependence level so they need either a little or a lot of help. Society needs that the older woman be healthy and that the professionals of mental health develop activities to prevent and rehabilitate because cognitive impairment and function are directly related with the quality of life.

Keywords: functionality, cognition, routine activities, cognitive impairment

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Authors: Peder O. Laugen Heggdal, Oyvind Nordvik, Jonas Brannstrom, Flemming Vassbotn, Anne Kari Aarstad, Hans Jorgen Aarstad

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Background: Hearing loss (HL) affect people of all ages and stages in life. To author's best knowledge, if patients with an HL have reduced Generic Quality of life (QoL), has yet not been answered. Aim: The aim of the present study was to investigate the relationship between HL and generic and disease-specific Health Related Quality of Life (HRQoL) in adult patients (aged 18–78 years) with an HL, seeking Hearing Aid (HA). Material and Methods: 158 adult (aged 18-78 years) patients with HL, referred for HA fitting at Haukeland University Hospital in western Norway, participated in the study. Both first-time users, as well as patients referred for HA renewals, were included. First-time users had been pre-examined by an Ear Nose and Throat specialist. The questionnaires were answered before the actual HA fitting procedure. The pure-tone average (PTA; frequencies 0.5, 1, 2 and 4 kHz) was determined for each ear. The generic European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire general part and a shortened version of the Abbreviated Profile of Hearing Aid Benefit (APHAB) were answered. In addition, EORTC HRQoL answers from a general population and patients with former head and neck cancer served as comparison. Results: In general, no lowered HRQoL scores were determined among HL patients compared to the general population. Patients with unilateral HL to some extent showed lower HRQoL than those with bilateral HL (social function and fatigue). The APHAB scores correlated significantly with the EORTC HRQoL scores. By stepwise linear regression analysis, the APHAB scores were scored secondary to PTA (best ear), cognitive and physical function. Conclusion: HRQoL scores in HL patients, in general, seems to be at the population level, but the unilateral HL patients scored to some extent lower than the bilateral HI patients. APHAB and generic QoL scores levels are associated. Both HRQoL and APHAB scores are generated more complexly than anticipated.

Keywords: quality of life, hearing loss, hearing impairment, distress, depression, anxiety, hearing aid

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Authors: Chalise Kiran

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The prime idea of inclusive education is to mainstream every child in education. However, it will be challenging for implementation when there are policy and practice gaps. It will be even more challenging when children have disabilities. Generally, the focus will be on the policy gap, but the problem may not always be with policy. The proper practice could be a challenge in the countries like Nepal. In determining practice, the teachers’ perceptions toward inclusive will play a vital role. Nepal has categorized disability in 7 types (physical, visual, hearing, vision/hearing, speech, mental, and multiple). Out of these, hearing impairment is the study realm. In the context of a limited number of researches on children with disabilities and rare researches on CWHI and their education in Nepal, this study is a pioneering effort in knowing basically the problems and challenges of CWHI focused on inclusive education in the schools including gaps and barriers in its proper implementation. Philosophically, the paradigm of the study is post-positivism. In the post-positivist worldview, the quantitative approach with the description of the situation and inferential relationship are revealed out in the study. This is related to the natural model of objective reality. The data were collected from an individual survey with the teachers and head teachers of 35 schools in Nepal. The survey questionnaire was prepared and filled by the respondents from the schools where the CWHI study in 7 provincial 20 districts of Nepal. Through these considerations, the perceptions of CWHI focused inclusive education were explored in the study. The data were analyzed using both descriptive and inferential tools on which the Likert scale-based analysis was done for descriptive analysis, and chi-square mathematical tool was used to know the significant relationship between dependent variables and independent variables. The descriptive analysis showed that the majority of teachers have positive perceptions toward implementing CWHI focused inclusive education, and the majority of them have positive perceptions toward CWHI focused inclusive education, though there are some problems and challenges. The study has found out the major challenges and problems categorically. Some of them are: a large number of students in a single class; availability of generic textbooks for CWHI and no availability of textbooks to all students; less opportunity for teachers to acquire knowledge on CWHI; not adequate teachers in the schools; no flexibility in the curriculum; less information system in schools; no availability of educational consular; disaster-prone students; no child abuse control strategy; no disabled-friendly schools; no free health check-up facility; no participation of the students in school activities and in child clubs and so on. By and large, it is found that teachers’ age, gender, years of experience, position, employment status, and disability with him or her show no statistically significant relation to successfully implement CWHI focused inclusive education and perceptions to CWHI focused inclusive education in schools. However, in some of the cases, the set null hypothesis was rejected, and some are completely retained. The study has suggested policy implications, implications for educational authority, and implications for teachers and parents categorically.

Keywords: children with hearing impairment, disability, inclusive education, perception

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Authors: Ayo Osisanya, Promise Ebuka Okonkwo

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Reduced hearing sensitivity among the elderly has been attributed to some risk factors and influence of age-related degenerative conditions such as diabetes, cardiovascular disease, Alzheimer’s disease, bipolar disorder, and hypertension. Hearing loss; especially the age-related type (presbycusis), has been reported as one of the global burden affecting the general well-being and quality of life of the elderly with hypertension. Thus, hearing loss has been observed to be associated with hypertension and functional decline in elderly, as this condition makes them experience poor communication, fatigue, reduced social functions, mood-swing, and withdrawal syndrome. Emerging research outcomes indicate a strong relationship between hypertension and reduced auditory performance among the elderly. Therefore, this study determined the prevalence, types, and patterns of hearing loss associated with hypertension, with a bid to suggesting comprehensive management strategies and a model of creating awareness towards promoting good healthy living among the elderly in Nigeria. One hundred and seventy-two elderly, aged 65–85 with hypertension were purposively selected from patients undergoing treatment for hypertension in some tertiary hospitals in southwest Nigeria for the study. Participants were suggested to Pure-Tone Audiometry (PTA) through the use of Maico 53 Diagnostic Audiometer to determine the degree, types ad patterns of hearing loss among the elderly with hypertension. Results showed that 148 (86.05%) elderly with hypertension presented with different degrees, types, and patterns of hearing loss. Out of this number, 123 (83.11%) presented with bilateral hearing loss, while 25 (16.89%) had unilateral hearing loss. Degree of hearing loss, 74 moderate hearing loss, 118 moderately severe and 50 severe hearing loss. 36% of the hearing loss appeared as flat audiometric configuration, 24% were slopping, 19% were rising, while 21% were tough-shaped audiometric configurations. The findings showed high prevalence of hearing loss among the elderly with hypertension in Southwest, Nigeria. Based on the findings, management of elderly with hypertension should include regular audiological rehabilitation and total adherence to hearing conservation principles, otological management, regulation of blood pressure and adequate counselling / follow-up services.

Keywords: auditory performance, elderly, hearing loss, hypertension

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Authors: Jawaria Zafaror, Najma Iqbal Malik

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The present study has been undertaken to explore the relationship among mild cognitive impairment, loneliness and depression among a convenient sample of old people (N = 100) living in old age homes (n = 50) and family home residence (n = 50). Mild Cognitive Impairment Questionnaire, Depression Subscale of Depression Anxiety Stress Scale and UCLA Loneliness Scales were used. Results revealed that Mild cognitive impairment had a significant positive relationship with depression and loneliness among old people both living in old age homes and family home residences. Results also showed that loneliness was the significant positive predictor of depression. However, t-test analysis revealed that old females had higher depression as compared to old males, but old males suffered a significantly high level of cognitive distortions and loneliness as compared to old females. Mediation analysis suggests that loneliness was the partial mediator between mild cognitive impairment and loneliness among old people. Limitations, suggestions and implications were also discussed.

Keywords: loneliness, mild cognitive impairment, depression, old age

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Authors: P. G. S. Madushani, L. D. Illeperuma

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Abstract Noise is one of the most common physical hazards in industrial settings. The prevalence of Noise Induced Hearing Loss (NIHL) is on the rise with increasedduration of exposure and the increase in the severity of hearing loss. The purpose of the study was to determine auditory effects among textile workers and to establish associations between the degree of hearing loss and exposure duration, degree of hearing loss and noise level and the proportion of hearing related complaints. A cross sectional descriptive study using purposive sampling was carried out. An interviewer administered questionnaire and Distortion Product Oto Acoustic Emission (DPOAE) hearing screening on 127 (72 female and 55 male) textile workers of the selected textile plant in Seeduwa, Sri Lanka was done (Age: M= 31.16, SD=7.75). Noise measurements were done in six sections of the factory and average noise levels were obtained. Diagnostic hearing evaluations were done for 60 (57.75%) subjects, referred from the DPOAE hearing screening test. The degree of hearing loss and the exposure duration had a significant association in the high frequency region of 4 kHz to 8 kHz (p < 0.05). Noise levels fluctuated between 90.3±0.8 dBA and 50.6. ±0.52 dBA. 30.83% of workers reported having NIHL. Most of the workers (33.9%) complained difficulty in conversing in noisy backgrounds. Other complaints as tinnitus, dizziness, ear fullness and headache were reported in less than 30%. workers who were exposed to noise for more than 15 years were affected with NIHL in the high frequency region. Administrative controls and engineering controls need to be implemented to manage hazardous noise levels in industrial settings. Hearing Conservation Programs should be initiated and implemented for textile workers.

Keywords: textile industry, NIHL, degree of hearing loss, noise levels, auditory effects

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Authors: Aleema Rahman

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Introduction: This study aims to estimate the prevalence of long-term otitis media with effusion (OME) and hearing loss in a prospective longitudinal cohort studyand to study the relationship between the condition and educational and psychosocial outcomes. Methods: Analysis of data from the Avon Longitudinal Study of Parents and Children (ALSPAC) will be undertaken. ALSPAC is a longitudinal birth cohort study carried out in the UK, which has collected detailed measures of hearing on ~7000 children from the age of seven. A descriptive analysis of the data will be undertaken to estimate the prevalence of OME and hearing loss (defined as having average hearing levels > 20dB and type B tympanogram) at 7, 9, 11, and 15 years as well as that of long-term OME and hearing loss. Logistic and linear regression analyses will be conducted to examine associations between long-term OME and hearing loss and educational outcomes (grades obtained from standardised national attainment tests) and psychosocial outcomes such as anxiety, social fears, and depression at ages 10-11 and 15-16 years. Results: Results will be presented in terms of the prevalence of OME and hearing loss in the population at each age. The prevalence of long-term OME and hearing loss, defined as having OME and hearing loss at two or more time points, will also be reported. Furthermore, any associations between long-term OME and hearing loss and the educational and psychosocial outcomes will be presented. Analyses will take into account demographic factors such as sex and social deprivation and relevant confounders, including socioeconomic status, ethnicity, and IQ. Discussion: Findings from this study will provide new epidemiological information on the prevalence of long-term OME and hearing loss. The research will provide new knowledge on the impact of OME for the small group of children who do not grow out of condition by age 7 but continue to have hearing loss and need clinical care through later childhood. The study could have clinical implications and may influence service delivery for this group of children.

Keywords: educational attainment, hearing loss, otitis media with effusion, psychosocial development

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Authors: Nor Wahiza Abdul Wahat, Nor Haniza Abdul Wahat, Siti Noormi Alias, Mohamad Sazali Shaari

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This study prepares the groundwork for the development of a strategic model and instrument for workplace inclusivity for deaf and hard-of-hearing employees in Malaysia. In the past, scholars have discussed inclusivity of workplaces to the extent to which employees feel they are significantly part of the organizational processes. Such processes include access to information, connectedness to colleagues and team members as well as their ability to participate in and influence decision-making processes. A qualitative study was conducted to explore on experiences of employed deaf and hard-of-hearing employees in a few Malaysian organizations. Data were collected from two focus group discussions involving male and female deaf and hard of hearing employees. Three in-depth interviews were also conducted with employer representatives. Generated themes highlighted individual, and team approaches towards crafting workplace inclusivity for deaf and hard of hearing employees in Malaysia. The adaptiveness of deaf and hard-of-hearing employees and social inclusion by colleagues were among the emerged sub-themes. This study allowed the researchers to further develop workplace inclusivity instruments and models for the benefit of deaf and hard of hearing Malaysian employees, as well as their employers.

Keywords: deaf, hard of hearing, workplace inclusivity, disabilities

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Authors: Amirreza Razzaghipour Sorkhab

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One of the most common disorders among humans is hearing impairment. This paper provides an evidence base that recovers understanding of Meniere’s disease and highlights the physical and mental health correlates of the disorder. Meniere's disease is more common in the elderly. The term idiopathic endolymphatic hydrops has been attributed to this disease by some in the previous. Meniere’s disease demonstrations a genetic tendency, and a family history is found in 10% of cases, with an autosomal dominant inheritance pattern. The COCH gene may be one of the hereditary factors contributing to Meniere’s disease, and the possibility of a COCH mutation should be considered in patients with Meniere’s disease symptoms. Should be considered Missense mutations in the COCH gene cause the autosomal dominant sensorineural hearing loss and vestibular disorder. Meniere’s disease is a complex, heterogeneous disorder of the inner ear and that is characterized by episodes of vertigo lasting from minutes to hours, fluctuating sensorineural hearing loss, tinnitus, and aural fullness. The existing evidence supports the suggestion that age and sleep disorder are risk factors for Meniere's disease. Many factors have been reported to precipitate the progress of Menier, including endolymphatic hydrops, immunology, viral infection, inheritance, vestibular migraine, and altered intra-labyrinthine fluid dynamics. Although there is currently no treatment that has a proven helpful effect on hearing levels or on the long-term evolution of the disease, however, in the primary stages, the hearing may improve among attacks, but a permanent hearing loss occurs in the majority of cases. Current publications have proposed a role for the intratympanic use of medicine, mostly aminoglycosides, for the control of vertigo. more than 85% of patients with Meniere's disease are helped by either changes in lifestyle and medical treatment or minimally aggressive surgical procedures such as intratympanic steroid therapy, intratympanic gentamicin therapy, and endolymphatic sac surgery. However, unilateral vestibular extirpation methods (intratympanic gentamicin, vestibular nerve section, or labyrinthectomy) are more predictable but invasive approaches to control the vertigo attacks. Medical therapy aimed at reducing endolymph volume, such as low-sodium diet, diuretic use, is the typical initial treatment.

Keywords: meniere's disease, endolymphatic hydrops, hearing loss, vertigo, tinnitus, COCH gene

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Authors: Magdy I. A. Alshourbagi

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Background: The National Institute for Deafness and Communication Disorders defines idiopathic sudden sensorineural hearing loss as the idiopathic loss of hearing of at least 30 dB across 3 contiguous frequencies occurring within 3 days.The most common clinical presentation involves an individual experiencing a sudden unilateral hearing loss, tinnitus, a sensation of aural fullness and vertigo. The etiologies and pathologies of ISSNHL remain unclear. Several pathophysiological mechanisms have been described including: vascular occlusion, viral infections, labyrinthine membrane breaks, immune associated disease, abnormal cochlear stress response, trauma, abnormal tissue growth, toxins, ototoxic drugs and cochlear membrane damage. The rationale for the use of hyperbaric oxygen to treat ISSHL is supported by an understanding of the high metabolism and paucity of vascularity to the cochlea. The cochlea and the structures within it require a high oxygen supply. The direct vascular supply, particularly to the organ of Corti, is minimal. Tissue oxygenation to the structures within the cochlea occurs via oxygen diffusion from cochlear capillary networks into the perilymph and the cortilymph. . The perilymph is the primary oxygen source for these intracochlear structures. Unfortunately, perilymph oxygen tension is decreased significantly in patients with ISSHL. To achieve a consistent rise of perilymph oxygen content, the arterial-perilymphatic oxygen concentration difference must be extremely high. This can be restored with hyperbaric oxygen therapy. Subject and Methods: A 37 year old man was presented at the clinic with a five days history of muffled hearing and tinnitus of the right ear. Symptoms were sudden onset, with no associated pain, dizziness or otorrhea and no past history of hearing problems or medical illness. Family history was negative. Physical examination was normal. Otologic examination revealed normal tympanic membranes bilaterally, with no evidence of cerumen or middle ear effusion. Tuning fork examination showed positive Rinne test bilaterally but with lateralization of Weber test to the left side, indicating right ear sensorineural hearing loss. Audiometric analysis confirmed sensorineural hearing loss across all frequencies of about 70- dB in the right ear. Routine lab work were all within normal limits. Clinical diagnosis of idiopathic sudden sensorineural hearing loss of the right ear was made and the patient began a medical treatment (corticosteroid, vasodilator and HBO therapy). The recommended treatment profile consists of 100% O2 at 2.5 atmospheres absolute for 60 minutes daily (six days per week) for 40 treatments .The optimal number of HBOT treatments will vary, depending on the severity and duration of symptomatology and the response to treatment. Results: As HBOT is not yet a standard for idiopathic sudden sensorineural hearing loss, it was introduced to this patient as an adjuvant therapy. The HBOT program was scheduled for 40 sessions, we used a 12-seat multi place chamber for the HBOT, which was started at day seven after the hearing loss onset. After the tenth session of HBOT, improvement of both hearing (by audiogram) and tinnitus was obtained in the affected ear (right). Conclusions: In conclusion, HBOT may be used for idiopathic sudden sensorineural hearing loss as an adjuvant therapy. It may promote oxygenation to the inner ear apparatus and revive hearing ability. Patients who fail to respond to oral and intratympanic steroids may benefit from this treatment. Further investigation is warranted, including animal studies to understand the molecular and histopathological aspects of HBOT and randomized control clinical studies.

Keywords: idiopathic sudden sensorineural hearing loss (issnhl), hyperbaric oxygen therapy (hbot), the decibel (db), oxygen (o2)

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Authors: Nihal Esam Abuzinadah, Areej Abbas Malibari, Arwa Abdulaziz Allinjawi, Paul Krause

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Deaf and hearing-impaired students face many obstacles throughout their education, especially with learning applied sciences such as computer programming. In addition, there is no clear signs in the Arabic Sign Language that can be used to identify programming logic terminologies such as while, for, case, switch etc. However, hearing disabilities should not be a barrier for studying purpose nowadays, especially with the rapid growth in educational technology. In this paper, we develop an Avatar based system to teach computer programming to deaf and hearing-impaired students using Arabic Signed language with new signs vocabulary that is been developed for computer programming education. The system is tested on a number of high school students and results showed the importance of visualization in increasing the comprehension or understanding of concepts for deaf students through the avatar.

Keywords: hearing-impaired students, isolation, self-esteem, learning difficulties

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Authors: Paula I. Buonfiglio, Carlos David Bruque, Lucia Salatino, Vanesa Lotersztein, Sebastián Menazzi, Paola Plazas, Ana Belén Elgoyhen, Viviana Dalamón

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Hearing loss (HL) is the most prevalent sensorineural disorder affecting about 10% of the global population, with more than half due to genetic causes. About 1 in 500-1000 newborns present congenital HL. Most of the patients are non-syndromic with an autosomal recessive mode of inheritance. To date, more than 100 genes are related to HL. Therefore, the Whole-exome sequencing (WES) technique has become a cost-effective alternative approach for molecular diagnosis. Nevertheless, new challenges arise from the detection of novel variants, in particular missense changes, which can lead to a spectrum of genotype-to-phenotype correlations, which is not always straightforward. In this work, we aimed to identify the genetic causes of HL in isolated and familial cases by designing a multistep approach to analyze target genes related to hearing impairment. Moreover, we performed in silico and in vivo analyses in order to further study the effect of some of the novel variants identified in the hair cell function using the zebrafish model. A total of 650 patients were studied by Sanger Sequencing and Gap-PCR in GJB2 and GJB6 genes, respectively, diagnosing 15.5% of sporadic cases and 36% of familial ones. Overall, 50 different sequence variants were detected. Fifty of the undiagnosed patients with moderate HL were tested for deletions in STRC gene by Multiplex ligation-dependent probe amplification technique (MLPA), leading to 6% of diagnosis. After this initial screening, 50 families were selected to be analyzed by WES, achieving diagnosis in 44% of them. Half of the identified variants were novel. A missense variant in MYO6 gene detected in a family with postlingual HL was selected to be further analyzed. A protein modeling with AlphaFold2 software was performed, proving its pathogenic effect. In order to functionally validate this novel variant, a knockdown phenotype rescue assay in zebrafish was carried out. Injection of wild-type MYO6 mRNA in embryos rescued the phenotype, whereas using the mutant MYO6 mRNA (carrying c.2782C>A variant) had no effect. These results strongly suggest the deleterious effect of this variant on the mobility of stereocilia in zebrafish neuromasts, and hence on the auditory system. In the present work, we demonstrated that our algorithm is suitable for the sequential multigenic approach to HL in our cohort. These results highlight the importance of a combined strategy in order to identify candidate variants as well as the in silico and in vivo studies to analyze and prove their pathogenicity and accomplish a better understanding of the mechanisms underlying the physiopathology of the hearing impairment.

Keywords: diagnosis, genetics, hearing loss, in silico analysis, in vivo analysis, WES, zebrafish

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Authors: Deepthy Ann Joy, N. Sreedevi

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Hearing impairment (HI) at an early age, identified before the onset of language development can reduce the negative effect on speech and language development of children. Early rehabilitation is very important in the improvement of speech production in children with HI. Other than conventional hearing aids, Cochlear Implants are being used in the rehabilitation of children with HI. However, delay in acquisition of speech and language milestones persist in children with Cochlear Implant (CI). Delay in speech milestones are reflected through speech sound errors. These errors reflect the temporal and spectral characteristics of speech. Hence, acoustical analysis of the speech sounds will provide a better representation of speech production skills in children with CI. The present study aimed at investigating the acoustic characteristics of vowels in Malayalam speaking children with a cochlear implant. The participants of the study consisted of 20 Malayalam speaking children in the age range of four and seven years. The experimental group consisted of 10 children with CI, and the control group consisted of 10 typically developing children. Acoustic analysis was carried out for 5 short (/a/, /i/, /u/, /e/, /o/) and 5 long vowels (/a:/, /i:/, /u:/, /e:/, /o:/) in word-initial position. The responses were recorded and analyzed for acoustic parameters such as Vowel duration, Ratio of the duration of a short and long vowel, Formant frequencies (F₁ and F₂) and Formant Centralization Ratio (FCR) computed using the formula (F₂u+F₂a+F₁i+F₁u)/(F₂i+F₁a). Findings of the present study indicated that the values for vowel duration were higher in experimental group compared to the control group for all the vowels except for /u/. Ratio of duration of short and long vowel was also found to be higher in experimental group compared to control group except for /i/. Further F₁ for all vowels was found to be higher in experimental group with variability noticed in F₂ values. FCR was found be higher in experimental group, indicating vowel centralization. Further, the results of independent t-test revealed no significant difference across the parameters in both the groups. It was found that the spectral and temporal measures in children with CI moved towards normal range. The result emphasizes the significance of early rehabilitation in children with hearing impairment. The role of rehabilitation related aspects are also discussed in detail which can be clinically incorporated for the betterment of speech therapeutic services in children with CI.

Keywords: acoustics, cochlear implant, Malayalam, vowels

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Authors: Rajani S. Pujar, Pandurangarao N. Kulkarni

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Increased temporal masking affects the speech perception in persons with sensorineural hearing impairment especially under adverse listening conditions. This paper presents a cascaded scheme, which employs a noise reduction algorithm as well as temporal splitting of the speech signal. Earlier investigations have shown that by splitting the speech temporally and presenting alternate segments to the two ears help in reducing the effect of temporal masking. In this technique, the speech signal is processed by two fading functions, complementary to each other, and presented to left and right ears for binaural dichotic presentation. In the present study, half cosine signal is used as a fading function with crossover gain of 6 dB for the perceptual balance of loudness. Temporal splitting is combined with noise reduction algorithm to improve speech perception in the background noise. Two noise reduction schemes, namely spectral subtraction and Wiener filter are used. Listening tests were conducted on six normal-hearing subjects, with sensorineural loss simulated by adding broadband noise to the speech signal at different signal-to-noise ratios (∞, 3, 0, and -3 dB). Objective evaluation using PESQ was also carried out. The MOS score for VCV syllable /asha/ for SNR values of ∞, 3, 0, and -3 dB were 5, 4.46, 4.4 and 4.05 respectively, while the corresponding MOS scores for unprocessed speech were 5, 1.2, 0.9 and 0.65, indicating significant improvement in the perceived speech quality for the proposed scheme compared to the unprocessed speech.

Keywords: MOS, PESQ, spectral subtraction, temporal splitting, wiener filter

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