Evaluation of the use of a questionnaire by non-specialists to detect hearing loss in preschool Brazilian children

Abstract

In developing countries there is a lack of trained personnel and testing equipment to facilitate early detection of hearing impairment in children. There is a need to develop a strategic functional model for identification of hearing impairments through a scheme for the optimal utilization of the limited and local resources in the community. A questionnaire offers a low-cost option, specially if it is administered by non-professionals. This study evaluated a parent report questionnaire by non-professionals, to identify hearing loss in pre-school children of a poor community in São Paulo city. Seven volunteers were trained by a professional to use the questionnaire. A total of 133 children aged 3-6 years enrolled in this study. Their parents answered the questionnaire administered by the volunteers and the children underwent audiological screening (audiometry and imitanciometry). The results showed that the volunteers reproduced the evaluation of the professional regarding the use of the questionnaire. The majority of the results were statistically significant and the minimal percentage of concordance was 77%. Of the 133 children who were tested, 12 failed the audiometry screening (9.02%) and 18 failed the tympanometry screening (13.53%). The questionnaire did not differentiate between the children who failed in the audiological screening from those who did not, suggesting further refinements are necessary.

Childhood Disability in Low- and Middle-Income Countries: Overview of Screening, Prevention, Services, Legislation, and Epidemiology

“…Some researchers developed questionnaires for their study but provided inadequate information on psychometric properties of the instruments. 12,25,30,34,36,47 The instruments gathered information on signs and symptoms of various disorders 25 and qualitative information on a child's social integration into society, 47 attitude of families toward their disabled children, 43,58 hearing ability, 30,34 and availability of human resources to provide service for disabled children. 36 Some of the researchers provided limited information on characteristics of the questionnaires and also compared them to more standard tools.…”

“…36 Some of the researchers provided limited information on characteristics of the questionnaires and also compared them to more standard tools. 30,34,36 Little is known about the development of the questionnaires except for the Indonesian adaptation of the Vineland Adaptive Behavior Scale 78 and the scale to measure social integration of children with epilepsy in the Indian context. 47 Table 2 outlines the screening tools that were either validated or adapted by different researchers.…”

“…[26][27][28][29][30][31][32][33] Some studies focused on the parents of children with disabilities and tried to assess their needs and attitudes with respect to disability. [34][35][36] Among the others, 3 studies [37][38][39] were clinic based, with a primary focus on the epidemiology and available services for cerebral palsy. One group of investigators 40 used participants from clinics and special institutions, and a control group of normal children, to assess maternal risk factors for disability.…”

Questionário para monitoramento do desenvolvimento auditivo e de linguagem no primeiro ano de vida

“…In this case, the hearing loss found is conductive, generally of a mild degree, which makes identifying it through the questions answered by the parents difficult; once the child reacts to and observes medium/strong-intensity sound, as well as observes verbal language acquisition and development, what turns to suspicion of auditory alteration on the part of the extremely difficult family. Previous studies demonstrated that questionnaires are not considered effective tools for the identification of conductive hearing losses, since they do not differentiate children with or without conductive disorders (25,26) .…”

School and Classroom Disabilities Inclusion Guide for Low- and Middle-Income Countries

“…WHO has recommended the use of questionnaires as an efficient, low-cost alternative for identifying hearing loss among children, particularly in developing countries (2010). This approach was analyzed by Gomes and Lichtig (2005), who evaluated a parent report questionnaire by nonprofessionals to identify hearing loss in preschool children in a poor community in Brazil. They found that the questionnaires matched professional screenings 77 percent of the time, although additional refinements were needed to improve reliability.…”