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Training audiology teams for developing countries
- 1. Audiology Work TeamsMaking a difference Methods & Considerations
- 2. Why go? To fit and provide hearing aids. Most deaf children who live in developing countries do not have hearing aids. To train parent and children in the use of aids. If a hearing aid is provided without training in its use and maintenance, the chances are good that within a month, the child will not be using it. Parents likewise need education, not only about hearing aids, but about their child’s hearing loss in particular.
- 3. Training the Recipients, Purpose:
- 4. What do parents and deaf children need to know that audiologists and other workers in the hearing industry can tell them?
- 5. Training: fit and adjustments
- 7. Training: repair & replace
- 10. A few more issues to consider
- 11. Prevent their sale Keep a database of names & serial numbers. Have your in-country hosts ask the cooperation of local audiologists to be on the lookout for those numbers. Inform parents they will not receive a replacement aid in future programs unless they turn in the non-functioning one, and that the serial numbers are recorded. Require accountability for any aids left with school employees to make sure they are not sold.
- 12. Batteries Need to be affordable and always available If batteries are out of reach financially (usually true for third world deaf children), consider a token charge (price) for each battery, and require old batteries to be traded in. The school office is the logical place for this to happen. Consider using rechargeable batteries, once the students learn not to lose them, with the charging station at the school.
- 13. Batteries, continued Consider charging a normal price for batteries of students who are finishing school, so they will be accustomed to the cost, and may continue to use their aids when they leave school. If teachers are expected to check batteries, then they should be provided with a basic battery tester for their classrooms and taught how to use them.
Editor's Notes
- Many parents of deaf children in developing countries do not realize what hearing loss means. They often are under the illusion that their profoundly deaf child can hear most of what they say to them. In some countries there is the added pressure that deafness is considered a shame to the family, or that deaf people are considered to be crazy, or have been reincarnated as deaf because of sins in a previous life.
- Both deaf children and parents need to understand about the care of hearing aids. (High school age students, if they have good communication skills, should be able to learn this w/o their parents, however.)If there is no training, most of the children will not be wearing hearing aids on your next visit, because they will be broken, lost, stolen, or out of batteries.It is not enough to merely hand out written material. Most deaf children in developing countries do not have adequate literacy skills to read the materials, nor do many of their parents. Even if parents can read, the chances are their communication skills with their deaf children are poor.
- From this point on, the emphasis is on what the audiologists and other team workers need to do to train the parents and children about hearing aids etc.
- Causes and cures for feedback. Often kids will be thrilled about their new hearing aids. Three days later their parents report that the children refuse to wear them al all! The problem is sometimes that parents have forced the child to wear their hearing aid all day long when they are not used to it. I recommend that they ask them to start out with just ten or fifteen minutes, and add a little day by day. Often after a few days, the child no longer has issues.
- If these issues are not addressed, most hearing aids do not last through a single year in a tropical climate. A well cared-for aid can last for years.
- Tropical heat can cause tubes to dry out and crack. Parents need to know these are inexpensive to replace.Parents need to know that as a child grows, their ears grow also, and new molds are needed from time to time.
- One little girl came to school without her hearing aid. When asked where it was, she responded that the rats had gotten it. Sure enough, they found it in a rats nest later, a bit worse for wear. Rats can be hoarders. She needs to keep her aid in a small box so that it is not so easy for a rat to carry off.Many developing countries have high crime rates, and hearing aids are a target. Sometimes the aid will be stolen because it is thought to be something else, like an ipod or a bluetooth phone set. Hearing aids should be kept in a secure location, out of sight when not in use.
- Parents in developing countries sometimes have not been exposed to hearing aids, and may see them as somewhat miraculous. Some think that once their child has a hearing aid, s/he will automatically become like a hearing child, and will be able to understand speech. They need to be educated on just what to expect from the aid.Also, parents see a 50dB loss as a 50% loss…Audiologists usually just hand them the audiogram, and they have no idea what it means. They don’t know how to look it up on the internet. Each parent needs some one on one time, where their child’s audiogram can be explained, even if for only five minutes. It is also a good idea to put some written explanation if possible, for them to refer back to later, even if they are not able to read it themselves.They need to understand especially what level of deafness their child has, and what s/he can expect to hear with aids. They need to know what the levels of deafness mean.
- Now we go back to you team members, rather than the parents, to touch on a few more issues you need to consider.
- Parents in developing countries have been know to sell their child’s hearing aid, and go back for the following year’s program to get another one—to sell. At times schools have sold extra aids which were left for new children coming in, to finance other school projects.The audiologists look out for the numbers not in order to confiscate the aids, rather to inform your program so that you can avoid giving new aids to parents who have sold them. Aids are sometimes stolen, as well. Usually the school employees can tell you if this is likely the case with a particular family.
- One frequent reason for leaving off the use of aids is that batteries have run out, and there is no money for replacements. It is not enough to give them an aid and a pack of batteries, if you expect them to continue using them for a year or more. A large supply of batteries should be kept at the school. The school should be held accountable for the batteries as well, so that they will not sell them except as agreed. A log book might be a good idea.
- Really teachers should have all the basic training for simple diagnosis of hearing aid problems, how to put them on, take them off, and adjust them etc. so that they can train the students. Just being told once is not enough for most students. They need the information reviewed from time to time.