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Author: admin, 16.07.2014
Aim: To study the opinions of grandmothers of newborns on hearing loss, Newborn hearing screening (NHS) and intervention options.
It is a screening test to check if your  baby's hearing is normal at birth or if more testing is needed. This site has fun activities, interactive models, and games to help both you and your child understand hearing loss.
Materials and Methods: 100 grandmothers were interviewed in a tertiary care hospital, using a questionnaire adapted from Olusanya, Luxon and Wirz (2006).
In the broadest terms, these include the use of public awareness campaigns, risk indicators, behavioral tests, and physiological tests.
The views of parents of hearing impaired children on the need for neonatal hearing screening. Family perceptions of early hearing detection, and intervention systems: Listening to and learning from families.
DFNB1 hearing loss due to abnormal connexin 26: Mutations in the GJB2 gene are a major cause of prelingual nonsyndromic deafness. The public awareness approach uses mass media campaigns, brochures, and checklists to educate the public about the risk factors of hearing loss in children.
Lewis,Vasudeva Guddattu International Journal of Pediatric Otorhinolaryngology. Approximately 10 percent of all congenital hearing loss and 50 to 70 percent of all nonsyndromic autosomal recessive forms are due to mutations in this gene. The frequency of carriers of mutations for this gene is 2 to 3 percent in Caucasians (white), 4 to 5 percent in Ashkenazi Jews and 1 per in Japanese. Among the causes studied, more awareness was present for family history (67%), noise exposure (62%), and ear discharge (61%). This gene was the first locus defined for recessive deafness (DFNB1) on chromosome 13q11 and was identified by in consanguineous families from Tunisia by Guilford et al. Majority knew that bewitchment (72%) and ancestral sins (69%) were not a cause for hearing loss.
Parental denial and lack of readiness to accept a hearing problem is linked with delays in diagnosis and hearing aid fitting.
Only 20% were aware that hearing loss could be identified at birth and 12% knew about availability of NHS.


Molecular genetic testing of the GJB2 and GJB6 genes detects more than 99% of deafness-causing mutations in these genes and is available clinically. 75% thought that intervention is possible for hearing loss, and 33% believed that hearing-impaired children could attend regular school, if intervened. Any decision in the family is often influenced by the significant others like grandmothers. Parents often seek their advice in taking care of their children since they have the experience of bringing up a child. And limited awareness was present on causes of hearing loss, identification of hearing loss at birth, NHS and intervention.
Therefore, grandmothers' knowledge and attitude may influence any decision making regarding the child in the family.The information of knowledge on issues related to hearing loss and the attitude towards it will help in developing appropriate educational tools and in providing adequate counseling during the newborn hearing screening (NHS) program. Also there is dearth of studies on caregivers' knowledge and attitude towards issues related to hearing loss and NHS in India.Aim of the studyTo find the grandmothers' knowledge on hearing loss, NHS and intervention of hearing lossTo find the grandmothers' attitude towards NHS and intervention of hearing loss. The interview was conducted at 1 or 2 days after the child's delivery, in the postnatal ward and without any interference by other family members. Since interview could not be completed in two participants, the responses of only 100 grandmothers were taken.
The subjects were from different socioeconomic status and educational background.QuestionnaireThe questionnaire has been adapted and modified from a previous study [5] which originally contained 15 items. Based on the participants' feedback, the difficult terms in the questions were modified.Core studyThe current study was carried out with each subject separately with their consent. The pictures of otoacoustic emission (OAE) and brainstem evoked response audiometry (BERA) testing were shown to the subjects to ask their preference of a screening tool. A South African study [6] indicated a similar rate of awareness of the congenital hearing loss (67%) among mothers. It is well-known fact that parents of infants with congenital hearing loss would like an early identification. They may wait till an observable sign of absence of speech beyond 1 year or till such comparisons are made by others. On the other hand, a good awareness may prepare the grandmothers to suspect hearing loss right from the birth if any facilitating them to approach the healthcare professionals as early as possible.Grandmothers' knowledge on causes of hearing lossResults in [Table 1] shows that grandmothers' knowledge was relatively high for family history (67%), noise exposure (62%), ear discharge (51%), and high fever (50%) as causes of hearing loss. In contrast, their knowledge was low for medication (9%), birth asphyxia (9%), and jaundice (14%).


Two studies [5],[6] have reported poor awareness of the above factors as a cause for hearing loss among mothers. Many Asians, including those from India believe that a disability or deformity is karma (fate), and therefore, nothing can be done about it.
Parents of a deaf child will often spend vast sums of money initially with orthodox medical practitioners and subsequently with traditional healers before accepting rehabilitative intervention. These attitudes stem, in part, from indigenous traditions that contribute to the stigma of deafness and to resistance to both hearing aids and to sign language.Grandmothers' knowledge on NHS and interventionAs shown in [Table 2], 75% of the grandmothers were aware that treatments are available for hearing loss, 67% knew about the speech and language difficulties, and 20% were aware that hearing loss could be identified soon after birth. This in comparison to another study [5] on mothers reported a relatively higher knowledge (57%) on identification of hearing loss soon after birth. Thirty-three percent were aware that children with hearing loss could attend normal school with amplification devices. Eighty-seven percent of the grandmothers preferred OAE as a screening tool for testing their babies. There was also a high acceptance of hearing aids (92%) and surgery (89%) as intervention for hearing loss. Overall, grandmothers demonstrated a positive attitude towards early detection and intervention for hearing loss. Similar results were reported in South African community [6] where, 99% of mothers had a positive attitude towards infant hearing screening. This is also supported a study in Nigeria [5] where a positive attitude for neonatal hearing screening was found in 92% of mothers; 84% had acceptance for hearing aid usage. It is encouraging; the results of the present findings were in line with developed country. About 70% of grandmothers were aware that bewitchment and ancestral sins were not cause of hearing lossKnowledge was limited with respect to medical complications like low birth weight, birth asphyxia and jaundice as a cause for hearing loss. So, careful attention has to be provided in creating awareness and in counseling towards the factors which had poor knowledge and negative attitude.
Also during counseling, family as a whole to be involved because, individual member's lack of knowledge may lead to the delay in identification and intervention of the hearing impairment.Further research can study the knowledge and attitudes of the other members of the family and their attitudes towards hearing impaired children.



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