A Tablet-Based Mobile Hearing Screening System for Preschoolers: Design and Validation Study.

Kwanchanok Yimtae,Pornthep Kasemsiri,Panida Thanawirattananit,Anukool Noymai,Sangvorn Seesutas,Tharapong Soonrach,Siwat Saibua,Pasin Israsena

doi:10.2196/mhealth.9560

Abstract

BackgroundHearing ability is important for children to develop speech and language skills as they grow. After a mandatory newborn hearing screening, group or mass screening of children at later ages, such as at preschool age, is often practiced. For this practice to be effective and accessible in low-resource countries such as Thailand, innovative enabling tools that make use of pervasive mobile and smartphone technology should be considered.ObjectiveThis study aims to develop a cost-effective, tablet-based hearing screening system that can perform a rapid minimal speech recognition level test.MethodsAn Android-based screening app was developed. The screening protocol involved asking children to choose pictures corresponding to a set of predefined words heard at various sound levels offered in a specifically designed sequence. For the app, the set of words was validated, and their corresponding speech power levels were calibrated. We recruited 122 children, aged 4-5 years, during the development phase. Another 63 children of the same age were screened for their hearing abilities using the app in version 2. The results in terms of the sensitivity and specificity were compared with those measured using the conventional audiometric equipment.ResultsFor screening purposes, the sensitivity of the developed screening system version 2 was 76.67% (95% CI 59.07-88.21), and the specificity was 95.83% (95% CI 89.77-98.37) for screening children with mild hearing loss (pure-tone average threshold at 1, 2, and 4 kHz, >20 dB). The time taken for the screening of each child was 150.52 (SD 19.07) seconds (95% CI 145.71-155.32 seconds). The average time used for conventional play audiometry was 11.79 (SD 3.66) minutes (95% CI 10.85-12.71 minutes).ConclusionsThis study shows the potential use of a tablet-based system for rapid and mobile hearing screening. The system was shown to have good overall sensitivity and specificity. Overall, the idea can be easily adopted for systems based on other languages.

Highlights

Hearing loss in one of the most common disabilities
The average time used for conventional play audiometry was 11.79 (SD 3.66) minutes
The average time used for the speech audiometry program was 82.9 (SD 24.13) seconds

Summary

Introduction

Hearing loss in one of the most common disabilities. The World Health Organization estimated that, in 2012, there were 360 million people in the world with disabling hearing loss (5.3%of the world’s population); 328 million (91%) were adults, and 32 million (9%) were children [1]. 1 (page number not for citation purposes) hearing loss, the sensorineural hearing loss is the most common In this case, the damaged hair cells of the inner ear diminish sounds to be effectively converted into nerve signals to the brain. Detection and intervention are, extremely important in children, as hearing loss affects the ability to learn and hinders crucial language, speech, and emotional development [2]. After a mandatory newborn hearing screening, group or mass screening of children at later ages, such as at preschool age, is often practiced For this practice to be effective and accessible in low-resource countries such as Thailand, innovative enabling tools that make use of pervasive mobile and smartphone technology should be considered

Methods

Results

Discussion

Conclusion