A low cost device to screen Hearing loss
Challenges and opportunities to develop low cost screening tools for hearing loss.
According to WHO reports (South east Asia, Fact sheet 2011), despite being the most frequent sensory disability, deafness has received little attention in health development agenda of the countries. The consequence of this is the rapidly increasing burden of deafness.
The numbers and statements in the report are staggering. At current estimates there are nearly 70-80 million people in India alone with some form of hearing loss with approximately 20 million of them being children.“Half of all cases of deafness and hearing impairment are avoidable through prevention, early diagnoses and management.” “Over two thirds of deaf children have no access to education and rehabilitation services due to the lack of teachers of deaf. “ “Current production of hearing aids meets less than 10% of global need. In developing countries, fewer than 1 out of 40 people who need a hearing aid have one.”
Screening is different from Diagnosis in that it is the ‘Identification of people with some kind of hearing impairment’ before the actual diagnosis, whereas Diagnosis is the identification of the exact problem.
Diagnosis is a lot more complex than screening, as it is highly specialized , requiring clean and soundproof environments & highly sensitive Audiological apparatus and probes. Screening procedures and equipment are much simpler, generic and mobile in nature. But it is also the the most challenging stage to implement. If people could be successfully screened, treatment is not far.What if screening was made simpler so that barefoot healthcare workers could easily use them, perhaps using ubiquitous, low cost technologies?
Pure tone Audiometry is an universally accepted diagnostic tool for Hearing related issues. It generally requires specifically designed audiological equipment for use, but our intention was to pave possibilites for such devices to be present on ubiquitous devices such as mobile phones.
The main issues with identification were the procedures of ‘Screening’ for hearing loss. Screening as a 3 pronged process when conducted generally by institutions :
2. School camps , where schools invite audiologists/institutes to conduct tests
3. Territorial level camps: Mobile or temporary stations are created where people from the entire village / town are invited for testing.
A WHO report from 2010 shows there are not enough trained people for screening in many Asian countries.
Equipment used now
1. Affordability of equipment, by even small district level centers, is an issue. (“A portable audiometer costs nearly Rs. 200,000 …”)
2. Power requirement. (“Days are lost during screening camps in villages with frequent power cuts …”)
3. Training required for operation, which limits usage
Experience based Plasticity and growth
Early identification (before 5 years of age) and assigning the right hearing aid to the right person and subsequent rehabilitation, even with mild/moderate hearing impairment in children is required so that damage is reduced and the child is able to join the mainstream sooner. The benefits are multifold: The family is able to cope with the situation and therapy, the child finds normalcy in his life sooner by active social participarion and ofcourse, the burden to the state for rehabilitation and employment is greatly reduced.
The Potentials in building Screening ecosystems around mobile computing technologies
Mobile phones are so ubiquitous in developing countries and they have astounding accessibility and coverage. With just limited training, social workers and barefoot doctors can easily use this to screen large groups of populations.
The device will be very portable, thus the overheads of operation and deployment almost none.
They can be easily charged and used during screening camps. Also there will be more screening devices making the process faster and effective.
This Audiological tool would then use the values attained, to programme a Body-worn hearing prosthesis
This device offers basic screening to identify potential individuals who are perhaps not even aware that they have a challenged hearing capability. In the case of children, many are not old enough to articulate that they cannot hear properly. And this the challenging part.
While the device screens the ‘can’ from the ‘cannot’, it simplifies the total population that would need further investigation, reducing the stress on the available resources.