KENYA MEDICAL TRAINING COLLEGE
Faculty of Clinical Sciences
Department of Clinical Medicine – Nairobi
OUTCOME OF USE OF HEARING AIDS AMONG CHILDREN AGED 10-17 IN
MACHAKOS DEAF SCHOOL
[NAME]
[ADM NO]
Research Proposal Submitted to Department of Clinical Medicine in Faculty of Clinical Sciences
in Partial Fulfillment of the Requirements for the Award of Diploma in Clinical Medicine and
Surgery of Kenya Medical Training College during 2020/2021 academic year
February, 2021
Declaration
This proposal is my original work and has not been presented for a diploma in any other
institution.
Signature ………………………………………… Date …………………………
[Name]
[ADM]
SUPERVISOR APPROVAL
This proposal has been submitted for review with the approval as
College Supervisors
Signature.……………………… Date ……………...
[Name]
[Department]
Acknowledgement
Table of Contents
Declaration.....................................................................................................................................2
Acknowledgement..........................................................................................................................3
Abbreviations and Acronyms.......................................................................................................5
Definition of terms.........................................................................................................................6
Abstract..........................................................................................................................................7
CHAPTER I - INTRODUCTION................................................................................................8
1.1 Background to the study.................................................................................................8
1.2 Problem statement.............................................................................................................10
1.3 Justification........................................................................................................................11
1.4 Research questions........................................................................................................12
1.5 Objectives...........................................................................................................................12
1.5.1 Broad objective...........................................................................................................12
1.5.2 Specific objectives.......................................................................................................12
1.6 Scope and limitation..........................................................................................................12
1.6.1 Scope............................................................................................................................12
1.6.2 Limitations of the study..............................................................................................13
Abbreviations and Acronyms.
Definition of terms
Abstract
The landscape of service provision for young children with hearing loss has shifted in recent
years as a result of newborn hearing screening and the early provision of interventions, including
hearing technologies. It is expected that early service provision will minimize or prevent
linguistic delays that typically accompany untreated permanent childhood hearing loss. The post-
newborn hearing screening era has seen a resurgence of interest in empirically examining the
outcomes of children with hearing loss to determine if service innovations have resulted in
expected improvements in children’s functioning. The Outcomes of Children with Hearing Loss
(OCHL) project was among these recent research efforts, and this introductory article provides
background in the form of literature review and theoretical discussion to support the goals of the
study. The OCHL project was designed to examine the language and auditory outcomes of
infants and preschool-aged children with permanent, bilateral, mild-to-severe hearing loss and to
identify factors that moderate the relationship between hearing loss and longitudinal outcomes.
We propose that children who are hard of hearing experience limitations in access to linguistic
input, which lead to a decrease in uptake of language exposure and an overall reduction in
linguistic experience. We explore this hypothesis in relation to three primary factors that are
proposed to influence children’s access to linguistic input: aided audibility, duration and
consistency of hearing aid (HA) use, and characteristics of caregiver input.
CHAPTER I - INTRODUCTION
1.1 Background to the study
The landscape of service provision for young children with hearing loss (HL) has shifted
dramatically in recent years as a result of newborn hearing screening and early provision of
interventions, including hearing technologies. Early identification and fitting of amplification in
infancy is far more common than in the past (Dalzell et al. 2000; Harrison et al. 2003; Spivak et
al. 2009), and these contemporary practices are predicated on the belief that they will have long-
term positive consequences for children with HL. However, there is a need to gather evidence
regarding the benefits of early provision of amplification, and to identify factors that contribute
to risk or protection for children who use hearing aids. Fortunately, service delivery changes
have occurred in tandem with new opportunities to conduct research on the early outcomes of
infants who are deaf or hard of hearing with support from the National Institute on Deafness and
Other Communication Disorders (NIDCD) and other federal agencies. A relatively new
development in the research domain has been the implementation of longitudinal, multi-center or
multi-site studies, which were rare in the past. Multi-site studies are critically needed to
overcome issues related to sampling and small sample sizes that limited many previous studies of
children with HL, and especially those involving children who are hard of hearing
(CHH; Moeller et al. 2007; Tomblin & Hebbeler 2007).
Several contemporary longitudinal research projects are examining the outcomes of children
with cochlear implants (CIs) and/or hearing aids (HAs) to gain evidence that will guide clinical
practice and future research efforts. Notable examples are a national cohort study in Australia,
the Longitudinal Outcomes of Children with Hearing Impairment (Ching et al. 2013), and studies
with multi-state participation in the U.S., such as the Early Development of Children with
Hearing Loss project (Nittrouer 2010), and the multi-state assessment system, the National Early
Childhood Assessment Project (Yoshinaga-Itano 2015). Other recent research projects focus on
specific subgroups, either children who are deaf with cochlear implants or children who are hard
of hearing (CHH) with hearing aids. Notable examples of studies focused on children with CIs
are those conducted by Geers and colleagues (see E & H supplement, 2011), and the Childhood
Development after Cochlear Implantation project, which is a multi-center national cohort study
examining outcomes of children with cochlear implants compared to those with normal hearing
(Fink et al. 2007; Niparko et al. 2010).
1.2 Problem statement
When teaching hearing-impaired students, visualizing learning material is one of the key
methods to address their special educational needs. In this context, ICTs and modern
technologies are vital for presenting learning material, both during in-class activities and in the
self-study process. However, recent studies have documented the difference in levels of
cognitive construal while performing information processing tasks based on using digital versus
non-digital platforms (degree of abstraction, memorizing, etc.). So, one can question the need for
using digital learning materials instead of conventional printouts in order to achieve certain
learning objectives. There is also a problem of selecting certain forms of presenting the
information (text, graphics, and diagrams, images) to improve the efficiency of its perception
when teaching hearing-impaired students. Our research is supposed to answer these questions
and to give recommendations for presenting information when teaching hearing-impaired
students taking.
1.3 Justification
The ability to hear well affects more than our ability to communicate; it also impacts a child's
development of vocabulary and sentence structure, academic achievement, social interaction and
career choice.
There are four ways in which hearing loss can affect children:
1. It causes delays in speech and language skills
2. The language deficit results in lower academic achievement
3. Communication difficulties lead to social isolation and poor self-concept
4. It may have an impact on vocational choices
Hearing impaired children have trouble learning abstract words like "before" and "after" and
understanding words with multiple meanings. They often have trouble hearing certain sounds,
such as "s", "sh", "f", "t", "k" and "ed," which affects the sentences they construct and the words
they include in their vocabulary.
While the gap between children with normal hearing and those with hearing loss widens as they
age, children with hearing loss can catch up if they receive proper diagnosis and treatment.
Hearing aids help to sort some of those problems.
1.4 Research questions
a How can there be increased access to hearing aids and other hearing devices?
b How can there be increased use of hearing aids and other hearing devices?
c What is the best way to educate the population on the prevention of hearing loss as
well as the effects of untreated hearing loss?
d What can we do to educate users on all the technical features of hearing aids, and how
they can interact with other devices?
1.5 Objectives
1.5.1 Broad objective
To determine the outcome of the hearing aids affecting children aged 10-17 in Machakos deaf
school.
1.5.2 Specific objectives
1. To encourage hearing impaired children to use their residual hearing to develop as
much language as possible so that they can master adequate communication skills
for use in their everyday life.
2. To help hearing impaired children grow up well-adjusted and independent so that
they can integrate into society.
3. To help hearing impaired children develop a correct sense of value and
citizenship.
1.6 Scope and limitation
1.6.1 Scope
The scope of the study will involve a schematic representing four stages of the listening
experience for hearing aid users.
1. Stage 1 includes the incoming signal and the acoustic properties associated with it. This
could include the context in which the signal is presented.
2. Stage 2 addresses the hearing aid and how it modifies the acoustic signal including the
hearing aid settings such as compression, gain, and frequency response.
3. Stage 3 begins when the signal is delivered to the ear. Acoustic waveforms are
transduced and processed through several parallel processing streams by the peripheral
and central auditory systems.
4. Stage 4 includes the higher order processes such as those that modulate attention and
memory, and all processes leading up to, and including, a behavioral response of some
kind.
1.6.2 Limitations of the study
Limitations of the study include the following:
a. Hearing aids amplify all sounds, including background noise that you do not wish
to hear.
b. Hearing aids require an adjustment period that may take several months.
