Hearing in Visually Impaired Children

Abstract

Early identification of hearing impairment is important for all children to minimise any impact upon their development, particularly their speech and language skills, and their educational outcomes. Children with visual impairment (VI) have additional reliance upon their hearing as it is their main ‘distance sense’, providing an awareness of the environment beyond their physical reach and cues for mobilisation and orientation. The impact of a dual-sensory loss is likely to be greater than the sum of deafness or blindness but is thought to be under-recognised by professionals (Nikolopoulos et al., 2006). There are multiple prenatal, perinatal and neonatal risk factors which are common to both hearing and visual impairment, such as hypoxia, hereditary causes and infection. It is likely, therefore, that there is a higher prevalence of hearing loss amongst visually impaired children than in the sighted population. This thesis investigates the prior knowledge regarding the prevalence of hearing loss amongst visually impaired children through a systematic review of the literature. As the evidence found by this review was limited and at high risk of bias, this thesis reports a study undertaken by the author to assess the prevalence of hearing loss in visually impaired children within a specialist school population. This study was unique as the prevalence was measured by audiometric assessment, rather than rely upon school or medical record reports of hearing status. In cases where hearing loss was recorded it is considered whether the cause of the loss is likely to be related to the cause of the child’s vision impairment. Although there is a higher risk of hearing loss amongst children with VI, there are currently no formal United Kingdom (UK) guidelines for their audiological monitoring. Children born in the UK will be offered a newborn hearing screen, but this may be the only hearing test undertaken unless concerns about hearing are raised by parents or professionals. It is important, therefore, that parents and professionals are aware of the indications of hearing loss, understand the impact this may have upon a child with vision impairment and feel confident to request a hearing test. The second study presented in this thesis investigates the awareness of childhood hearing problem with parents and teachers of visually impaired children using a survey and semi-structured interviews. Knowledge of the prevalence of hearing loss amongst children with VI and whether the current strategy of community surveillance (reliance upon parents or professionals to raise concerns) is effective is important information for local and national policymakers to consider when producing guidance for audiological assessment during childhood.

Date of Award	31 Dec 2021
Original language	English
Awarding Institution	The University of Manchester
Supervisor	Kai Uus (Supervisor)