Search Results (11)

Background/Objectives: This study aims to assess dietary quality among Chinese pregnant women across three gestational trimesters using different assessment indices while investigating the relationship between dietary patterns and longitudinal alterations in maternal body composition parameters and bone mineral density (BMD) during pregnancy. Methods: A total of 556 healthy pregnant women were recruited. Dietary intake was assessed utilizing a semi-quantitative food frequency questionnaire (FFQ). Diet quality was evaluated through three indices: the Dietary Balance Index for Pregnant Women (DBI-P), the Dietary Inflammatory Index (DII), and the Eastern Health Diet Index (EHDI). Multiple linear regression models and mediation analyses were constructed to elucidate the relationships between dietary indices, body composition parameters, and BMD. Results: In the first trimester, excessive dietary intake was associated with increased maternal fat mass but reduced BMD, while insufficient intake correlated with declines in muscle mass, water compartments, and inorganic salt levels. Pro-inflammatory diets further exacerbated reductions in non-fat body composition, including protein and muscle mass. By the second trimester, low-quality diets continued to negatively affect muscle mass and water balance, whereas no significant dietary effects on body composition or BMD were observed in the third trimester. Mediation analyses revealed that body composition partially mediated the relationship between dietary imbalance and reduced BMD. Conclusions: Unbalanced, pro-inflammatory, and low-quality diets during early-to-mid pregnancy contribute to adverse changes in maternal body composition and bone health, especially in the first and second trimesters, with the DBI-P index demonstrating superior applicability for assessing dietary impacts in Chinese pregnant women. Full article

Globally, many countries have promulgated extensive, contextually relevant disability legislative policies for children with hearing impairment/d/Deafness (HI/d/D). The alignment of policies with their implementation, with robust monitoring, is essential for effective early intervention (EI) and early education (EE) outcomes. The study’s purpose was to review current South African EI and EE regulations, acts, and policies in relation to children with HI/d/D from birth to age six. An adapted Arksey and O’Malley framework with inductive thematic analysis was applied to synthesise and evaluate relevant information. Documentation was sourced between 1993 and 2023 from the official South African government portal and Google online searches using keywords. While 7976 documents were initially identified with the broad search and 1249 with a refined category search, only 17 met the specific inclusion criteria for policies referencing hearing impairment in early intervention and education. Seventeen documents were selected for study inclusion, with sixteen mentioning HI/d/D and multi-disciplinary, multi-sectoral, family-centred, culturally sensitive considerations superficially. One document from the Department of Health (DoH) specifically addressed early hearing detection and intervention (EHDI). Three main themes emerged, including Partnerships, Participation and Integration, Screening, Identification and/or Intervention, and Education/Special Education. Greater engagement with South African EI and education policies is essential to strengthen implementation, especially across sectors and at the community level. Mandating EHDI guidelines is critical to improving service delivery and ensuring smoother transitions between health, education, and social services for children with hearing impairment. Full article

Background: Early Hearing Detection and Intervention (EHDI) programmes must partner effectively with families navigating complex circumstances. Adolescent parents (APs) in Teen Parent Units (TPUs) represent a dynamic group demonstrating resilience as they balance childcare, education, and their own developmental journeys. This study explores their understanding of infant hearing, sources of knowledge, and the development of an effective teaching tool. Methods: A qualitative study was conducted with AP learners at a TPU in Aotearoa, New Zealand. Following a period of relationship-building, three focus groups were held. Data were analysed using content analysis and reflexive thematic analysis. Results: AP learners demonstrated a strong awareness of multisensory interactions. Major sources of knowledge included their relational interactions with people they trusted (midwives and family members), rather than social media. Four key themes emerged in the teaching tool’s development: (1) the effectiveness of multimodal teaching tools, (2) the benefits of peer-supported group learning, (3) the impact of high strain, and (4) the importance of Te Ao Māori (a Māori worldview). Conclusions: This study highlights the importance of culturally grounded health interventions for families navigating complex life circumstances. Group-based learning fostered peer support, hands-on multimodal teaching was effective, and culturally relevant materials and pedagogies enhanced engagement. EHDI programs may more effectively support infants from families navigating complex circumstances by collaborating with trusted support people, integrating with wraparound care networks, utilising safe and familiar settings, and delivering interventions in an engaging and culturally appropriate manner. Full article

Background: Early Hearing Detection and Intervention (EHDI) is essential for minimising the negative impact of childhood hearing loss on speech, language, and cognitive development. However, in low- and middle-income countries such as South Africa, various challenges hinder the implementation of EHDI services, leading to delayed diagnosis and intervention. Aim: This study explores caregivers’ experiences with EHDI services, identifying key challenges and facilitators affecting access and timely intervention. Methods: A narrative inquiry approach was used as part of a broader research initiative on family-centred EHDI. Nine caregivers of children who are deaf or hard of hearing (DHH) were purposively sampled, and data were collected through semi-structured interviews. Results: Thematic analysis revealed systemic and structural challenges, logistical and financial constraints, and caregiver-related factors that hindered access to EHDI services. Key facilitators included caregiver knowledge and advocacy, family support services such as counselling and South African Sign Language training, and high-quality audiological and educational services. Conclusions: Findings emphasise the need for policy-driven reforms, including expanding newborn hearing screening programmes, improving financial assistance mechanisms, and increasing public awareness. Addressing these challenges and leveraging facilitators can help South Africa align with global EHDI benchmarks and improve outcomes for DHH children. Full article

Background/Objectives: Although newborn hearing screening (NHS) programs have been successfully implemented in many countries worldwide, challenges to these programs have been reported in the literature, such as a lack of awareness among families and healthcare professionals and limited funding. Challenges to the NHS programs in Saudi Arabia have not been systematically reported. This study aimed to assess the level and quality of evidence supporting the existing challenges of the NHS programs in Saudi Arabia. Methods: A systematic review of all peer-reviewed literature on Saudi NHS programs published between 2016 and 2024 was conducted according to the PRISMA guidelines. Search strategies were executed in seven databases. Data were collected from studies that met the inclusion criteria. Results: A total of 37 records were reviewed, and 13 peer-reviewed publications met the inclusion criteria. Characteristics of included studies were classified by study language, study sample, sample size, location of the study sample, study purpose, and study method via evidence tables. Each study was critically appraised according to the quality. Results revealed that cross-sectional prospective description was the main research design with low strength of evidence. Six main challenges were identified and described: lack of awareness and gaps in knowledge, lost to follow-up, inadequate data entry, management, and tracking system, limited or absence of services in some residential areas, insufficient training and frequent changes of NHS personnel, and absence of a standardized NHS protocol. Conclusions: This review may assist in overcoming these challenges and improving the NHS programs in Saudi Arabia. There is a need to establish national education campaigns about the NHS programs, improve documentation by using database management and tracking systems, and expand the early hearing detection and intervention (EHDI) services for children in all Saudi regions. Full article

Family-centred early hearing detection and intervention (FC-EHDI) is an established framework globally recognized for its emphasis on family involvement in supporting children who are deaf and hard of hearing (DHH). In the African context, unique sociocultural and systemic challenges necessitate tailored approaches to ensure effective implementation. This narrative review explores the relevance of FC-EHDI in Africa, highlights barriers to its implementation, and offers recommendations for creating sustainable and culturally aligned interventions. A narrative review methodology synthesizing evidence from African countries to examine the intersection of FC-EHDI with cultural practices, systemic barriers, and opportunities for innovation was adopted. Databases including PubMed, Scopus, Web of Science, and Google Scholar were searched for peer-reviewed journal articles, books, and reports published between 2000 and 2024. Keywords included “family-centred care”, “EHDI”, “Africa”, “cultural responsiveness”, and “early hearing detection and intervention”. Studies were included if they addressed EHDI in African contexts, explored family-centred approaches, or provided barriers and recommendations specific to the region. Thematic analysis was employed to synthesize findings into barriers, evidence, and strategies for FC-EHDI implementation. Data were extracted and analysed thematically to identify patterns and gaps in knowledge. Key challenges identified include resource limitations, economic constraints, linguistic and cultural diversity, and fragmented healthcare systems. Evidence highlights the effectiveness of community-based care, linguistic inclusivity, and culturally tailored interventions in enhancing family engagement and programme outcomes. Recommendations focus on leveraging technology, interdisciplinary collaboration, and policy advocacy. FC-EHDI offers a transformative approach to addressing DHH African children by integrating family involvement, cultural responsiveness, and systemic innovations. Future efforts should emphasize technology, scalable models, and family empowerment to create sustainable and equitable services. Full article

Background: Early intervention approaches play a critical role in shaping the communication outcomes of children with hearing loss, influencing their language development and overall learning trajectory. Objectives: The main objective of this study was to compare the communication outcomes of children with hearing loss who received Listening and Spoken Language-South Africa (LSL-SA) with those who received Traditional Speech-Language Therapy (TSLT). Methods: A retrospective record review was conducted to gather data on communication outcomes from participants’ speech-language therapy records. Communication outcomes were measured using standardized assessments evaluating speech intelligibility, expressive vocabulary, receptive language, expressive language, audition, and cognitive–linguistic skills. The data were analyzed using quantitative statistics. Key statistical methods included measures to determine associations, identify statistical significance, determine outcomes, and compare differences between the two groups. Results: The study found that children in the LSL-SA group had statistically significant better communication outcomes, with 63% achieving age-appropriate speech intelligibility compared to 45% in the TSLT group (p = 0.046). Similar trends were observed for expressive vocabulary (LSL-SA: 58% vs. TSLT: 39%, p = 0.048) and receptive language (LSL-SA: 60% vs. TSLT: 39%, p = 0.043). Additionally, 66% of children in the LSL-SA group were recommended for mainstream schooling, compared to 39% in the TSLT group (p = 0.0023). These findings highlight the importance of early amplification and structured intervention in improving communication outcomes. The results also emphasize the importance of Early Hearing Detection and Intervention (EHDI) in decreasing the odds of delay in communication outcomes, irrespective of the type of communication approach, although a higher proportion of children in the LSL-SA approach group achieved age-appropriate communication outcomes than those in the TSLT group. Conclusions: This study highlights that communication intervention approaches aligned with the LSL-SA practice promote better communication development and enhance spoken language outcomes in children with hearing loss, facilitating successful transitions to mainstream schooling. Contribution: This study provides contextually relevant evidence for implementing an LSL-SA intervention approach for children with hearing loss. The implications of these findings for clinical practice and future research are discussed in detail. Full article

Background/Objectives: Globally, many countries have endorsed the World Health Organisation’s (WHO) early intervention (EI) guidelines through their legislation with contextual variations. Sensitive evaluation of gaps within EI-recommended systems is essential, especially in the translation of policy into practice across high-income and low- to middle-income country (LMIC) contexts, including South Africa. The main objective was to explore and identify the current evidence reflecting the application of hearing-specific government policy regarding EI and early education (EE) for hearing-impaired/d/Deaf/hard-of-hearing (HI/D/HH) children aged six and below. Method: An integrative review was conducted on peer-reviewed articles that examined policy in practice regarding EI for HI/D/HH children aged six and below. Studies were accessed via four databases (Ebscohost, Sabinet, Scopus, and ScienceDirect) and one search engine (Google Scholar) between 2014 and 2024. Qualitative evaluation ensued of themes identified deductively. Results: Twenty-six peer-reviewed studies were included. Deductive thematic analysis revealed six derived themes: EI timing, early hearing detection and intervention (EHDI)/EI mechanisms; EI services, EE, family considerations, and policy. Five of the 26 directly scrutinised government policy in its EI/EE practical application. Articles reflected the need for consideration of the complex processes that allow for policy actualisation, such as adequate infrastructure and family considerations. Conclusions: A bottom-up approach to policy actualisation, with grass-roots contextual considerations such as EI access and caregiver concerns, may improve policy application. Current findings have implications, particularly for LMIC contexts including South Africa, where EI and EE policy scrutiny regarding hearing impairment/deafness specificity is imperative for understanding its application alignment. Full article

Parent-to-parent support is an important component of early hearing detection and intervention (EHDI) programs for deaf and hard of hearing (DHH) children. In this study, we asked parents of DHH children what advice they would give to new parents in their situation. Seventy-one hearing parents of DDH children living in Canada, Switzerland, France, and Belgium participated in interviews that included the following question: “What advice you would give to parents who just learned that their child is deaf?”. We performed a thematic analysis and developed three overarching themes, revolving around the importance of trust, the need for reassurance, and finally, the quest for help. The findings allow to better understand how parental expertise can be used to improve early intervention services for DHH children. Full article

Background: An early hearing detection and intervention program (EHDI) is the first step for the habilitation of children with permanent hearing impairment (PHI). Actually, early intervention programs have increasingly shifted toward family involvement, emphasizing that the child’s family should take an active role in the habilitation process. Therefore, familiar empowerment is the best way to improve a child’s emerging abilities. The aim of this study was to investigate parental self-efficacy beliefs and involvement as well as the language skills of deaf or hard of hearing DHH children who were habilitated with hearing aids and followed using the T.A.T.A web app (NeonaTal Assisted TelerehAbilitation), an example of asynchronous telepractice. Methods: The study describes the early stages of the habilitation program of 15 PHI children followed through the T.A.T.A. web app, which empowers families through a weekly questionnaire submitted during the first 270 to 360 days of their child’s life, for 14 weeks. The family involvement rate scale (FIRS) was used to evaluate parental compliance, and all children received in-person visits at the beginning and at the end of the training period. Results: The children showed greater auditory perceptual skills at the end of the training period on the basis of both the Infant Listening Progress Profile (ILiP) score and the Categories of Auditory Performance (CAP) and FIRS scales. In other words, the auditory skills improved with age as well as with parental participation. Conclusions: The T.A.T.A. web app promotes a proactive management and a tailored habilitation through an active familiar involvement, easily achieved in clinical routine and in emergency settings without additional costs. Full article

Universal newborn hearing screening (UNHS), when accompanied by timely access to intervention services, can improve language outcomes for children born deaf or hard of hearing (D/HH) and result in economic benefits to society. Early Hearing Detection and Intervention (EHDI) programs promote UNHS and using information systems support access to follow-up diagnostic and early intervention services so that infants can be screened no later than 1 month of age, with those who do not pass their screen receiving diagnostic evaluation no later than 3 months of age, and those with diagnosed hearing loss receiving intervention services no later than 6 months of age. In this paper, we first document the rapid roll-out of UNHS/EHDI policies and programs at the national and state/territorial levels in the United States between 1997 and 2005. We then review cost analyses and economic arguments that were made in advancing those policies in the United States. Finally, we examine evidence on language and educational outcomes that pertain to the economic benefits of UNHS/EHDI. In conclusion, although formal cost-effectiveness analyses do not appear to have played a decisive role, informal economic assessments of costs and benefits appear to have contributed to the adoption of UNHS policies in the United States. Full article