Читать книгу Early Detection and Intervention in Audiology - Группа авторов - Страница 29

Audiologists need to evaluate the contexts in which they work, and decide on the most suitable approach to early detection of hearing impairment. The evaluation needs to consider the costs involved with NHS, as well as the availability of equipment and human resources. This evaluation can be conducted using the needs assessment and planning guide in the HPCSAs' EHDI guidelines. Audiologists could trial the use of non-audiologists as screening personnel following training as detailed in the curriculum suggested in the EHDI guidelines. The guidelines include a practical training and competency checklist which can be used to evaluate non-professional screeners (HPCSA, 2018).

Once the chosen approach is well established, there needs to be consideration of how to better develop the programme that is in place. This can only be done if it is evaluated regularly against key benchmarks specified in the guidelines, including: ages by which screening and confirmation of hearing impairment should take place in various levels of service delivery; evidence of an otologic evaluation in children diagnosed with hearing impairment; audiological and medical evaluations that are perceived as positive and supportive by families; and support to families in terms of appropriate provision of information and referrals for intervention (HPCSA, 2018).

Audiologists should also share key challenges and successes of the programmes at appropriate forums in order to develop such programmes at provincial and national levels. Differences between levels of service delivery also need to be explored and tiered approaches may need to be implemented to ensure the highest possible coverage rate. In chapter 4, Petrocchi-Bartal, Khoza-Shangase and Kanji explore implementation of early detection services at various levels of service delivery in the South African context. Audiologists need to record data accurately in order to monitor the efficiency of programmes, document prevalence and incidence rates for hearing impairment and use these data to motivate for funding for equipment.

As noted, careful consideration needs to be given to the possibility of training non-audiologists as screeners in order to overcome human resource shortages in developing contexts. In situations where TNHS is the chosen approach, audiologists need to screen newborns and infants in neonatal intensive care units and high care wards instead of using predetermined risk factors. All case history factors should be recorded in detail at the time of screening in order to facilitate retrospective, evidence-based research of risk factors associated with hearing impairment.