A Tablet-Based Mobile Hearing Screening System for Preschoolers: Design and Validation Study
Kwanchanok Yimtae1, Pasin Israsena2, Panida Thanawirattananit1
1Department of Otorhinolaryngology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
Insights
A new tablet-based system offers rapid hearing screening for young children, showing good accuracy and significantly reducing screening time compared to traditional methods. This technology is promising for accessible pediatric hearing assessments.
Area of Science:
- Pediatric audiology
- Mobile health technology
- Speech and language development
Background:
- Early childhood hearing is crucial for speech and language acquisition.
- Mass hearing screenings are conducted after newborn tests, particularly at preschool age.
- Low-resource settings require innovative, accessible tools like mobile technology for effective screening.
Purpose of the Study:
- To develop a cost-effective, tablet-based system for rapid hearing screening.
- To implement a minimal speech recognition level test using mobile technology.
- To create an accessible tool for preschool-aged children's hearing assessment.
Main Methods:
- Developed an Android-based application for hearing screening.
- Validated word sets and calibrated speech power levels for the app.
- Recruited 122 children (4-5 years) for development and 63 for version 2 testing, comparing results to conventional audiometry.
Main Results:
- Version 2 demonstrated 76.67% sensitivity and 95.83% specificity for mild hearing loss.
- Screening time averaged 150.52 seconds, significantly faster than conventional play audiometry (11.79 minutes).
- The system proved effective for rapid, mobile hearing screening in young children.
Conclusions:
- Tablet-based systems show potential for rapid, mobile hearing screening.
- The developed system exhibits good overall sensitivity and specificity.
- The concept is adaptable for multilingual applications and broader implementation.
Background:
Hearing ability is important for children to develop speech and language skills as they grow. After a mandatory newborn hearing screening, group or mass screening of children at later ages, such as at preschool age, is often practiced. For this practice to be effective and accessible in low-resource countries such as Thailand, innovative enabling tools that make use of pervasive mobile and smartphone technology should be considered.
Objective:
This study aims to develop a cost-effective, tablet-based hearing screening system that can perform a rapid minimal speech recognition level test.
Methods:
An Android-based screening app was developed. The screening protocol involved asking children to choose pictures corresponding to a set of predefined words heard at various sound levels offered in a specifically designed sequence. For the app, the set of words was validated, and their corresponding speech power levels were calibrated. We recruited 122 children, aged 4-5 years, during the development phase. Another 63 children of the same age were screened for their hearing abilities using the app in version 2. The results in terms of the sensitivity and specificity were compared with those measured using the conventional audiometric equipment.
Results:
For screening purposes, the sensitivity of the developed screening system version 2 was 76.67% (95% CI 59.07-88.21), and the specificity was 95.83% (95% CI 89.77-98.37) for screening children with mild hearing loss (pure-tone average threshold at 1, 2, and 4 kHz, >20 dB). The time taken for the screening of each child was 150.52 (SD 19.07) seconds (95% CI 145.71-155.32 seconds). The average time used for conventional play audiometry was 11.79 (SD 3.66) minutes (95% CI 10.85-12.71 minutes).
Conclusions:
This study shows the potential use of a tablet-based system for rapid and mobile hearing screening. The system was shown to have good overall sensitivity and specificity. Overall, the idea can be easily adopted for systems based on other languages.
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