A Holistic Approach to the Design of Hearing Aids for Children with Hearing Impairment in Resource Constrained Settings

Speech and language rehabilitation of hearing impaired children is an economically and socially challenging situation in resource constrained settings. The economic challenge is due to the high costs of hearing aid and social challenge is due to lack of adequate therapy personnel to provide a framework in the community after starting therapy in the hospital. The paper describes an innovative smartphone-based application integrated with an affordable hearing aid to provide a community-based framework for parents to provide therapy at home and update the therapist about ongoing progress. Based on clinical immersion, stakeholder analysis and habitat observation, acoustic requirements, ingredients for scoring the progress of therapy and minimum technical specifications of the application were derived. The application was designed to integrate with a prototype hearing aid. It has a hearing aid mode and therapy mode. The hearing aid mode provides high quality amplification. The therapy mode assists the parent to train the child in the first two components of speech therapy, namely auditory localization and discrimination. There is an in-built option to monitor progress of therapy. One section was devoted to providing motivation to parents by showcasing success stories of hearing impaired children Expert opinion rated the application high on novelty, relevance and utility in resource limited settings of Indian context. Experts recommended improving richness of content and making all stimuli culturally appropriate. Field trails of the application will examine its effectiveness in providing a community-based framework for speech and language rehabilitation and reducing drop outs form therapy.