6. / Brief Resume of the intended work
6.1. Need for study:
The ability to communicate in a crucial aspect of human life as auditory sense is very important for communication of any kind. It is indispensable for the normal mental development of a child. Hearing impairment in children acquires a special significance as a large percentage of population affected are children. As reported from various earlier studies the prevalence rate of hearing impairment in children varies from as low as 2.7% in some studies to as high as 15% in some studies1.
Hearing impairment refers to complete or partial loss of the ability to hear from one or both ears.
Deafness: Refers to complete loss of ability to hear from one or both ears2.
Children with hearing impairment often experience delayed development of speech and cognitive skills which may result in slow learning and difficulty progressing in school2.
The impact of hearing impairment on child’s speech, language, education and social integration depends on the level and type of hearing impairment and the age of onset especially if it begins before the age when speech normally develops2.
Interventions to reduce the occurrence of communication disabilities with hearing impairments are most successful if affected children are diagnosed early3.
As there is lack of data regarding hearing ability in school going children this study is an attempt to evaluate hearing ability in these children in Bangalore city. The hypothesis tested is that hearing impairment is a common problem among school going children.
6.2. Review of Literature
  1. Studies on deafness in general and various etiological factors with severity and grading in children have been reported in literature where hearing impairment is defined as a full or partial decrease in the ability to detect sounds4.
  1. The practice of screening school age children has been in existence for more than 50 years in the west. In India school screening programs have been conducted since 1965 as per reports available. Fisch (1981) argued that school screening is very effective and should be done in all areas4.
  1. The prevalence of hearing loss in India according to ICMR survey of 1983 is 10.7% in rural area and 6.8% in Urban area5. Accordingly the prevalence of hearing loss in school children have been reported ranging from 5.4% to 14.9% depending on targeting different sections of the community as per different studies done from 1961 to 1962. 5,6
  1. The National sample survey organization (NSSO) Govt. of India 1991 report shows that in rural India the rate of hearing impairment in children of age group 0 to 14 years is 2.7% and for speech disability in 8.9%. In the same age group urban statistics are 3.0% for hearing impairment and 8.3% for speech disability6.
  1. Various studies done from 1998 to 2006 show a decrease in the hearing impairment prevalence ranging from 11.7% to 12.47% as compared to earlier studies. 7,8,9.
6.3. Objectives of the Study:
  1. To make a Pure Tone Audiometric (P.T.A) assessment of auditory acuity in school going children of age group 10 – 13 years, of Bangalore South City.
  1. To find the degree of hearing impairment in the above group of children.

7. / Materials and Methods:
7.1. Source data:
School going children of 10 – 13 years of age group from selected schools across BangaloreSouthCity. The selection of schools will be done on the basis of simple randomization taking into consideration children from all sections of the society.
7.2. Method of collection of data (including sampling procedure)
The study group consisting of 200 school children. The selection of schools will be done on the basis of simple randomization. The selection is based on inclusion and exclusion criteria.
Inclusion criteria:
  1. School going children of both genders of BangaloreCity.
  1. Age 10 – 13 years.
  1. Located in the same school at least since 5 years.
Exclusion Criteria:
  1. Children whose parents are not willing to enroll their children in the study.
  1. Children with complaints of diminished hearing with complications.
  1. Children with profound or total hearing loss where the degree of hearing loss is so severe that the child is not benefited with hearing aid also.
  1. Children with hearing loss of more than 90dB detected on audiometry.
Methods of data collection:
The total population of school going children of 10 – 13 years age group in Bangalore South is 1,37,190 distributed among 900 govt. schools. Topographically all schools have been distributed among 5 blocks, which have been divided into 70 clusters.
We have taken 2nd block in South Bangalore which is divided into 8 clusters containing 70 schools. One school will be taken from each cluster by simple randomization method. In each of these schools children selected will be taken up as subjects after due informed consent from parents.
The subjects are selected based on inclusion and exclusion criteria. A general physical and ear, nose and throat examination will be carried out, using tuning fork of 512 Hz and otoscope as screening tools.
Children detected with impaired hearing on screening will undergo Pure Tone Audiometric assessment using ARPHI 500 MKI audiometer in a sound proof room, as a confirmatory test. Using the Pure Tone audiometer audiograms will be recorded separately for both ears. Data is entered in a Master Chart.
Data is analyzed using appropriate statistical methods like mean, SD, Chi-square test etc., to find out total No. and degree of hearing impairment.
7.3. Does the study require any investigation or interventions to be conducted in patients or animals? If so describe briefly.
A non invasive test of recording an audiogram using pure tone audiometer will be carried out and also ENT examination and examination of Tympanic membrane using a portable auto scope and hearing test using tuning fork.
7.4. Has ethical clearance been obtained from your institution in case of 7.3.
Yes
8. / LIST OF REFERENCES:
  1. Chaturvedi VN, Hearing Impairment & Deafness – Magnitude of Problem and Strategy for Prevention. IJO & HNS 1999; 51 (2): 2.
  1. Deafness and Hearing Impairment. WHO factsheet N0 300. Geneva: World Health Organisation: 2006. factsheets/ fs300/en/index.html.
  1. Mauk GK, White KR, Mortensen LB, Behrens TR. The effectiveness of screening programs based on high – risk characteristics in early identification of hearing loss. Ear Hear 1991; 12; 312 – 9.
  1. Sharma H, Bhushan V, Dayal D, Mishra S. Preliminary study of hearing handicap in school goind children. Indian J. Laryngol Otol Head Neck Surg 1992; 1 (3); 119 – 24.
  1. Mishra SC, Shukla G K, Bhatia N, et al, Ear health care and promotion of hearing amongst school children of slum areas. Indian Journal of Otology. 1992; 10: 18 – 23.
  1. Kamath. RD, Mishra RN, Bhatia BP. The effect of hearing handicap on the growth and development of school children. Lucknow: LucknowUniversity; 1964.
  1. Jacob A, Rupa V, Job A, Joseph A. Hearing impairment &otitis media in a rural primary school in South India. Int J Pediatr Otorhinolaryngol 1997; 39 (2); 133 – 8.
  1. Kalpana R, Chamyal PC. Study of prevalence and aetiology of the hearing loss amongst school going children. IJO & HNS. 1997; 49 (2): 142 – 4.
  1. Phaneendra Rao RS, Malvika A, Subramanyam N, Nair et al, Hearing impairment & ear diseases among children of school entry age in rural South India. Int J Pediatr Otorhinolaryngol 2002; 64 (2): 105 – 10.
  1. Mawson SR, Ludman H. Diseases of the Ear – A textbook of otology. 4th Ed. London: Edward Arnold Ltd; 1979.
  1. Chan KH, Sensorineural hearing loss in children. Otolaryngol Clin North Am 1994; 27 (3): 473 – 86.
  1. Ganga N, Rajgopalan B, Rajendra et al. Deafness in children – An analysis Indian Pediatr. 1991 ; 28 (3): 273 – 6.
  1. Kumar S, D’Mellow J. Identifying children at risk for speech and hearing disorders. A preliminary survey report from Hyderabad, India Available from: URL: 172006.