Download The effect of early diagnosis of auditory inadequacy on the social

The effect of early diagnosis of auditory inadequacy on the social and academic
performance of the students in Hail, KSA.
Maha Al-shammari, Asma Ashankyty, Najmah Al-Mowina, Nadia Al-Mutairy,
Anfal al-qrnas, Lulwah Al-shammari and Susan Amin*
College, of Medicine, University of Hail, Po Box 2440, Hail 81451, Saudi Arabia.
*Address for correspondence S. Amin, College, of Medicine, University of Hail, Po Box 2440, Hail 81451,
Saudi Arabia. Tel- 0598587165, [email protected].
Abstract
Objective
In order to assess how limitations in the auditory system effect the social and academic
performance of high school students, we assessed the social and academic performance of the
students at boys and girls deaf high schools in Hail, KSA.
Aims for this study : Determination of the type and degree of deafness. The age of identification
of different degrees of deafness and the use of any treatments and identification of the effects of
hearing loss in the home and school.
Methods
A cross sectional study was carried out on a hundred males and females of ages 16-18 with
varying degrees of deafness, attending high schools in Hail. This was carried out by interviews
and surveys of the students, to answer our aims.
Results and Discussion
We were able to get a lot of gender specific information comparing female and male responses in
Hail. Males tended to favor subjects like History, Females tended to favor subjects like science.
More girls tended to have hearing aids whereas more males tended to communicate by sign
language, Hearing aids were easier for the girls as some found the sign language difficult, Sign
language would be easier for the boys as they had less barriers when dealing with people. More
girls felt they were treated differently by their parents about their disability than the boys.
These specific tendencies could be gender specific and more studies on a larger scale would
have to be accomplished to verify this as well as comparing this to other regions .This data has
aided our understanding of the role of deafness and its causes in Hail.
Introduction
The term "hearing loss" in the medical and social senses has served to mean "an impairment of
hearing". When a sound has to be increased in intensity for a person to hear it, then, this is also
called a hearing impairment1
Types of hearing loss (HL) can by categorized by site of the auditory system damaged.
There are three basic types of hearing impairment (HI): 1) conductive HI involving an
impairment in conduction of sound from the outer ear to the middle ear ossicles, 2) sensorineural
HI, involving an impairment to the inner ear ossicles or from the inner ear to the brain 3) mixed
HI, involving the outer, middle and the inner ear 2.
The “Deaf Community” is the term which is sometimes applied to the population of deaf people
who use sign language as their principal means of communication 3.
Most people with HL could be helped medically, surgically (with cochlear implants) or with
hearing aids4.
Information is known about the impact of deafness on social being in the western world, but the
information is much limited on the impact in the middle east. Information on causes and patterns
of deafness in an area will help with preventative measures for this area.
One group has found that sensorineuronal deafness is more common in Saudi Arabia than in any
other developing or developed region. They reported heredofamilial factors as the most
common etiology 5 . In the Asir region of KSA studies have been made on the hearing levels of
normal students 6 7. A study in a male deaf school reported sensorineuronal deafness as the
most common type of deafness in the Abha Asir region of Saudi Arabia8. There are not many
studies that exist for deaf schools for the girls or in comparing boys with girls. Most of the
studies that have been written for deafness have been based on younger children and adults. The
studies on children such as between the ages of 15-18 are insufficient. The aims of the present
study was to look at the patterns of deafness among females and males in high schools in Hail,
Saudi Arabia through the following:
- Identification of the effects of deafness in the school and the home
- The possible causes of deafness.
- Responses on the academic performance of the deaf students.
- Types of treatment for deafness in Hail.
- Recommendations for future research in deafness.
Methodology
A cross sectional study of a hundred students ( Male and female) with impaired hearing levels
from a boy’s and girl’s high school in Hail, were interviewed and surveyed by the participating
student researchers. The questions in the survey were designed to collect information on the aims
for the project and to give us some information on deafness in Saudi Arabia.
This study was conducted during the period of December. 2011 to April. 2012 at a high school
for the deaf ( Boys and Girls separated) in Hail. Their ages ranged from 16-18 years. The
questionnaires used were in Arabic. The data collected from the questionnaires was translated
into English.
The study protocol was approved by the research committee at the University of Hail and from
the respective high schools. In addition, all the schools and students consented to involvement in
the study.
We used a Chi Squared test for the two groups to test for differences in the responses of the
males and female students to the questions in the survey. The level of significance in a chisquare for a two-tailed 1-df test is always a value of 3.84 or greater.
Results
Two groups of students males and females of the same age group (15-18) were analyzed with questions in
the survey.
1) The Identification of the effects of deafness in the school and the home.
Figures 1a to 1c were designed to answer questions for Aim 1 on the Identification of the
effects of deafness in the school and home.
Compared with males, females on average felt they were treated significantly (χ 2 > 3.84) more
differently by their parents ( 24 versus 10) ( Figure 1a).
Compared with females, males on average felt they took more longer significantly (χ 2 > 3.84)
to complete daily tasks because of their deafness ( 23 versus 21) ( Figure 1b).
Male and females felt on average significantly (χ 2> 3.84) more comfortable with their situation
( 22 versus 20) ( Figure 1c).
Figure 1a: Responses to the question do you feel that your parents treat you differently because of your deafness?
The X axis is for gender and the Y axis is frequency of yes and no responses.
Figure 1b: Responses to the question do you take more time to deal with daily tasks because of your deafness ?
The X axis is for gender and the Y axis is frequency of yes and no responses.
Figure 1c:Are you comfortable with your situation? The X axis is for gender and the Y axis is frequency of yes and
no responses.
2) The possible causes of deafness.
Figures 2a-2d were designed to answer Aim 2:The possible causes of deafness.
Compared with females, More males significantly on average (χ 2 > 3.84) were born deaf in
this study ( 20 versus 8) ( Figure 2a).
There were fewer females and males significantly (χ 2 > 3.84) in this study that had a family
history of deafness ( 5 versus 1) ( Figure 2b).
There were fewer females and males significantly (χ 2 > 3.84) in this study that had an
underlying disease as a cause of their deafness ( 6 versus 4) ( Figure 2c).
There was a large number of males and females who did not know the exact cause of their
deafness (χ 2 < 3.84) ( 20 versus 14) ( Figure 2d).
Figure 2a: Were you born deaf? The X axis is for gender and the Y axis is frequency of yes and no responses.
Figure 2b: Do you have a family history of deafness? The X axis is for gender and the Y axis is frequency of yes and
no responses.
Figure 2c:Was your deafness caused by a chronic disease? The X axis is for gender and the Y axis is frequency of yes
and no responses.
Figure 2d:Was your deafness caused by something unknown? The X axis is for gender and the Y axis is frequency of
yes and no responses.
3) Responses on the academic performance of the deaf students
Figures 3a to 3d are designed to answer questions on the responses of the academic
performances of the deaf students.
Compared with females, more males significantly on average (χ 2 > 3.84) had difficulty in
communicating with others ( 26 versus 9) ( Figure 3a).
Figure 3a:Do you face difficulty in communicating with others ? The X axis is for gender and the Y axis is frequency
of yes and no responses.
Males and females significantly on average ( χ 2> 3.84) felt that their academic performance
was affected by their deafness ( 26 versus 25) ( Figure 3b).
Figure 3b: Do you think that your performance is affected at school because of your deafness? The X axis is for
gender and the Y axis is frequency of yes and no responses.
Most of the females liked science, whereas most of the males liked history (χ 2 <3.84) ( 20
versus 14) ( Figure 3c).
Figure 3c:Are there any subjects you like ? The X axis is for gender and the Y axis is frequency of yes and no
responses.
A majority of the males and females rated their academic performance in terms of performing in
exams and classes as excellent. This was no significant difference (χ 2< 3.84) ( 14 versus
18)(Figure 3d).
Figure 3d:How would you rate your academic performance ? The X axis is for gender and the Y axis is frequency of
yes and no responses.
4) Types of treatment for deafness in Hail.
Figures 4a and 4b are designed to answer the aim on types of treatment in Hail for deafness.
Compared with females, more males significantly on average (χ 2 > 3.84) knew sign language
( 24 versus 9) ( Figure 4a). Compared with males, more females significantly on average (χ 2
> 3.84) were fitted with hearing aids ( 29 versus 6) ( Figure 4b).
Figure 4a: Do you know sign language ? The X axis is for gender and the Y axis is frequency of yes and no
responses.
Figure 4b : Has the state provided you with a special device to help you to communicate? The X axis is for gender
and the Y axis is frequency of yes and no responses.
5) Recommendations for future research in deafness.
Figure 5a-5b are designed to answer Aim 5 : Recommendations for future research in deafness.
Compared with males, more females significantly on average (χ 2 > 3.84) agreed that
businesses should provide special services for people with special needs ( 24 versus 12) ( Figure
5a). Compared with females, more males significantly on average (χ 2 > 3.84) agreed that the
university should provide sign language for all ( 24 versus 12) ( Figure 5b).
Figure 5a: Should businesses provide special services for people with special needs? The X axis is for gender and
the Y axis is frequency of yes and no responses.
Figure 5b : Do you want the university to offer courses in sign language for all? The X axis is for gender and the Y
axis is frequency of yes and no responses.
Discussion
The following study was undertaken to look at the patterns of deafness among girls and boys in
Hail, Saudi Arabia through the following:
1) Identification of the effects of deafness in the school and the home
2) The possible causes of deafness.
3) Responses on the academic performance of the deaf students.
4) Types of treatment for deafness in Hail.
Two groups of students, male and female of ages 15-18 were surveyed with questions designed to answer
the aims.
Most of the boys in this study were actually deaf since birth compared to the girls , also there was not
many incidences of a family history of deafness in the Hail students. These results differ from one study
survey of 6421 Saudi infants and children in Riyadh, where 66.07% cases were found to be due to
hereditary reasons 9. Another study in Saudi Arabia revealed (41%) of its deaf participants were born as
a result of consanguineous marriages and (32%) had a family history of deafness10.In order to get a
clearer picture on the numbers of deafness and different causes of deafness, studies would have to be done
in all parts of KSA, especially the remote regions. As there maybe region specific causes as well.
There was also a large number of males and females who had unknown causes for their deafness. This
coincides with one study that found a 12.2% incidence of deafness in KSA due to unknown causes 8.
Understanding what the unknown causes could be warrants further investigations.
We were able to get a lot of gender specific information comparing female and male responses. Males
tended to favor subjects like History, Females tended to favor subjects like science. More girls tended to
have hearing aids whereas more males tended to communicate by sign language, Hearing aids were easier
for the girls as some found the sign language difficult, Sign language would be easier for the boys as they
had less barriers when dealing with people. More girls felt they were treated differently by their parents
about their disability than the boys. These specific tendencies could be gender specific and more studies
on a larger scale would have to be accomplished to verify this as well as comparing this to other regions .
One study from 11, reported more males than females as being deaf. Deafness maybe gender specific and
may be due to there being more boys than girls residing or born in some regions of KSA compared to
others as well as an hereditary component. Genetic testing would have to be carried out and related to
demography in future studies to answer this.
The lack of family history, should not be abandoned as we were not able to get information on other
generations of the same family that the student might not know like skipping a generation or the cause
could be sex linked which would make more males susceptible to deafness than females or vice versa
depending on who was the carrier. There might be a certain gene that could be carried by Saudi’s that
could also make then susceptible to deafness and again more studies would have to be carried out to
answer this. DFNB1 which codes for connexins 26 and 30 which are gap junction binding proteins
expressed on cochlea have been found in one study to account for 3% of the non syndromic cases of
hearing loss in the Saudi Population 12. This may be one of many genes waiting to be discovered.
There was a a high number of males and females who had difficulties in communicating and found that
their academic abilities were affected by their deafness, even though they rated their performance in
classes as excellent. They may be okay in the school as they have a teacher, but may find it difficult at
home when they are in isolation. More help in high schools could help combat this. More assistance to
deaf students in their classes such as longer lesson periods, Hearing students who know sign language to
be buddies for them and a tutor to help them in their class work should aid in their transition from High
school to university.
In terms of differences in the responses between the males and females, The males finished their surveys
much quicker and with ease compared to the females who needed more time to understand the questions.
For the girls who are deaf and may be expecting children or have children, there should be workshops
arranged to help them in dealing with child care issues, or even a nurse or maid to help them in the home.
Conclusions
Barriers to understanding could be prevented by introducing sign language in a number of schools and
universities like the USA. Saudi society is becoming more accepting to these students with hearing loss,
there is more government services available as well as entrance to universities in the KSA region.
There should be more assistance in high schools to prepare deaf students for Universities, such as tutors
or interpreters.
There should be routine examinations done for newborn babies to detect for hearing deformities in KSA.
This is a common practice in some parts of the western world.
More facilities for deaf students and non deaf students to interact as well as more workshops to help us
understand about deafness and its effects on society.
Acknowledgements
All parents and students of Hail who gave us all the assistance we needed in answering the questionnaires.
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