Protocols for early audiology intervention services: Views from early intervention practitioners in a developing country
Objectives. To identify the protocols and practices for audiology early intervention (EI) in Gauteng government hospitals, and determine whether these protocols comply with the principles for effective EI in audiology. Methods and materials. Self-administered questionnaires were hand-delivered and distributed to participants in government hospitals in Gauteng. Participants. Eighty-six professionals consisting of speech therapists and audiologists (N=20), paediatricians (N=33), ear, nose and throat specialists (ENTs) (N=7), and nurses (N=26) working in EI were included in the study. Analysis of results. Findings were analysed via thematic content analysis which made it possible to determine the predominant themes with regard to EI protocols in government hospital settings. Additional quantitative descriptive statistics were also utilised to handle the data. Results. Findings indicate inconsistent perceptions among the EI practitioners regarding the protocols implemented and that these may influence referrals and early management of children with hearing impairment. Delay of identification and diagnosis (later than 2 years of age) as well as delayed amplification were identified by audiologists. Factors contributing to lack of provision of EI services in audiology included inadequate referrals by professionals, lack of neonatal screening, and poor parental knowledge. Although the medical team believed that identification occurs at less than 6 months of age, they reported intervention to occur much later than identification. Principles of EI tested were generally perceived to be applicable to the South African context and in agreement with best practice in EI.