To do a hearing screen test on each and every Grade 1 learner entering the South African school system is easier said than done. Current equipment used can also be quite cumbersome and costly – and needs a degree of training for the tests to be done well. Luckily audiologist Prof De Wet Swanepoel’s team from the University of Pretoria has come up with a quick and easy solution – the hearScreen cell phone app.
Since 2012 the hearing of all South African Grade 1 learners must be screened. This is thanks to the introduction of the Integrated School Health Policy which was produced by the National Departments of Health, Basic Education and Social Development. However, it is a requirement that is logistically easier said than done, as 1.1 million new learners enter the school system every year.
“Hearing is the cornerstone for developing language, for learning to speak and to communicate,” says Prof Swanepoel of UP’s Department of Speech-Language Pathology and Audiology. “Even minor hearing defects can have a major impact on language development and the academic performance of children, because they simply get lost within the noisy environs of a classroom.”
This expert in the early detection of hearing problems in babies and children served as advisor to the Department of Basic Education in drafting the policy. Also, along with his students he trains school nurses who have to perform these screening tests. These experiences gave him a good idea of just how difficult a requirement it is to fulfill. Current screening devices can cost up to R25 000 a unit.
They are quite cumbersome, heavy to handle, need electricity and also a certain level of expertise and training. Environmental noise cannot be blocked out or controlled, and these devices also do not offer the data capturing and management possibilities that are possible thanks to mobile connectivity.
Prof Swanepoel realised that what was needed is an app that can be calibrated on a low-cost cell phone. He took the idea to fellow UP researcher, Dr Herman Myburgh of the Department of Electrical, Electronic and Computer Engineering. With the help of students they set about to develop, test and validate a software solution.
The team’s brainchild is now a finalist in the innovative research category of the 2014 National Science and Technology Forum (NSTF) Awards, to be announced on 3 July. The innovation was also shortlisted for the recent African Innovation Prize Award.
The app adheres to international calibration standards, can be loaded onto a R800 Samsung smartphone, and is automated. The cell phone is lightweight and battery operated. A screening test can be completed within a minute – and all with the press of a few buttons. Background noise is continually measured with the built-in microphone, to ensure environmental quality control. The data is captured on-site and can be uploaded through the cellphone network to a centralised management site, where it can be evaluated for necessary recommendations.
“To set up hearScreen with the cell phone and headphone is four times cheaper than other screening devices, and can be used by anyone that knows how to work a cell phone,” elaborates Prof Swanepoel, who is also an executive board member of the International Society of Audiology. “It significantly improves and alters current models of school and community-based identification of hearing loss.”
“In South Africa, and Africa for that matter, we need cost-effective and sustainable methods with which to identify hearing loss early in life,” he adds. “This is where mHealth or mobile health technologies such as this app are becoming more and more important in taking healthcare to the people, in places where the infrastructure does not exist.”
The app was clinically tested on 800 children in Tshwane, as well as in a number of old age homes in the Western Cape. Come spring, hearScreen will be loaded onto the cell phones of community health workers in Mamelodi. They are part of a pilot study that will test the use of mHealth technologies to assist community-oriented primary care.