Over the years, considerable research has been done showing the advantages of early identification of hearing loss and its impact on children in developing speech and language skills. Although the universal early hearing detection and intervention (EHDI) program is fully functional in developed countries it has not been actualized in developing global regions like Asia, Africa and Latin America. The primary reason could be precise government policies and the necessary funds to support them. There is also a lack of awareness and initiative form the parent's side. The purpose of this paper is to describe and support the need for a universal early detection of hearing loss and intervention program in India. Objectives for developing a universal early identification and intervention program and the recommendations for actualizing them have been included. / text

Thesis (M Speech Path)--University of Stellenbosch, 2011. / ENGLISH ABSTRACT: Various approaches to the communication-development of the young child with a hearing impairment exist, of which the auditory-verbal approach is one. This approach is based on the principle that the child with a hearingimpairment develops speech- and language skills by using his/her residual hearing that is appropriately strengthened with the use of a hearing aid and/or cochlear implant. One of the most important requirements for the successful application of this approach is the appropriate transfer of the techniques and strategies that is used in institution-based intervention to the child’s home environment. Parents, teachers, speech-language therapists and audiologists are responsible for facilitating the transfer of intervention methods and acquired skills to the home environment and it is important that all team members are aware of his/her own, as well as each other’s roles, in the application of this approach. The principal aim of the proposed research project was to describe and explain the perceptions of parents/caregivers, teachers, speech-language therapists and audiologists, that are involved in the intervention of the hearing impaired child, regarding the auditory-verbal approach to education. Semi-structured interviews were conducted with nine parents of hearing impaired children younger than the age of four, and with four teachers that are involved in the education of the said children. Lastly, semi-structured interviews were held with four speech-language therapists and two audiologists that are involved in the provision of the intervention to hearing impaired children younger than four years. All the participants were affiliated with a specific centre for children with hearing impairment in the Western Cape province of South Africa. All the participants noted that parents must take part in the decision-making process with regards to the selection of the most suitable communication approach for their child with a hearing loss. Participants also agreed that most parents choose the auditory-verbal approach to communication development of their child because speech as a communication medium, is familiar to them and it is also associated with normality. Parents also indicated that the auditory-verbal approach is the most suitable approach for all children with a hearing loss. Teachers, speech-language therapists and audiologists did not completely agree with the parents as they mentioned some aspects, e.g. the presence of additional disabilities must be taken into account before a decision can be made regarding whether the child with hearing loss could follow the auditory-verbal approach to communication development. All participants displayed a positive attitude towards the auditory-verbal approach and it appears that parents, teachers, speech-language therapists and audiologists have good insight into the principles and outcomes of this approach. / AFRIKAANSE OPSOMMING: Daar bestaan verskeie benaderings tot kommunikasie-ontwikkeling by die jong kind met gehoorverlies waarvan die ouditief-verbale benadering een opsie is. Hierdie benadering is gebaseer op die beginsel dat die kind met gehoorverlies spraak- en taalvaardighede ontwikkel deur gebruik te maak van hulle residuele gehoor wat deur middel van die gebruik van ‘n gehoorapparaat en/of kogleêre inplanting toepaslik versterk word. Een van die belangrikste vereistes vir die suksesvolle toepassing van die benadering is toepaslike oordrag van die tegnieke en strategieë wat in terapie gebruik word, na die kind se tuisomgewing. Ouers, onderwysers, spraak-taalterapeute en oudioloë speel ‘n baie belangrike rol om hierdie oordrag na alledaagse kontekste te fassiliteer en dit is belangrik dat elke spanlid bewus is van sy/haar rol asook die ander lede se rolle in die toepassing van die benadering. Die hoofdoelwit van die voorgestelde navorsingsprojek was om ouers/versorgers, onderwyseresse, spraaktaalterapeute en oudioloë, betrokke by die intervensie en opvoeding van die kind met gehoorverlies, se persepsies rakende die ouditief-verbale benadering tot opvoeding te beskryf en te verduidelik. Tydens die studie is daar semi-gestruktureerde onderhoude gevoer met onderskeidelik nege ouers van kinders, jonger as vier-jaar oud, met gehoorgestremdheid en met vier onderwyseresse wat betrokke is by die die opvoeding van genoemde ouers se kinders met gehoorverlies. Laastens is daar ook semi-gestruktureerde onderhoude gevoer met vier spraak-taalterapeute en twee oudioloë wat betrokke is by die verskaffing van intervensie aan kinders met gehoorverlies, jonger as vier-jaar oud. Al die deelnemers was verbonde aan ’n spesifieke sentrum vir kinders met gehoorverlies in die Wes-Kaap provinsie van Suid Afrika. Al die deelnemers het aangedui dat ouers betrek word by die besluitnemingsproses rakende die keuse van die mees geskikte kommunikasie-benadering vir die kind met gehoorverlies. Deelnemers het almal saamgestem dat ouers meestal die ouditief-verbale benadering tot kommunikasie-ontwikkeling vir hulle kind kies omdat spraak as kommunikasiemedium bekend is aan die ouers en verband hou met normaliteit. Ouers het aangedui dat die ouditief-verbale benadering die mees toepaslike benadering is vir enige kind met gehoorverlies. Onderwyseresse, spraak-taalterapeute en oudioloë het nie volkome saam met die ouers gestem nie en hulle het genoem dat daar sekere aspekte, byvoorbeeld die teenwoordigheid van bykomende gestremdhede, is wat oorweeg moet word voor daar besluit word of die kind die ouditief-verbale benadering tot kommunikasieontwikkeling moet volg. Deelnemers het oor die algemeen ‘n positiewe houding getoon teenoor die ouditief-verbale benadering en dit wil voorkom asof ouers, onderwyseresse, spraak-taalterapeute en oudioloë goeie begrip toon van die beginsels en uitkomstes van die benadering.