A Qualitative Analysis of Early Identification of Pediatric Hearing Loss and Early Intervention Services for Families in Mongolia

Abstract

There are four equally important elements that must be in place in a continuum of care for successful outcomes in young children with hearing loss learning to listen and speak: a) early identification of hearing loss, b) family engagement, c) hearing technology, and d) access to local professionals with expertise in habilitation services (audiology, early intervention). The aim of this study was to understand the experience in Mongolia for those families who choose the listening and spoken language communication modality after their babies and young children are identified with hearing loss. The study had two objectives: 1) to elicit strengths and weaknesses in the current delivery of pediatric hearing health care services in Mongolia for children with hearing loss learning to listen and speak from newborn hearing screening to habilitation, and 2) to identify cultural, economic, and social enablers and barriers that motivate or demotivate families as they progress along the continuum of care. A qualitative study design was used. Semi-structured in-depth interviews were conducted with 26 individual Mongolian family members of babies and young children with hearing loss who either use hearing aids or cochlear implants or are in the process of obtaining such hearing technology. Focus group discussions and interviews were administered with 41 Mongolian medical professionals and therapists who provide pediatric hearing services to rural and urban populations and with four Mongolian government representatives. Thematic content analysis was applied to the data using inductive coding in the context of a grounded theory approach. Analysis revealed strengths and opportunity areas at each stage of care which contributed to varying family experiences in obtaining pediatric hearing health care services for their children with hearing loss. Results indicated that expanding existing pediatric hearing health care services and professional expertise beyond the capital of Ulaanbaatar, increasing awareness about pediatric hearing loss across Mongolian society, and providing additional financial aid to families would contribute to advancing pediatric hearing health care services in Mongolia. Investment in these areas would enable more of their children with hearing loss to access the essential support they need to learn to listen and speak and reach their potential.