https://www.um.edu.mt/library/oar/handle/123456789/1179 2026-04-14T23:17:55Z 2026-04-14T23:17:55Z https://www.um.edu.mt/library/oar/handle/123456789/145583 2026-04-14T13:12:51Z 2025-01-01T00:00:00Z

Title: A user-experiences-based approach for designing connected speech and language therapeutic toys in a smart city Abstract: This study explores the design, development, and evaluation of SALTT-CITY, a connected bilingual language intervention tool for Maltese-English-speaking children aged between five-to-eight years old, namely those diagnosed with Developmental Language Disorder (DLD). Given the scarcity of local, evidence-based gamified resources for bilingual intervention in Malta, this research seeks to investigate the need for innovative, user-centred tools that combine traditional play with connected technologies. Using a user-centred research design and a mixed-methods approach, the study integrated qualitative and quantitative data collection to explore the diverse perspectives of speech and language pathologists, caregivers and children on the SALTT-CITY board game and companion app. Semi-structured interviews, questionnaires, and thematic analysis were used to scrutinise how connected technologies stand to enhance engagement and accessibility and support both implicit and explicit language intervention approaches. The findings suggest that SALTT-CITY has the potential to facilitate more tailor-made and engaging intervention experiences by aligning with tiered service delivery models and promoting collaborative learning. The study identified key design considerations for integrating connected technologies into language intervention while highlighting challenges related to usability, personalisation, and clinician adoption. Ultimately, this study contributes to the evolving field of gamified and connected therapeutic tools by offering a look into their role in language intervention. Through the bridging of traditional and digital play, SALTT-CITY brought forth a scalable model for the enhancement of language therapy practices, with further implications for future technology assisted therapy. Description: M.Sc.(Melit.)

2025-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/145418 2026-04-08T12:47:07Z 2025-01-01T00:00:00Z

Title: Educators’ perspectives in supporting students with hearing impairment in Maltese schools Abstract: Purpose: The purpose of the study was to explore the perspectives of Maltese educators toward supporting students with hearing impairment in Maltese schools. A total of 329 educators were recruited, which included 135 teachers, 161 learning support educators (LSEs), and 33 categorised as ‘other’ educators. The majority were aged between 30 and 44 years (N=167), followed by educators aged 45 to 49 years (N=87). A large proportion of participants were female (N=312) and worked in state schools (N=223). These were followed by participants working in church schools (N=75) and independent schools (N=31). As part of the study objectives, relationships between educators’ perspectives and a range of variables—such as professional role, school type, age group, years of experience, past experience, and training received—were explored. The perceived facilitators and barriers influencing these perspectives were also investigated. The findings from this analysis informed recommendations for improving the support provided to students with hearing impairments. Methods: A mixed methods (MMR) approach was adopted. Initially, a modified version of the Opinion Relative to Integration of Students with Disabilities (ORI) was administered. It consisted of a demographic section followed by 25 nominal, close-ended statements, each rated on a Likert scale ranging from ‘strongly agree’ to ‘strongly disagree.’ The data was analysed using parametric tests through the Statistical Package for the Social Sciences (SPSS). This was followed by three one-to-one interviews, each comprising nine open-ended questions, and the data was analysed using thematic analysis. Results: The findings revealed that educators expressed relatively positive perspectives toward supporting students with hearing impairment. No significant differences were identified across school types; however, variations to different extents were observed in relation to the other variables explored. The study also addressed facilitators and barriers influencing the support provided by educators, which helped inform recommendations aimed at benefitting students with hearing impairment and educators. Conclusion: The findings highlighted the need for additional research and improvements in the support provided to students with hearing impairment. Across studies, educators express positive perspectives; however, existing gaps in practices must be addressed to improve outcomes for these students. Description: M.Sc.(Melit.)

2025-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/145414 2026-04-08T12:24:04Z 2026-01-01T00:00:00Z

Title: Tympanostomy tubes and bone-conduction hearing aids in children with cleft palate : intervention outcomes Abstract: Children with cleft palate (CP) are highly susceptible to conductive hearing loss (CHL) due to chronic eustachian tube dysfunction (ETD) and middle ear effusion (MEE). Tympanostomy tubes (TTs), better known as grommets, and bone-conduction hearing aids (BCHAs) represent the most common interventions; however, direct comparative evidence in this population remains limited. This study involved a multiple case study design integrating quantitative and qualitative data analysis. Six children with CP, their caregivers, and nine healthcare professionals (HCPs), which included three ENT specialists, two audiologists, and four speech-language pathologists (SLPs), also participated in this study. Audiological and medical records provided secondary quantitative data of hearing thresholds and tympanometric outcomes, while semi-structured interviews explored lived experiences, clinical decision-making, and perceptions related to intervention effectiveness. Quantitative analyses showed improvements in aided hearing thresholds among children who used a BCHA, specifically the bone-anchored hearing aid (BAHA) softband, with stable aided performance over time. In contrast, TTs outcomes were perceived as beneficial but in the short-term, as often extrusion of TTs was followed by recurrence of MEE. Qualitative findings indicated that both intervention options supported speech and language development; however, HCPs viewed BCHAs as providing more stable and long-term hearing access in this cohort. Parents valued multidisciplinary team (MDT) support and empathetic communication but identified delays, inconsistent follow-up, and limited information at diagnosis as persistent challenges. Given the findings, the need for structured protocols, clearer MDT coordination, and improved information sharing within Malta’s clefthearing services is underscored. Description: M.Sc.(Melit.)

2026-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/145412 2026-04-08T12:22:22Z 2026-01-01T00:00:00Z

Title: The awareness of paediatric hearing loss across medical, educational and social settings in Malta Abstract: The primary purpose of this study was to investigate educators’, general practitioners’ and caregivers’ awareness towards paediatric hearing loss. The current study used a mixed-methods approach, combining quantitative and qualitative research methods to reach its’ aim. Three questionnaires for the three studied populations were designed by the researcher following analysis and reading of literature. These questionnaires explored the level of awareness, knowledge, and attitudes regarding paediatric hearing loss and aimed to identify gaps in understanding, referral practices, and perceptions of early detection and intervention in these populations. A one-to-one interview with an audiologist was conducted to explore professional perspectives on the current awareness, misconceptions, and challenges surrounding paediatric hearing loss across medical, educational, and parental contexts. It aimed to gain deeper insight into interdisciplinary collaboration, parental reactions to diagnosis, and strategies for improving awareness and support for affected children and their families, while also contextualising the findings and highlighting systemic strengths and challenges within the Maltese context. The data gathered from the questionnaire was analysed statistically using SPSS while the data gathered from the interview was analysed qualitatively through a conversational and thematic analysis. Results revealed variability in awareness across groups. Among educators, nearly half had experience teaching a child with hearing loss, yet a substantial proportion reported limited familiarity with the condition despite generally recognising its effects on speech, language, and social-emotional development. While participants were generally aware of common classroom accommodations such as preferential seating and visual aids, familiarity with assistive technologies and sign language was lower, and the majority had received no formal training on supporting children with hearing loss. Nonetheless, all educators expressed strong interest in receiving additional training and resources, highlighting a clear demand for structured professional development in inclusive and auditory support practices. General practitioners demonstrated high awareness of paediatric hearing loss and recognised the importance of newborn screening. They identified common causes such as ototoxic drugs, infections, otitis media, and trauma, and consistently associated speech or language delays and lack of response to sound with potential hearing loss, though awareness of recurrent otitis media as a cause was moderate. Most participants had received no formal training, but most expressed strong interest in further education, highlighting the need for enhanced training and clearer guidance to support early detection and referral. Caregivers generally perceived their understanding of paediatric hearing loss as fair, indicating moderate awareness of the condition, and most attributed hearing loss to genetic factors or prenatal infections, with fewer recognising environmental causes. The majority considered hearing testing at birth important, and nearly all acknowledged that hearing loss can affect a child’s language and speech development, though some were unsure where to access testing. Most caregivers were aware of grommets as a treatment option, although around one-third were unfamiliar with or unsure about this intervention. In the interview, the audiologist mentioned the rising awareness about paediatric hearing loss since the implementation of the newborn screening, more specific referrals by ENT consultants, social stigma, parental emotional reactions to an early diagnosis, the need for support and multidisciplinary team collaboration and accessibility to information. This study highlights the need for accessible professional training and creation of awareness campaigns for educators, general practitioners, and caregivers to improve awareness, early identification, and effective management of paediatric hearing loss. It underscores gaps in practical knowledge, familiarity with screening processes, and confidence in implementing classroom accommodations or referral practices. Additionally, the findings emphasize the importance of interdisciplinary collaboration and the provision of targeted resources to support children with hearing impairments and their families. Description: M.Sc.(Melit.)

2026-01-01T00:00:00Z