https://www.um.edu.mt/library/oar/handle/123456789/1179 Fri, 24 Apr 2026 12:58:28 GMT 2026-04-24T12:58:28Z https://www.um.edu.mt/library/oar/handle/123456789/145636 Title: Sensitivity and specificity of otoacoustic emission and automated auditory brainstem response tests in universal neonatal hearing screening programme in Malta Abstract: The aim of this study was to evaluate the effectiveness of the Universal Neonatal Hearing Screening Programme in the Maltese Islands between October 2021 and October 2022. A retrospective, cross sectional, non-interventional quantitative research design was employed. The study population consisted of 4,427 newborns delivered in Malta and Gozo during the one-year study period. The results demonstrated that 93% of newborns across both islands were screened, indicating near universal programme coverage and alignment with established standards for accessibility and early hearing detection. The prevalence of confirmed neonatal hearing impairment was 0.21%, corresponding to approximately 2.1 cases per 1,000 live births. Performance evaluation of the screening modalities showed that the Automated Auditory Brainstem Response (AABR) test achieved a sensitivity of 90% and a specificity of 96%, while Otoacoustic Emissions (OAE) testing demonstrated a sensitivity of 80% and a specificity of 91%. Although AABR exhibited higher diagnostic accuracy, the combined use of AABR and OAE improved overall screening effectiveness and population coverage. In conclusion, a staged dual-testing approach incorporating both AABR and OAE enhances diagnostic accuracy and supports the primary objective of early and universal identification of neonatal hearing impairment. Description: M.Sc.(Melit.) Wed, 01 Jan 2025 00:00:00 GMT https://www.um.edu.mt/library/oar/handle/123456789/145636 2025-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/145583 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.) Wed, 01 Jan 2025 00:00:00 GMT https://www.um.edu.mt/library/oar/handle/123456789/145583 2025-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/145418 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.) Wed, 01 Jan 2025 00:00:00 GMT https://www.um.edu.mt/library/oar/handle/123456789/145418 2025-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/145414 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.) Thu, 01 Jan 2026 00:00:00 GMT https://www.um.edu.mt/library/oar/handle/123456789/145414 2026-01-01T00:00:00Z