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.