EHDI Services should be accessible! caregivers’ expectations of EHDI services in South Africa

Progress of Early Hearing Detection and Intervention (EHDI) services within the South African context lags behind that made by high-income countries internationally. Implementation of EHDI services in this context faces many challenges that underscore the need to ensure contextualized intervention approaches that meet the needs of South Africa’s linguistically and culturally diverse population. The aim of the current study was to describe caregivers’ expectations of EHDI services, and to evaluate the success and/or failure of the EHDI services in relation to these expectations. To achieve this aim, in-person, telephonic and videoconferencing narrative interviews were conducted with nine caregivers of children who are Deaf-or-Hard-of-Hearing (DHH), and analysed through reflexive thematic analysis. The following themes and sub-themes emerged from the narrative interviews: (1) expectations of the EHDI process (‘early detection of hearing loss and ‘EHDI should be accessible’), and (2) expectations for the outcomes of EHDI services (‘age-appropriate acquisition of spoken language’, ‘mainstream education’, and ‘further education and independence’). These themes speak to concerns with the entire EHDI process from detection to intervention, including continuity of care. In order to ensure effective and sustainable EHDI services within the South African context; caregivers’ expectations should be used to inform service provision and to guide best practice. Furthermore, these findings suggest a need to implement wide spread, integrated, and inter-disciplinary EHDI services that are linguistically and culturally responsive and relevant; with caregivers and families forming a crucial part of the programmes.