The research found the prevalence of hearing loss in school children in Nepal is very high and the parents and teachers of hearing loss children lack the knowledge and competency to support speech and language development and learning of children with hearing loss. Hence, with support from the Royal Kentalis, SHRUTI developed the experts to provide itinerant support to the children with hearing loss and to coach their parents and class teachers in 2021. SHRUTI has started to provide itinerant support services to young children with hearing loss with the support of the Ministry of Women, Children and Senior Citizens and the Kathmandu Metropolitan City. Now 18 young children with hearing loss are getting the service beyond their regular schooling time at SHRUTI’s premises. Besides the support services to the children with hearing loss, SHRUTI also provides training to the parents of hearing loss children and teachers of the schools where the hearing loss children study.
SHRUTI concluded a seminar to disseminate the overall activities and the outcome of the program on 26 June 2022. Representatives from the government authorities, such as Woman Children and Senior Citizens, Education Department and Social Development Department of the Kathmandu Metropolitan City; elected ward members (Ward 4 and 5) of Kathmandu Metropolitan City, representatives from the other organizations of people with disabilities, representatives from schools management, and teachers and parents of the hearing loss children participated in the seminar. The learning issues of the hearing loss children were discussed and the witnessed progress of the support services provided by the SHRUTI was highlighted in the seminar. Parents and class teachers of the children with hearing loss also shared the positive changes in the children after they applied the learning methods learned from the SHRUTI to the children at home as well as in the classroom.
The policymaker understood the importance of the support services for the children with hearing loss and committed to supporting continuing the services. The right of children with disabilities to acquire quality education in mainstream schools nearby their residence was discussed and guaranteed in the program, as some parents faced challenges to enroll their children in mainstream schools. Similarly, being invisible disability, the hard of hearing people have faced challenges to be recognized them as a disabled people by the government or to get disability cards from the local government.
A Pilot Project of Accessible Communication Support for Hard of Hearing Patients in Kathmandu Hospital is being implemented by SHRUTI and ZENNANCHO under the financial support of the Japan International Cooperation Agency (JICA). The goal of the project is to establish communication support services for hard-of-hearing patients in the ENT Department of Tribhuvan University Teaching Hospital. The main outputs of the project are to develop communication support tools and manual for Nepali HoH persons; implement sustainable communication support between HoH people and the hospital staff; widen the understanding of the communication support model in other hospitals of Kathmandu.
In May and Jun 2022, SHRUTI and ZENNANCHO successfully completed 5-days remote training for the accessibility of hard-of-hearing patients in hospitals. Four trainees of SHRUTI and two trainees of TUTH participated in the remote training provided by the different Japanese professionals. The Nepali trainees gained lots of knowledge of the accessibility needs of hard-of-hearing patients in the hospitals and are able to observe the situation of the hospital and develop a communication support tool and manual to fit in the context of Nepal.
The project has been started in January 2022 and will be implemented for three years, till Dec 2024. It is expected that at the end of the project, the TUTH will have its own communication tool and manual and will be able to provide sustainable accessible communication support to its hearing loss patients.
The teachers’ training program was held on 11 and 18 June 2022 in Kathmandu. Pre-school and primary school teachers who were educating young children with hearing loss in the mainstream schools participated in the two-day training provided by the SHRUTI under the financial support of the Ministry of Women, Children and Senior Citizens and coordination of the Kathmandu Metropolitan City. More than 20 teachers acquired the knowledge of educating hearing loss young children in a mainstream classroom.
The training aimed to let the teachers know about hearing loss, and its causes and symptoms; understand the impact of hearing loss on a child; gain knowledge on the communication methods, classroom management, and teaching strategies; understand behavior changes in the children and appropriate intervention to handle it, and recognize the vital role of a teacher in educating the hearing loss children.
It was observed that the teachers already noticed the changes after implementing the knowledge on the hearing loss children in the classroom, as some teachers shared the experience on the second day of the training. SHRUTI hopes the teachers implement the acquired knowledge and find more changes in the children with hearing loss in the days to come.
Parents Interaction Programs were held on 7th May and 4th June 2022. Parents were given training on the understanding of hearing loss and interacting with hard-of-hearing children. The training aimed to know about the hard of hearing and hearing loss, and its causes and symptoms, understand the impact of hearing loss on a child, gain knowledge on intervention and the role of parents, and understand behavior changes in the children and the rights provided in the legislation. Similarly, the Itinerant Services Provision (ISP) teachers of SHRUTI shared the progress and challenges of children who have received ISP services from SHRUTI.
After the training, the parents came to know how to interact with their hard-of-hearing children, the importance of the role of the parents, and the provision for hard-of-hearing people in the legislation in Nepal. The parents were very interactive and they shared their challenges, experiences, and views, and asked questions. Parents drew special attention to the change in the behavior of their hearing loss children after participating in the Itinerant Service Provision (ISP) provided by SHRUTI. It was observed that government support is very important to address the needs of hard-of-hearing children. Parents further realized that the unity of parents is very important for the advocacy to materialize the provision provided by the legislation for hard-of-hearing people. The program was participated by more than 30 parents of hard of hearing and monitored by the representative of Kathmandu Metropolitan City. It was our privilege that the program was also observed by the Executive Director of the Global Foundation for Children with Hearing Loss.
SHRUTI intends to operate as an expertise center for hard-of-hearing people in Nepal. With the financial and technical support of Kentalis International Foundation/Royal Kentalis, the Netherlands, SHRUTI had been implementing a project on the development of itinerant service providers for children with hard of hearing studying in mainstream schools from Jul 2019 to Dec 2021. This project aimed to develop itinerant experts to support the development of language and communication skills and improve the quality of education of the hard-of-hearing young children by providing itinerant services for them and their parents, caregivers, and teachers.
In order for SHRUTI to be able to provide itinerant services and to become an expertise center for hard-of-hearing children in Nepal, Kentalis experts provided training for the experts working at SHRUTI which comprises a psychologist, an educational expert, and two communication supporters. After the completion of the two year’s training in June 2021, the senior itinerant experts of SHRUTI have been providing training to the other 4 trainees with the supervision of the experts of Kentalis. After completion of the project in Dec 2021, SHRUTI has a viable knowledge base to develop into a center of expertise and is able to provide itinerant services to schools with hard-of-hearing learners as well as information and coaching to parents, caregivers, teachers, and school management members.
SHRUTI’s itinerant experts have started supporting children with hard of hearing in the schools of Kathmandu and Lalitpur Metropolitan Cities and developed individual education plans for each targeted child. The trained itinerant teachers have been observing their development and providing coaching to the parents. Even after the completion of the project, SHRUTI has been providing itinerant support services to 18 children with hearing loss with the financial support of the Ministry of Women, Children and Senior Citizens and close coordination with the Kathmandu Metropolitan City. SHRUTI intends to expand the service to regular pre-schools and primary schools and teachers where hard-of-hearing children study.