Saudi Arabia, officially the Kingdom of Saudi Arabia (KSA), is a country in West Asia. It is bordered by the Red Sea to the west; Jordan, Iraq, and Kuwait to the north; the Persian Gulf, Bahrain, Qatar and the United Arab Emirates to the east; Oman to the southeast; and Yemen to the south. Arabic is the native language, and English is also spoken as well as four main regional dialect groups: Najdi, Hejazi, Gulf including Baharna dialects, and Southern Hejaz and Tihama dialects.

Incidence and Prevalence of Hearing Loss

According to the World Health Organization (2012), the prevalence of disabling hearing loss is estimated to be around 0.9% in Middle Eastern countries, including Saudi Arabia. The estimated incidence of permanent congenital or early onset hearing impairment in developing countries in 2012 was six cases per 1000 live births.^[1] An epidemiological study of hearing impairment in children in Riyadh, Saudi Arabia, reported that the prevalence of hearing impairment was found to be 7.5% of the children surveyed, with 2.6% of them having sensorineural hearing loss.^[2] In another study, the prevalence of hearing impairment among children who were screened in random areas of Saudi Arabia was reported to be 13% of 10,000 children aged up to 15 years. ^[3] Approximately 1.5% of the children in Saudi Arabia were reported to suffer from either a unilateral or bilateral permanent sensorineural hearing loss. In a study on the incidence of congenital hearing impairment in the Saudi population a total of 11986 non-high-risk neonates were screened by transient evoked otoacoustic emission over a period of 8 years. ^[4] The incidence of sensorineural hearing loss was estimated to be 0.18%, with no significant difference between males and females. In a cross-sectional study of 2,574 children aged 4-8 years, 45 children were diagnosed with hearing impairment, with an overall prevalence of 1.75%. ^[5]

Information About Audiology

History

The field of audiology is relatively new in Saudi Arabia. It is thought that the audiological history of Saudi Arabia goes back to the 1980s, when the first audiology and speech-language pathology program was established at King Saud University.

Education

The first audiology and speech-language pathology program were established at King Saud University about 30 years ago, whereas the Saudi Society of Speech-Language Pathology and Audiology (SSSPA) was officially established in 2003 (SSSPA, 2014). The idea of establishing new audiology and speech-language pathology programs in some educational facilities has become popular across Saudi Arabia; yet, only four undergraduate and graduate programs are currently available. At present, Saudi universities offer three undergraduate programs and only one graduate program in audiology and/or speech-language pathology, of which two are governmental and one is private. King Saud University offers a combined undergraduate program (i.e., a dual degree program) in speech and hearing rehabilitation for male and female students. Princess Nourah Bint Abdulrahman University provides two separate undergraduate programs in audiology and speech-language pathology for female students. Dar Al-Hekma University offers undergraduate and graduate programs in speech-language pathology for female students (SSSPA, 2014).

Audiology Practice: Public and Private

Most audiologists practicing in Saudi Arabia are Saudi citizens with different levels of experience. Audiologists, who are mainly working in government hospitals as full-time workers, serve different numbers of geriatric and pediatric patients on a daily basis. However, the main government hospitals, rehabilitation centers, and schools in Saudi Arabia only hire a few graduated audiologists. There are several reasons, but the lack of understanding of the professional services provided by audiologists and the complexity of recruitment policies and procedures are the main ones.

Services Offered by Otolaryngologists, Otologists and Otoneurologists

Ear-related services provided by ENT doctors in Saudi Arabia include diagnosis and medical and surgical treatment of ear pathologies and balance disorders of all ages, from common conditions to some of the most complex medical cases. Cochlear implants and bone-anchored hearing aids have become among the most common surgical procedures in Saudi Arabia. Other common procedures, such as the placement of ventilation tubes, tympanoplasty, mastoidectomy, and hearing reconstruction with prosthetic ossicles, are also conducted in the main hospitals. The other hearing-related service provided by nurses is the hearing screening of newborns. Nurses are mainly responsible for performing newborn hearing screenings in hospitals that have the newborn hearing screening program.

Audiological Services

Audiologists practicing in Saudi Arabia provide several audiological services. A summary of audiology services was provided by Alanazi in 2017. ^[6]

Professionals

There is no available data about the number of licensed audiologists or other hearing health-related practicing specialists (e.g., speech-language pathologists) in Saudi Arabia. The Saudi Commission for Health Specialties (SCHS), which conducts licensure examinations for native and foreign diplomats and foreign nationals before they may practice in Saudi Arabia and ensures quality of care, should announce these numbers.

Professional and Regulatory Bodies

The Ministry of Education supervises and regulates all academic programs, including audiology programs, at all universities. Moreover, it accredits all foreign qualifications in audiology and other academic fields. SCHS conducts licensure examinations for native and foreign diplomats and nationals before they may practice in Saudi Arabia. The Saudi Society of Speech-Language Pathology and Audiology (SSSPA) works to develop the audiology profession by connecting audiologists with each other and with other professionals, providing scientific advice in the field of audiology, encouraging theoretical and clinical scientific research, and facilitating the exchange of scientific production and scientific ideas in the interests of association between relevant bodies and organizations within and outside Saudi Arabia.

Scope of Practice and Licensing

An undergraduate degree in audiology is mandatory to practice audiology in Saudi Arabia. Before graduation, audiology students must complete a 12-month (or a 6-month internship if the program is combined) supervised internship in audiology clinics. After graduation, audiologists must be licensed by SCHS to practice in Saudi Arabia.

Challenges, Opportunities and Notes

Challenges

The current undergraduate programs are not enough to cover the high demand for audiology services in Saudi Arabia. Trained audiologists will be increasingly needed to meet the demands of the community. More undergraduate and graduate programs must be established. The efforts aiming to establish academic programs in Saudi Arabia may encounter a number of obstacles, such as the complexity of regulations and a shortage of faculty with research and academic degrees. Further, there are other challenges, one of which is the national accreditation of the clinical doctorate programs (i.e., Doctor of Audiology [Au.D.] programs). The Ministry of Education in Saudi Arabia accredits Au.D. degree as a bachelor's degree. The Au.D. degree should be equivalent to at least a master’s degree for a person who already has an undergraduate degree. The profession of audiology is still in its infancy in Saudi Arabia. Cooperation among a diverse group of stakeholders, including SSSPA, SCHS, current audiology academic program directors and faculty members, the Ministry of Health, the Ministry of Education, and the King Salman Center for Disability Research, should be started and supported to achieve better education and practice and encourage research.

References

↑ Olusanya, Bolajoko O. (2012-07). "Neonatal hearing screening and intervention in resource-limited settings: an overview". Archives of Disease in Childhood 97 (7): 654–659. doi:10.1136/archdischild-2012-301786. ISSN 1468-2044. PMID 22611062. https://pubmed.ncbi.nlm.nih.gov/22611062.
↑ Bafaqeeh, S. A.; Zakzouk, S. M.; al Muhaimeid, H.; Essa, A. (1994-04). "Relevant demographic factors and hearing impairment in Saudi children: epidemiological study". The Journal of Laryngology and Otology 108 (4): 294–298. doi:10.1017/s0022215100126581. ISSN 0022-2151. PMID 8182312. https://pubmed.ncbi.nlm.nih.gov/8182312.
↑ Al-Abduljawad, Khayria A; Zakzouk, Siraj M (2003-10). "The prevalence of sensorineural hearing loss among Saudi children". International Congress Series 1240: 199–204. doi:10.1016/S0531-5131(03)00913-0. https://linkinghub.elsevier.com/retrieve/pii/S0531513103009130.
↑ Habib, H.S.; Abdelgaffar, H. (2005-06). "Neonatal hearing screening with transient evoked otoacoustic emissions in Western Saudi Arabia". International Journal of Pediatric Otorhinolaryngology 69 (6): 839–842. doi:10.1016/j.ijporl.2005.01.018. https://linkinghub.elsevier.com/retrieve/pii/S0165587605000595.
↑ Al-Rowaily, Mohammed A.; AlFayez, Abdulrhman I.; AlJomiey, Mohammed S.; AlBadr, Adil M.; Abolfotouh, Mostafa A. (2012-11). "Hearing impairments among Saudi preschool children". International Journal of Pediatric Otorhinolaryngology 76 (11): 1674–1677. doi:10.1016/j.ijporl.2012.08.004. https://linkinghub.elsevier.com/retrieve/pii/S016558761200448X.
↑ Alanazi, Ahmad A. (2017). "Audiology and speech-language pathology practice in Saudi Arabia". International Journal of Health Sciences 11 (5): 43–55. ISSN 1658-3639. PMID 29114194. PMC 5669511. https://pubmed.ncbi.nlm.nih.gov/29114194.

		Contributor to the original text
Ahmad A. Alanazi

Edited in part by Joyce Rodvie Sagun

[1] Olusanya, Bolajoko O. (2012-07). "Neonatal hearing screening and intervention in resource-limited settings: an overview". Archives of Disease in Childhood 97 (7): 654–659. doi:10.1136/archdischild-2012-301786. ISSN 1468-2044. PMID 22611062. https://pubmed.ncbi.nlm.nih.gov/22611062.

[2] Bafaqeeh, S. A.; Zakzouk, S. M.; al Muhaimeid, H.; Essa, A. (1994-04). "Relevant demographic factors and hearing impairment in Saudi children: epidemiological study". The Journal of Laryngology and Otology 108 (4): 294–298. doi:10.1017/s0022215100126581. ISSN 0022-2151. PMID 8182312. https://pubmed.ncbi.nlm.nih.gov/8182312.

[3] Al-Abduljawad, Khayria A; Zakzouk, Siraj M (2003-10). "The prevalence of sensorineural hearing loss among Saudi children". International Congress Series 1240: 199–204. doi:10.1016/S0531-5131(03)00913-0. https://linkinghub.elsevier.com/retrieve/pii/S0531513103009130.

[4] Habib, H.S.; Abdelgaffar, H. (2005-06). "Neonatal hearing screening with transient evoked otoacoustic emissions in Western Saudi Arabia". International Journal of Pediatric Otorhinolaryngology 69 (6): 839–842. doi:10.1016/j.ijporl.2005.01.018. https://linkinghub.elsevier.com/retrieve/pii/S0165587605000595.

[5] Al-Rowaily, Mohammed A.; AlFayez, Abdulrhman I.; AlJomiey, Mohammed S.; AlBadr, Adil M.; Abolfotouh, Mostafa A. (2012-11). "Hearing impairments among Saudi preschool children". International Journal of Pediatric Otorhinolaryngology 76 (11): 1674–1677. doi:10.1016/j.ijporl.2012.08.004. https://linkinghub.elsevier.com/retrieve/pii/S016558761200448X.

[6] Alanazi, Ahmad A. (2017). "Audiology and speech-language pathology practice in Saudi Arabia". International Journal of Health Sciences 11 (5): 43–55. ISSN 1658-3639. PMID 29114194. PMC 5669511. https://pubmed.ncbi.nlm.nih.gov/29114194.

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