HL can be a substantial barrier to education and social integration. Early identification and intervention for HL can provide important benefits because hearing is critical for learning oral communication, as well as academic and social participation . The current findings revealed that both fathers and mothers possessed a relatively high level of knowledge in relation to the statement “babies can be born with HL”, followed by the statement “head trauma can cause HL”, but possessed the least knowledge in relation to the statement “jaundice can cause HL”, followed by the statement “low birth weight <1500 g can cause HL.” A previous study by Ravi et al. reported that knowledge of risk factors among participants was higher in relation to the statement “prolonged noise can cause HL”, while participants possessed poor knowledge regarding the statement “drugs/medication can cause HL.”  In contrast, a study of knowledge on SNHL by Kaspar and colleagues revealed that participants had better knowledge about “noise exposure” and “family history”, but poor knowledge regarding the statement “jaundice can cause HL”, followed by “delayed crying at birth can cause HL.”  In contrast, Sanju and colleagues reported that, among a sample of surveyed nurses, 70% were aware of the “harmful effect of noise on hearing to infant” while most were not aware of the consequences of “hyperbilirubinemia on infants hearing.”  The aspects of knowledge about risk factors of HL highlighted in previous studies differed from the results in the current study. Moreover, the current findings suggest differences in participants’ knowledge regarding HL, compared with previous studies. There are no similar studies done in the region regarding this topic which may contribute to these discrepancies may have also been caused by differences in the culture and believes among the people in Saudi Arabia.
Moreover, questions about the knowledge of parents regarding OM in the current study revealed that both fathers and mothers possessed a relatively high level of knowledge in relation to the statement that “ear discharge and OM can cause HL”, whereas questions about the identification and intervention of HL and revealed a high level of knowledge in relation to the statement “children with HL can attend school.” These findings are consistent with those of previous studies conducted in India and Solomon Island [4, 5]. Moreover, a low level of knowledge in relation to the statement “treatment for hearing loss is available” was also highlighted in both studies.
Regarding the attitudes and practices of parents in relation to childhood audiology services, parents typically expressed positive attitudes in relation to the statement “I would like my child tested at school” followed by “more information about the service.” This finding conflicts with the results of previous studies in India and Solomon island [5, 14], but further confirmed the positive attitudes of parents toward childhood audiology services. In contrast, Sanju and colleagues reported that 40% of surveyed nurses expressed negative attitudes in relation to the statement “HL can be identified soon after birth”, and 88% of nurses were unaware that some children with hearing impairments can still hear and speak .
The current study also examined the overall knowledge and attitudes of parents toward childhood HL, revealing that 103 parents (42.4%) possessed good knowledge, while 140 parents (57.6%) possessed poor knowledge. However, 224 parents (92.2%) expressed positive attitudes toward childhood audiology services, with only 19 parents (07.8%) expressing negative attitudes. To our knowledge, this is the first study to calculate the overall prevalence of knowledge and attitudes toward childhood HL in Saudi Arabia. Overall, our findings revealed that most participants possessed poor knowledge regarding childhood HL, although most expressed positive attitudes and practices regarding the hearing tests and audiology services.
Moreover, we also measured the relationship between knowledge, attitudes, and socio-demographic characteristics of parents, revealing a significant relationship between age group and knowledge level as we have found out that people above the age of 40 years old have good knowledge towards children hearing loss in comparison to those who are below the age of 40 years old. To our knowledge, this is the first study to report this association.