Teleaudiology for Infant Diagnostic Assessments: Audiologists' Views on Challenges and Opportunities in a Well-Established Screening Program

PURPOSE: Universal newborn hearing screening allows early identification of hearing loss; however, some families face difficulties accessing diagnostic audiology. This study aimed to investigate audiologists' opinions regarding implementing a teleaudiology infant diagnostic audiology service in Victoria, Australia, a region where traditional access barriers persist despite high follow-up rates. METHOD: Nine experienced infant diagnostic audiologists participated in three focus groups. Prompt questions, based on the Capability, Opportunity, Motivation-Behaviour model of behavior change, explored clinician-identified barriers and facilitators to teleaudiology implementation. Thematic analysis was used to analyze audiologists' opinions of the proposed model. RESULTS: Audiologists identified that teleaudiology infant diagnostic services may introduce a barrier trade-off; while teleaudiology had the capacity to reduce barriers to service access for some families, it may introduce additional challenges compared to in-person testing. Three main barriers or areas of concern regarding a teleaudiology model of infant diagnostic services were identified: communication and support concerns, risk of error, and financial and motivational concerns. Participants proposed a training model, where experienced clinicians could support and upskill less experienced audiologists acting as in-person facilitators of the service, to address both service delivery and workforce development needs. CONCLUSIONS: A teleaudiology model of infant diagnostic assessments in Victoria has the potential to improve accessibility if facilitator training, effective family communication, and resource management are prioritized to ensure service quality is not impacted. A proposed training model offers a novel approach to use teleaudiology to maintain service access, as well as improve workforce experience in underserviced areas.