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New Sound Scouts App Improves Access to Hearing Tests for Children

Posted by Colin Klupiec on April 21, 2016 at 3:10 PM

Carolyn-Mee-854099-edited.jpgCarolyn Mee is an edtech entrepreneur who wants to change the way children get screened for hearing loss.

She has a background in media, and a strong desire to improve learning outcomes for children.

She’s developed an app called Sound Scouts. It has been developed in collaboration with National Acoustic Laboratories, a research division of Australian Hearing.

The app is a gamified test that invites children to take part in a story. Along the way, their hearing is tested.

Carolyn’s work with Sound Scouts has the potential to radically improve detection rates of hearing loss. This will help to provide intervention more quickly and lead to better learning.

It’s a serious undertaking, backed by scientific research and ongoing development.

Listen to Carloyn share her journey with Sound Scouts in this episode of the Learning Capacity podcast.

Topics covered

  1. Hearing test/screening
  2. Auditory processing disorders

People & organisations mentioned

  1.  Sound Scouts
  2. Simon Townsend's Wonder World
  3. Jason Donovan
  4. Guy Pierce
  5. Professor Kelvin Kong
  6. Jonathan Coleman
  7. National Acoustic Laboratories
  8. Australian Hearing
  9. Dr. Harvey Dillon
  10. New South Wales Health Minister, Jillian Skinner

Previous podcast episodes on SoundCloud

If you would like to read the complete podcast transcript, here it is:

 Episode 51 of The Learning Capacity Podcast

EdTech entrepreneur Carolyn Mee improves hearing test access for children with Sound Scouts app.

Colin Klupiec: Carolyn, welcome to the conversation.

Carolyn Mee: Thank you. Great to be here.

Colin: It's really great to do this interview with you in person, because, for the benefit of our listener, people might not know this but I'm actually sitting with someone who has worked with Australian television media history. You've worked on Simon Townsend's Wonder World

Carolyn: I did indeed, many years ago. I was a presenter on the show.

Colin: Stop right there. Did you ever meet Woodrow?

Carolyn: I did. I did, yes. 

Colin: Man, I always liked Woodrow, Woodrow was always funny. Woodrow, for our listeners who aren't familiar with Simon Townsend's Wonder World, it was a children's current affairs variety show.

Carolyn: Magazine style.

Colin: Yeah, magazine style show and there's Simon Townsend presenting with his mascot Woodrow the bloodhound, a real dog, on set. And occasionally, Simon would have to do a bit of clean up work because Woodrow had a drooling problem. I remember a couple of episodes where Woodrow just said, "Look, enough with the cameras, enough with the lights, I'm out of here," and just walked off.

Carolyn: And walked off set. What do they say? Never work with animals.

Colin: Or children, that's right. 

Carolyn: We loved the challenge of both.

Colin: So you would've got to meet famous people too?

Carolyn: I most definitely did meet some very famous people. Perhaps they weren't so famous then, but they're certainly very famous now. In fact, we were just talking about the challenges of doing many jobs. And I was doing a shoot with Jason Donovan and Guy Pierce.

Colin: Jason Donovan

Carolyn: And, yes, the boys were absolutely fantastic and were happy to film in the spirit of the day. But we worked with a lean team and it was the cameraman, sound recorder, and myself. And I was talking to Guy and Jason and they were like, "Where's the rest of the team? Where's hair and makeup?" And I said, "I'm it."

We decided to do a Beatles style, catch me if you can. And I went into this square in Melbourne, this was years ago, and said, "Okay," I grabbed ten girls and said, "Can you chase us when we run?" And of course, within minutes, the ten girls multiplied and we had hundreds of girls chasing Jason and Guy. And we had to do a very sneaky exit to get them out in one piece. 

Colin: So from Jason Donovan and Guy Pierce, now we're talking about Sound Scouts and that seems to be quite an interesting journey. But as I was thinking about the Simon Townsend's Wonder World connection, in the work that I do, in podcasting and interviewing people, I get to wear headphones a lot.

And I talk into microphones and so forth. And that made me think about my own history and having my hearing tested. And I started to wonder, and I could be way off here, but I started to wonder, you must have been in that environment too. I suspect you've worn headphones more than once. Did that media environment get you thinking about hearing, or what's going on in the mind? Is there some sort of connection there?

Carolyn: How did I transition into this space? I actually did some study in 2010, looking at new media. And at the time, I was looking for a project to develop. And I heard about Australia's first indigenous surgeon, his name's Associate Professor Kelvin Kong. And I...that spurred me on to think about the challenges that sit around hearing testing, and hearing testing lots of children.

I have three children, and my two youngest boys both needed to have hearing tests because of challenges they had with learning to read. And so when I put all those pieces together, and I was studying new media and the area of gaming came up, serious gaming, it came together and it seemed a logical flow to create a game that could test for hearing loss.

Colin: Actually there is another Simon Townsend's Wonder World connection here. For our listeners who are unfamiliar with the program, Jonathan Coleman was also a presenter on the show. And I do remember an episode where he was testing smell. Perhaps in the same way that you're investigating hearing, I'm drawing a long bow here again, but hey, this is show biz.

And he developed what was called the Nostophone. So he put a small lavaliere microphone against his nose, and then he went around smelling different foods. He would look into the camera and say, "Can you smell this coming through your television? Are you getting this?" I'm not sure how far he went down that path insofar as the science is concerned, but you've come a long way down the path with Sound Scouts.

Now just briefly, I just wanna check this. Sound Scouts is an app based game that tests hearing. It's a short test, it's about 15 minutes. And it gives an idea as to whether there's some sort of hearing loss. Is that right?

Carolyn: Absolutely, that's right. When the game's played well, and the parents supervise play, then we can also determine what kind of hearing loss there is. So principally, there are three types of hearing...let's call them hearing issues. You've got sensory neural loss, which is nerve damage.

You've got conductive loss, which is a blockage in the ear. And then you've got auditory processing disorders, which are brain-based hearing issues. And when the game's played well, we can discriminate between those conditions.

Colin: Alright. I'll actually come to the game itself in a little more detail in a moment. But thinking as far as education is concerned, this fits right into what we call the educational technology, or in modern language, the edtech space. Or edutech, as some people say. Now I think there'd be many people out there saying, "Well this is great because technology has matured to the point where we can actually do this kind of thing in the home."

Some people thinking, "Great. Education is now available to us online," etc., etc., and, "I can buy apps from the app store that help me do stuff." But some people might also be asking the question about efficacy and reliability. And I think that would be one of the big questions that people would have. "Okay, I'm going to download this app, I'm gonna put some headphones on my kid.

And I'm going to watch them do this, and it's gonna tell me that there's hearing loss." Presumably, you've done a lot of work in trying to get that right from a scientific point of view. Can you talk us through your approach to that?

Carolyn: So to start with, to ensure that I was creating something that would be scientifically valid, I partnered with the National Acoustic Laboratories that now, as they're known, are the research arm of Australian Hearing. So it was very important for me to know that I was working with the best scientists in the business and that whatever we created was clinically valid.

So I've been working with Dr. Harvey Dillon, a director of NAL, to ensure that Sound Scouts is as reliable as possible.

Colin: So it's not a backyard project?

Carolyn: It's definitely not a backyard project. 

Colin: Well, that's good to know.

Carolyn: Yes, indeed. There is a lot of research and development that's gone into Sound Scouts. It's been in the pipeline for over...close to five years. We've built a prototype, tested the premise with the prototype, and then we've just improved it. Iterated, as they say. Tested again, made changes, and fine-tuned to the point where all the data and the science says that it's doing what it should do.

So for example, we would take a version into a kindergarten class. And we would also go in with an audiologist. So the children would play Sound Scouts, and they would have their hearing tested by the audiologist. And we then look at and compare the results.

Colin: Okay. Alright. Testing for hearing as you've just mentioned in a lab, that's a fairly controlled environment. Well, it's a highly controlled environment. I've had my hearing tested in a hearing lab and you go into a little booth and its sound proof. And it's very, very quiet in there. Testing in the home though is a different situation. And I'm curious, how have you allowed for environmental variation?

And what I mean by that is, we're doing this interview now in an office, and there are people around us. We can hear people through walls and so forth, and that might be even picked up on the mics here today. You say on your website that you need to be in a quiet part of the house. How can you control for the variations, and what people might think is quiet enough?

Carolyn: That's a great question. And before I answer it, I'm going to just preface it with saying that while labs, certainly sound proof rooms, are controlled spaces, they control the sound but they don't control the emotion of the child. And a child being in a foreign environment can also have an impact on the child's results.

So just putting that aside what we do with Sound Scouts is we use something called a signal to noise ratio. So we take a measure of the signal or the target sound against a background noise. So that allows us to deal with variable headphones and variable background noises because it's a relative measure.

I mean, like all hearing tests, you do have to be in a quiet space for them to work or to have any relevance. But ambient background noise is something that the game can deal with.

Colin: And you mentioned variance in headphones as well. I use several headphones for the work that I do. And I like listening to music, so I like a nice pair of headphones. There is incredible variation across those, and you find that you've been able to cope with that as well? 

Carolyn: Absolutely. Again, the signal to noise ratio that we're measuring, which is our key measuring tool, means that we don't have to worry about the nuances in headphones. We do say that you can't use gaming headphones.

Anything that interferes with the audio tracks, that have been processed or engineered, will disrupt the testing mechanisms, so it's...we don't need fancy headphones. Nice, good, reliable pair of headphones is what we recommend. 

Colin: Is enough. So they don't have to be expensive? 

Carolyn: No, absolutely not.

Colin: Well, that's good news. Now something that really fascinates me, and I've been thinking about this prior to our interview, is that presumably you've been collecting data for a few years now. So about five years?

Carolyn: Yes.

Colin: I'm curious, the data...well, sorry. It says on your website that you get a report straight away, but that something also gets emailed to you in terms of how the app has processed the results. You must be collecting a very wide range of data. Are you seeing any patterns? 

Carolyn: At this early stage, probably not so much seeing patterns. I suspect the people that are coming to Sound Scouts, at this point there is...the parents suspect a hearing issue. So I am seeing quite a few fails come through, but I think when there comes a time when we implement a universal screening and see all children tested to ensure that they don't have undetected loss, I don't think the rates will be as high as the rates I'm seeing come through at the moment. 

Colin: Okay. So are you allowing that feedback to go back into the product development as well, to test it even better all the time?

Carolyn: Every single thing that we learn in every test that's done, we're looking at the results. So throughout the testing process and the trial and research development phase, everything we've learned we've put back into the game and fine-tuned, and tried to build in every different variation that you can imagine. So for example, if the children tap the screen too many times, we actually count all those taps.

And there's a point where the gameplay becomes invalid because the child's tapping too many times. So we've tried to I guess factor in as many variables as possible, so the results we're getting at the end of the day are a valid test of the child's hearing.

So when I'm seeing results come through from testing out in the wild, for want of a better term, I'm also looking at those results and analysing them and making sure that there's nothing unusual that we haven't factored in through the course of development.

Colin: Gamification and this might seem like...or this question might seem to have an obvious answer. Kids love to play games, but why specifically a game based test rather than just a straight test?

Carolyn: Hearing testing, I think, can be notoriously boring. Dare I say?

Colin: But we love audiologists. 

Carolyn: We do, we do, absolutely. And the important thing with hearing testing is to get enough information, enough data points. So if you can bury those data points in a fun game then you're much more likely to retain the attention of the child and get good quality data throughout the entire test, rather than just valid, good responses at the beginning.

So the game is...it's a narrative based game. And so the children very much become absorbed in the narrative and want to know what's happened and how it plays out. So that drives their engagement. And we find that almost all children play and are concentrating to the end of the game.

Colin: And 15 minutes is enough? 

Carolyn: It is. It was funny. When I started developing Sound Scouts, people were like, "Oh, that's so long," and, "The children won't play for that long." I have personally sat with over 1000 children. And I can tell you there has been no issue with those children remaining focused. And a lot of them get to the end and say, "Can I do it again?"

Colin: Yeah, well, okay. So school use, let's move into a school environment. Let's say testing a child's hearing is a tricky issue for parents. Maybe they don't want to address that, maybe there's something that makes them feel uncomfortable about that. I can see from the app store that you have volume pricing for the app.

So you download the app to your device, and then you can pay for the number of tests that you want to do. As soon as I saw that, I thought, "Well, there's obviously a scale for schools." Are you using it in schools?

Carolyn: We've had some interest, some early interest from schools. And we're certainly hoping and looking towards building those relationships with different schools. It's definitely an area where we can see Sound Scouts being very appropriately applied. In all the testing I've done, I'll go into the schools and I'll ask the teachers, "Is there anyone you'd like me to test first?"

And they can pin point the children that they think may have a problem. And nine times out of ten, they're spot on. Because those children are often disruptive. Having hearing loss impacts a child's ability to concentrate in the classroom. And you've got to understand that these little children, they're concentrating really hard to try and overcome this hearing loss.

But there's a point where fatigue sets in and then they lose concentration and they become disruptive. That's something that impacts not only the child, the teacher but the entire classroom. So certainly the importance of picking up children with hearing loss within a school environment is paramount.

And that's what we've targeted, really. The statistics from Australian Hearing show that while a certain number of children are picked up at birth through the newborn hearing test, which is absolutely fantastic, by age eight, three times those number of children have been fitted with hearing aids.

Colin: Is that right?

Carolyn: Exactly. So those children are being found to have a hearing loss after they start school when they start to do badly at school.

Colin: Yeah. When it's almost too late, really.

Carolyn: Well the problem is many may get found. But by the time they're found to have a loss, then they've had one, two, possibly even three years of struggle. And that struggle can undermine their self-esteem, and obviously, delay their learning. And it takes a long time to recover from the loss of those very, very formative learning years.

Colin: So in general, the feedback you get from teachers when you approach them is very positive I would imagine?

Carolyn: Very positive. They're very interested to get more information about the children that do have a problem, they want to discount hearing issues as the cause for the child's problem. And yes, they're very supportive. For teachers, the pain point is often with them.

Because they're trying to manage those children on all fronts, trying to manage their struggle to learn, without being able to hear, and then trying to manage the classroom with the children that then become disruptive because it's hard for them to engage.

Colin: Well if you think about it, it really is the invisible problem, isn't it? It's something that you can't see. If you can't see it, you're generally not going to think about it very much. When someone says it could be a hearing problem, you think, "Oh, that's too hard to test.

That means I've got to go somewhere, and I've got to sit in a booth, and I've gotta..." It's complicated. Whereas this shortcuts all of those problems, potentially. Have you had much contact with school administrators about this, or just directly with the teachers?

Carolyn: So at this stage, we've being very much focused on getting the science right with Sound Scouts. Now the science is right, and we launched at the end of January with the New South Wales Health Minister, Jillian Skinner. And so we're slowly, now, reaching out to schools, and preschools, and GPs, and working to make as many people aware of Sound Scouts as possible.

As you say, there's a lot of obstacles for parents in getting their children's hearing checked through traditional means. They've got to take time off work, they've got to wait sometimes six to eight weeks to get an appointment. And of course, there's the cost implications as well. So we've really focused on bringing...making the test more accessible, making that screening solution accessible so it can be done at home, it can be done on the weekend, it's cost effective.

And so the parents can take action. And then as a second pass, if the parents are unable to take action, then I think, yes, the schools are an appropriate second stage.

Colin: So with some of the problems you mentioned earlier were about actual loss of hearing, in other words, "I can't hear," but auditory processing disorder is not quite like that because you can hear but the brain has trouble with what to do with what it hears.

So it doesn't really know quite what to do, and there's a delay in how a child might perceive what its hearing. That prompted me to wonder if there was also an application here for Sound Scouts to screen for attention. Have you given that some thought? 

Carolyn: We've focused very heavily on ensuring that it's testing for hearing issues, but there are cases when you can see that the children do lose attention. And when you've got such a large test base, you know that the vast majority of children can focus for that required 15 to 18 minutes of time. So we've got population norms there that establish that it is completely within the realms of a five-year-old child's attention spectrum to get this game done and play it.

As a screening tool, Sound Scouts has certainly been developed to point towards hearing issues. But if the child fails, and then it's not attributed to hearing loss, my thoughts would be that the parents need to look further to determine what it is, and if it is...there is an underlying attention issue. Because the evidence says that most children can pass this and play this game effectively. So I hope that's making sense.

Colin: No, what I'm hearing is you've got enough attempts at the program now to show that, by and large, children can complete this over a period of 15 minutes, even if perhaps they don't find it that interesting.

So that if a child bugs out after five, six, seven, or eight minutes, then clearly there's an issue with them. Either there's something that they're hearing that is upsetting them, or they just think it's boring, or they simply can't attend which is a flag to then saying, "Maybe we need you look at something else."

Carolyn: I think that's a reasonably good summation. Definitely, if the child is not able to finish the program, it would suggest that there is something not quite right. It is targeted at five to seven-year-olds, the story is set to five to seven-year-olds.

I've seen a lot children playing it up to 14 years, and there's no reason why they can't also get a valid result from it. But if a five to seven-year-old is struggling to get through it, then it would be an indication that something else may be wrong.

Colin: You mentioned up to 14 years, that's approaching year seven and eight level. So are we still getting reliable results at that junior high school level?

Carolyn: An adult can play Sound Scouts and get a valid hearing test result.

Colin: So it's completely indiscriminate of age? Anyone can do it?

Carolyn: Anyone can do it. I guess the engagement is best in the younger years because the children get...

Colin: Are you suggesting that I might find the story boring?

Carolyn: Oh, the characters are so cute, you won't find it boring. It'd be like watching a kids cartoon versus watching a sophisticated adult program.

Colin: You've got to remember I used to watch Simon Townsend's Wonder World every day after school. Every day. So it's quite likely that I'll get through the 15 minutes. So this is an encouragement to our older listeners. Have a go of Sound Scouts. You might find yourself pleasantly surprised by the story, and you might find out what you're...well, you might have lost a bit of hearing. "What was that, dear? Come again?"

So okay, so there's a broad range of application. So I guess you could use that then as a targeted thing, just coming back again to the high school situation. Any teacher then could say, "Well, look, I've got a year nine class where that kid over there, I'm just not sure if I'm getting through." And you could say, "How about we just give him a lesson where you say, 'Hey, try this, see what you think of it.'"

So that's very interesting. Now in the edtech space, I'm going to ask you a very big and broad question. Because you are in the start up edtech space, and I love that. Specifically for what you're doing in helping people with their hearing because it's a very important thing. What's next? Is there anything on the horizon?

Carolyn: For me or generally?

Colin: For Sound Scouts, for you? You're a hearing entrepreneur.

Carolyn: Indeed. Certainly, and following on from the conversation about adults and adolescents, we're certainly looking to build specific versions of Sound Scouts for the different age groups.

Colin: Okay, so specialisation.

Carolyn: Indeed, yes. And what works for children, or for five-year-olds, definitely does need to be tweaked and fine-tuned for adults. I've watched adults play games, and this win at all costs, "I must win." And the thing with a hearing game is you get to a point where you actually can't hear any lower than your hearing threshold.

That's the lowest point at which you can hear. Whereas children, I guess, may be slightly oblivious to that they'll just push on. Adults are still trying to win and...so the game will need to be slightly modified to be more effective for adults. And we're across that. 

Colin: Straight away I can see a corporate application here, that you can test your corporate executive's hearing. You need to go and search for the missing millions. So immediately there's an adult story there. 

Carolyn: That's right. And maybe a reward if they find it.

Colin: "If you find the missing millions..." That's great. Carolyn, it's been an absolute inspiration to talk to you. I wish you all the very best. Thanks so much for joining us. 

Carolyn: Thank you, Colin. It's been my pleasure.

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