Exploring teacher knowledge and attitudes towards the inclusion of children with hearing impairment in mainstream education- A systematic review

Introduction: Mainstreaming education is considered one of the most effective approaches to including children with hearing impairment (CWHI) in regular classrooms. The success of such inclusion in mainstream education depends on teachers' attitudes and knowledge towards hearing loss and inclusion. It was thus felt essential to document and understand the teachers' attitudes and knowledge towards the inclusion of CWHI in mainstream education. Method: Systematic review was carried out to identify studies related to the teachers' attitudes and knowledge towards the inclusion of CWHI in mainstreaming education using PubMed, Scopus and Cochrane databases. The inclusion criteria included studies conducted in school teachers (both primary and secondary) using questionnaires to explore their knowledge and attitudes towards inclusion of CWHI in mainstream classrooms, published in English up to March 2024. The review followed the guidelines outlined in the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement. Results: 366 articles were identified, and after screening, only seven studies were included in the present review that met the criteria. All seven studies reported positive attitudes among teachers towards the inclusion of hearing-impaired students in regular classrooms. Strategies such as modifying the teachers' working environment, providing training, and installing schools with assistive listening systems were found to eliminate the negative attitudes. Conclusion: Both positive and negative attitudes persist among teachers towards the inclusion of children with hearing impairment in mainstream education. While there is overwhelming support for the inclusion of CWHI in mainstream classrooms, teachers' reluctance is mainly related to insufficient training and resources to meet the needs of these children.