Sarah Fredj: “Every child with undetected hearing loss is a missed opportunity for development.”

More than 430 million people worldwide suffer from moderate or greater hearing loss, including 34 million children, according to the World Health Organization’s 2025 report. Up to 60% of childhood hearing loss cases are preventable with timely intervention. Despite the scope of the problem, children in North America are still frequently undiagnosed or misdiagnosed, affecting their cognitive, emotional, and social development.

What systemic solutions can change this status quo? We spoke with Sarah Fredj, a clinical audiologist based in Montreal, a member of OOAQ, and the founder of the Childhood Hearing Loss Awareness Project. In this interview, she shares the key reasons behind delayed diagnoses in children, her unique multidisciplinary approach to early detection, and how her project empowers schools and families to provide inclusive support and education for children with hearing loss.

 “I’ve seen too many children receive delayed diagnoses, with consequences that could have been avoided.”

– Sarah, you’re a clinical audiologist with over a decade of experience, a member of OOAQ, and the founder of a unique initiative — the Childhood Hearing Loss Awareness Project, which has the potential to transform national child hearing screening practices. What led you to create this initiative?

— In my clinical practice, I’ve encountered many cases where children with mild to moderate hearing loss were overlooked for far too long. Parents, teachers, and even doctors often misinterpret the signs of hearing difficulties as attention issues or behavioral challenges. This can lead to serious consequences for a child’s cognitive, emotional, and social development.

One case that stands out was a girl who had long been treated for recurring ear infections, but the real issue was a chronic hearing loss that significantly hindered her ability to learn and communicate. Cases like this continue to motivate me to change the system and develop tools for early detection, so children get the help they need before misunderstandings and misdiagnoses cause lasting harm. Each of these stories reminds me that behind the numbers and reports are real children, real futures, and real lives.

The desire to prevent such situations and support families from the earliest stages served as the primary impetus for the project. Drawing on over ten years of clinical experience in Quebec and international best practices, I have developed a comprehensive approach tailored to the North American context. This approach integrates medical, educational, and social elements and can be implemented in any school setting.

– Your project has already attracted attention from specialist media such as Healtheral and Gilmore Health News, which recognized it as both innovative and socially relevant. What do you think has made it stand out even before its official launch?

— The main factor is the urgency and relevance of the issue we’re addressing. Although childhood hearing loss has long remained overlooked, its consequences significantly affect learning and development. What we offer is a simple, accessible, human-centered solution that resonates with both parents and professionals.

Our proactive involvement with professional associations and educational communities, combined with my participation in volunteer and advocacy initiatives, has also fostered a sense of trust in the project. We’re not just calling for change; we’re offering a structured solution. The project follows a clear three-tier strategy: training school staff, integrating digital tools for monitoring and adaptation, and building a network of “multipliers” — specialists who can share knowledge and provide local support. This systemic model is what attracted media attention.

– You’ve drawn inspiration from international programs such as Hear Our Heart in Australia and NDCS initiatives in the UK, but adapted your project specifically for North America, especially the U.S. What were the main challenges in that process?

— The key challenge was maintaining clinical and academic rigor while accounting for cultural, linguistic, and institutional differences. The U.S. healthcare and education systems have unique features — from varied protocols and organizational structures to linguistic diversity.

To address this, I developed standardized yet flexible training modules and a digital platform that allows rapid adaptation across regions. We also tested the approach in schools with different socioeconomic profiles to ensure the model’s scalability and effectiveness. That helped us confirm its adaptability and maintain high-quality implementation and support.

“The real solution lies in uniting healthcare, education, and social support.”

– Your project blends medical, educational, and inclusive components — something not yet seen in major American child hearing initiatives. Why do you think this multidisciplinary approach has been so long overlooked?

— Hearing care has traditionally been limited to clinical settings, even though hearing loss affects all aspects of a child’s life, including academic performance, social interaction, and emotional well-being. Multidisciplinary collaboration requires professionals from diverse fields such as audiologists, educators, psychologists, and social workers. However, bureaucracy and the lack of integrated platforms often hinder the implementation of such cross-sector projects. My project removes these barriers by training teachers and engaging families, creating a comprehensive support system. I also provide practical tools for all stakeholders — from visual aids for teachers to home guides for parents.

– Among the tools you’ve developed are educational resources, adapted screening protocols, and inclusive learning methods. Which element do you see as the most groundbreaking?

— I see the inclusive education tools as especially transformative. They allow teachers and parents to understand the child’s needs without requiring complex medical language. This enables quick and effective adaptations in the classroom, even before an official diagnosis is made.

Thanks to these resources, teachers feel confident in taking action, and children feel supported. We’ve seen how even small changes — like adjusting a child’s seating or using visual instructions — can have immediate, positive effects.

– You’re building an interdisciplinary community of audiologists, educators, speech therapists, and psychologists, and you actively participate in volunteer work, training sessions, and mentorship programs. How important is this collaboration to your mission’s success?

— It’s crucial. Bringing together professionals from different fields allows us to address the issue holistically. Each expert contributes their perspective — audiologists handle diagnostics, educators focus on learning, and psychologists support emotional well-being. Real change occurs when all stakeholders—families, schools, healthcare providers, and communities—work together. Volunteering and mentorship also help share knowledge, build trust, and form strong support networks. They’re a key way to find and empower future project ambassadors — people who will carry the mission forward.

We’re also building a network of regional coordinators who act as local anchors. This ensures sustainable growth while maintaining quality during the scaling process.

 “A strategy must be grounded in the real needs of children and their families.”

– You not only develop the methodology but also personally implement training modules and adapt the project to specific schools and regions. How do you balance strategic leadership with hands-on work?

— For me, it’s essential that the strategy reflects real-world needs. That’s why I constantly contact educators, audiologists, and families, gathering feedback and refining our materials accordingly. The digital platform helps centralize training, making the program scalable without compromising quality.

We’ve already created a model suitable for over 100 schools and 100,000 students. At the same time, I remain involved in pilot projects to stay grounded and observe how the model performs in real-world settings.

– You focus mainly on socially vulnerable families, including single mothers and low-income households. How do you ensure the project is accessible and effective for them?

— We work with local community organizations already serving these families, provide free, easy-to-use materials, and hold events in familiar, welcoming spaces.

We also translate resources into relevant languages and adjust them for varying literacy levels, ensuring that every parent feels capable of navigating the situation.

 “Every child with undetected hearing loss is a lost opportunity for full development.”

– Your project is focused not only on diagnostics but also on inclusive education. Why was it so important to involve schools and teachers from the start?
— Teachers are often the first adults outside the home to notice signs of difficulty. They observe children daily and can detect subtle changes before a physician would. By engaging schools early on, we create an effective early detection mechanism that accelerates access to care and minimizes the long-term effects of hearing loss.

Schools become more than learning environments — they become gateways to support. That fundamentally changes children’s outcomes.

– You plan to publish the methodology and outcomes to contribute to the scientific and professional community. How important is academic validation for the success of social and medical initiatives like yours?

— Scientific rigor is a cornerstone — it strengthens our credibility with institutions, helps secure funding, and builds legitimacy. Publishing our results facilitates knowledge sharing, engagement in academic dialogue, and continuous improvement. It also lays the foundation for long-term systemic impact in both healthcare and education.

 “Social impact isn’t just about ideas — it’s about scale and sustainability.”

– Your project is now preparing for national scaling. What strategies are you using to ensure sustainability as you expand to new states and school districts?

— We’re developing standardized, easily adaptable training modules to launch programs quickly in new regions. We’re also building strong partnerships with local organizations to provide community-based support. Ongoing monitoring and feedback enable us to remain agile and responsive, essential for long-term sustainability.

– You’ve been recognized as a professional whose work serves the national interest of the U.S. (EB2-NIW visa category). In your view, what are the most important criteria for evaluating the social value of initiatives like yours?

— First, measurable outcomes are measured by how many children received support and how their academic or communication performance improved. Second, accessibility and ease of implementation — the model should work in both urban and rural settings. Third, scalability — the solution must be reproducible without loss of quality. These principles have been at the core of our approach from day one.

– Despite lacking commercial funding, your initiative has already gained support from schools, clinics, and professional associations. How did you build such a broad network of trust and collaboration?

— It results from a long professional journey and sustained community involvement. My engagement in volunteer, educational, and mentoring programs has helped establish strong partnerships and trust. People see that this project addresses real needs and delivers real results — and that’s the foundation of successful collaboration.

My ultimate goal is to ensure that every child with hearing loss can realize their potential and feel truly seen and heard. That’s what drives me forward and attracts more people to this mission.