With around 20 per cent of indigenous children experiencing hearing loss – as high as 50 per cent in remote communities – increased access to audiologists and other allied health professionals is imperative for improved long term outcomes.

“Hearing loss caused by middle ear disorder is very common in the indigenous community,” says Hearing Assessment Program Manager for Hearing Australia, Michelle Clapin.

“Otitis Media (infection of the middle ear) is the most common childhood illness for all children,” she says.

“However, our First Nation children are more likely to have their first bout of otitis media at a younger age - often only two months, and are more likely to develop chronic otitis media.”

Otitis media blocks the middle ear, as well as sound from reaching the inner ear, causing hearing loss as a result. If the infection can be treated and cleared, the hearing can return to normal. 

“Good hearing in the first years of life is essential for children’s learning and development,” says Ms Clapin.

“Hearing loss can delay their ability to learn to talk and prevent children from interacting appropriately with other children and family members.  Even if their hearing returns to normal levels, the language and learning delays may remain. 

“Often children with hearing loss are seen as being naughty because they don’t respond appropriately when spoken to.  They will have difficulty keeping up at school, and are at high risk of absenteeism and not completing their schooling. 

“If we are to prevent these other problems we need to identify and overcome the problem early in life.”

Unfortunately, there are multiple barriers making diagnosis, and subsequent treatment, difficult within indigenous communities.

“Children under three can’t do the same hearing test as older kids and adults - they need a special test that is more like a game,” says Ms Clapin.

“Right now, you have to see an audiologist to have this test. 

“Accessing audiologists has been an issue for indigenous communities - not just remote communities but also in the cities.”

However, new training has been developed to enable primary health workers to conduct the initial checks, meaning only children with identified problems would need to be sent to an audiologist.

Hearing Australia’s HAPEE program was developed with Aboriginal Community Controlled Health Services representatives along with key people from the Aboriginal and Torres Strait Islander hearing health sector.

The program uses world leading hearing screening resources developed by the National Acoustic Laboratories (NAL), along with research division of Hearing Australia, to identify hearing problems earlier in young
Aboriginal and Torres Strait Islander children.

Parent-evaluated Listening and Understanding Measure (PLUM) and the Hearing and Talking Scale (HATS) have been developed in collaboration with Aboriginal health and early education services

As well as providing free diagnostic assessments, HAPEE aims to upskill and support primary care providers, early education staff, and parents and carers with the ability to identify, manage and monitor potential hearing loss in young children.

“The new PLUM and HATS tools are great because they can tell the health workers which little kids are likely to have hearing loss,” says Ms Clapin.

“Communities can decrease their reliance on audiologists if their local health staff are able to do the initial checks - HAPEE staff can support local health staff in developing these skills. 

“We are also finding that a lot of the children need to be assessed by a Speech Pathologist - sometimes accessing a Speech Pathologist can also be difficult.”

Another barrier contributing to diagnosis prevention is the fact that there are often no visible signs of an ear problem.

“In the past lots of kids had discharge from their ears, but we are not seeing that so much now, so it is not immediately noticeable to parents or health workers.

“We want to make everyone aware that this is an invisible problem so that they don’t wait for symptoms before organising a check.”

Increasing the numbers of trained local Indigenous staff, with the skills to conduct initial screens, would provide communities with more control over their own care, improving short and long term health outcomes.

“Now that we are all getting used to doing things by teleservice, the HAPEE audiologist and the local health worker can collaborate to provide virtual assessments - this way we could do the tests when it suits the community, not just when the audiologist is able to visit,” says Ms Clapin.

“Left untreated, children can experience delayed speech, language and communication skills. 

“If kids start school with speech and language delays, they will find it hard to keep up with their schoolwork. 

“If they also have hearing loss, they can’t hear what the teacher is saying and will fall further behind. 

“These things mean that the kids are more likely to disengage with school or that they become disruptive. 

“And if the kids then drop out of school early that affects their ability to get work when they are adults. 

“So, identifying hearing loss early can have a big positive impact on kids’ lives.”