https://orcid.org/0000-0002-1588-5599
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ABSTRACT
Ear infection or otitis media (OM) occurs in many Aboriginal and Torres Strait Islander children at a young age and tends to persist over a long period of time. Chronic OM is associated with conductive hearing loss that reduces a child’s access to sounds. This can have a negative impact on development of listening and communication skills. Primary health and early childhood workers are best positioned to detect children with hearing and listening problems. However, they lack appropriate tools to screen and triage young children for early referral. By using a co-design approach with Aboriginal primary health workers and early childhood teachers, we have developed the Parents’ Evaluation of Listening and Understanding Measure (PLUM) listening skills questionnaire. The PLUM provides a systematic framework for front-line workers to explore a parent’s observations of their child’s listening behaviour in everyday situations to detect hearing and listening problems in young Aboriginal children. This paper reports the development of the scale. PLUM scores for 438 children from urban, regional and remote communities in Australia were collected. The internal consistency reliability was 0.87. Normative data from 235 children with normal hearing (hearing thresholds averaged between 0.5 and 4 kHz in the better ear to be no greater than 20 dB HL) were used to define the relationship between PLUM scores and age. The functions allow performance of individual children to be related to their normal-hearing peers.
Acknowledgement
We acknowledge the traditional owners of the land on which the reported work was conducted, and pay our respects to Elders past, present and emerging. The authors wish to thank the children and families that participated in this study. We thank all the clinicians of the Hearing Assessment Program and Outreach services in Hearing Australia for their assistance with this study. We also thank Michele Clapin, leader of the Hearing Assessment Program, for her support for this study. We are grateful to Caroline Jones, Eugenie Collyer, Chantelle Khamchuang, and Jaidine Fejo for their contributions to the co-design workshops, data collection, and filming of a training video. We are grateful to all the healthcare workers and early education carers and teachers from Tharawal Aboriginal Corporation in Sydney, Wurli-Wurlinjang and Binjari Aboriginal in Katherine, and Birra-Li Aboriginal Maternal and Child Health Service in Newcastle who contributed to this study through participation in co-design workshops and data collection. We thank all the staff at Hunter ENT for providing a location and for supporting the filming of a training video for the PLUM and HATS tools. This research was funded by the Prime Minister and Cabinet Grant and the Health Discretionary Fund of the Department of Health in Australia.
Disclosure statement
No potential conflict of interest was reported by the author(s).
Notes on contributors
Teresa Y. C. Ching, PhD, heads the Communication Sciences Department at the National Acoustic Laboratories, Australia. She leads research on (re)habilitation of hearing loss in children. Her current research includes methods for fitting hearing-aids, measuring benefits of hearing-aids and cochlear implants, identifying factors influencing outcomes of children with hearing loss, and devising electrophysiological and behavioural methods for predicting candidacy for cochlear implants in infants, children and adults. Recent research focuses on co-production of methods for early detection and intervention for hearing and communication problems in Aboriginal and Torres Strait Islander children. Teresa is particularly interested in the translation of research results to manufacturers and service-providers.
Sanna Hou is a research audiologist working at the National Acoustic Laboratories. She completed a Master in Clinical Audiology at Macquarie University in 2000. She worked as a clinical audiologist in Hearing Australia for more than ten years and has a strong clinical experience in hearing assessment, device fitting and rehabilitation for adult and children with hearing loss. As a family audiologist, she counselled patients about hearing health and the possible need for treatment and management. Currently, she is involved in hearing loss research studies with a focus on the longitudinal outcomes of children with hearing loss, the impact of children with unilateral hearing loss, the hearing and listening abilities of Aboriginal and Torres Strait Islander children and the evaluation of bimodal hearing in adults that use hearing aids together with cochlear implants.
Mark Seeto has been a statistician at National Acoustic Laboratories since 2009, having previously worked as a clinical audiologist at Hearing Australia.
Samantha Harkus is based in Sydney and lives on Gadigal land. She completed a Masters of Public Health specialising in Aboriginal health and wellbeing at the University of New South Wales in 2018 and has degrees from Macquarie University including a Postgraduate Diploma (Audiology) and a Bachelor of Arts (Psychology). Sam is currently Principal Audiologist, Aboriginal & Torres Strait Islander Services at Hearing Australia. Sam’s clinical experience has been in the area of paediatric and complex adult rehabilitative services, and feels privileged to have worked with urban, regional and remote Aboriginal & Torres Strait Islander communities in different parts of the country. Sam is involved in research that focusses on tools and pathways that lead to equity of access to and uptake of hearing health services for Aboriginal and Torres Strait Islander children and adults.
Meagan Ward is an audiologist who has specialised in paediatric habilitation, working with newly diagnosed infants and their families, providing ongoing audiological care through to the children’s young adulthood. Her clinical practice entails working closely with early intervention agencies and schools. She has worked extensively in urban, regional and remote Aboriginal communities. Currently she is involved in promoting the early diagnosis of otitis media in Aboriginal and Torres Strait Islander children by enabling families, primary health and early educators to be able to identify young children at risk with the aim to reducing the impact of ear disease.
Vivienne Marnane is a researcher in the Communication Sciences Department at the National Acoustic Laboratories, located on Wattamattagal land in Sydney. She has Bachelor of Applied Science (Speech Pathology) and Master of Epidemiology qualifications. Since 2007 she has been involved in research primarily investigating the impact of early identification and intervention, and the factors that affect short and long term outcomes for paediatric populations with hearing loss. She is passionate about research that empowers and drives real world impact, whether it be at the individual level or at a policy level.
Kelvin Kong, BSc, MBBS(UNSW), FRACS, hails from the Worimi people of Port Stephens, NSW, Australia. He completed his Bachelor of Medicine, Bachelor of Surgery at the University of NSW in 1999 and began his surgical training at St. Vincent’s Hospital in Darlinghurst, completing resident medical officer and registrar positions at various Hospitals in NSW. Along the way, he has been privileged in serving the urban, rural and remote community. Kelvin qualified as the first Aboriginal Fellow of the Royal Australasian College of Surgeons (RACS), in 2007, now practising on Awabakal Country in Newcastle. He feels lucky to have a very broad practice in ORL, including community clinics, primary health care, outreach, a private practice and a commitment to research. He has also been humbled to partake and serve in various roles with a variety of government, NGO’s and private sector groups. His pride and strength is his family.