Audiologist JANETTE BRAZEL discusses a pilot program to build capacity and confidence in audiometry skills for Aboriginal Health Workers in Indigenous Communities and train them in their Certificate IV in Audiometry.
Middle ear disease is a chronic condition in First Nations people and there is often a lack of access to services, particularly in regional and remote areas. Otitis media occurs much earlier in infancy for Indigenous children (often the first occasion being in the first 12 months of life), than in non-Indigenous children. When left untreated, chronic otitis media can affect every aspect of the child’s life including hearing loss, education and future employment outcomes. These ongoing problems can affect quality of life, over the person’s lifespan.
In 2023 a consensus statement evolving from the Routine ear health and hearing checks for Aboriginal and Torres Strait Islander children aged under 6 years attending primary care: a national consensus statement, an extension to the existing guidelines, was recommended to include the following: “Undertake checks at least six-monthly, commencing at six months until four years of age, then at five years. Undertake checks more frequently in high risk settings for children under two years, when acceptable to families, or in response to parent/carer concerns”.
Last December in the Australian Government web report Ear and hearing health of Aboriginal and Torres Strait Islander people 2024, the following statistics were reported:
- The prevalence of hearing loss among First Nations people is high, with 43% of those aged seven and over having measured hearing loss in one ear (20%) or both ears (23%) in 2018–2019.
- Among First Nations people assessed as having moderate to profound hearing loss, fewer than half (47%) reported having long-term hearing loss.
Training clinicians from Community
One possible way to address these statistics of high, and often untreated occasions of hearing loss, is to train more hearing health clinicians, particularly from Community. With that thought in mind, two teachers from the Australasian College of Audiometry (AuCA) developed a pilot program to train a group of Aboriginal Health Workers in gaining their Certificate IV in Audiometry.
Several prospective students from regional NSW coastal areas, working in Aboriginal Medical Services and Community Health organisations, were approached to take part in this program. Eight students signed up for the course with most having had some experience in ear health and with working and/or training with the teachers, audiologists Janette and Eliza Brazel, in other programs.
The students’ work environment as Aboriginal Health Workers includes assisting children, families and Elders from their communities. The Certificate IV in Audiometry includes assessing adults and screening the hearing of children aged four years and older (as outlined in the government training package HLT47415). Early identification of hearing loss in children is critical to learning language, speech and stories from their community.
The more regional and remote hearing assessors we have on the ground able to test children’s hearing (and adults’) is vital in identifying hearing health issues.
Interactive training
The training program is highly interactive, with two online tutorials per week, regular face-to-face workshops and clinical practicum settings, as well as yarning opportunities with other students and their trainers. This experiential teaching model is one I have used before in my long history of teaching audiometry students. I believe early opportunities with hands-on equipment and placing students in real-life clinical settings, from the start of their training, is important to gaining confidence in using audiometric skills. Building trust is also important when building confidence in students, to ensure they excel in their studies.
The program began in February 2025 and so far students have had the opportunity to visit schools for hearing screening days, as well as testing adult clients in clinic and community settings. The aim is to have the students complete the program over 12 months and then use their hearing assessment skills in their roles as Aboriginal Health Workers, to build capacity for ongoing hearing services in much needed areas.
About the Author: Janette Brazel is a NSW audiologist on the Australasian College of Audiometry (AuCA) teaching panel. She has had a varied audiological career working across public and private institutions for almost four decades. For much of it she has worked as a teacher/trainer/supervisor for students of audiometry, audiology and occupational health. Her main passion has been working with Indigenous communities to improve access to hearing services and build capacity for health workers in audiometric skills. She is a board member of ACAud Inc. HAASA and works for a local community health service.
