More than one third – 35% – of young Aboriginal and Torres Strait Islander children experience fluctuating ear disease where otitis media changes over time, new clinical findings from Hearing Australia reveal.
Analysis of data from the HAPEE1 program also found that 8% have persistent ear trouble.
Hearing Australia, which runs the government funded Hearing Assessment Program – Early Ears or HAPEE program, released the new figures in the lead up to NAIDOC Week next week (6-13 July 2025).
It has run HAPEE since 2019, providing services to more than 10,000 First Nations children aged 0-6 every year.
More than 26% of children assessed are found to have undiagnosed ear disease and one-in-five have undiagnosed hearing loss.
Hearing Australia is calling for urgent action to detect and treat ear disease early, giving children the best start in speech, learning and social development before school.
Yorta Yorta woman Ms Kirralee Cross, partnership specialist at Hearing Australia, said otitis media in Aboriginal and Torres Strait Islander children remained among the highest globally.2
“It can often start in early infancy without any obvious symptoms which is why regular ear health checks are important,” she said.
“Middle ear infections can impact a child’s hearing over time and their ability to develop important listening, speech and language skills. Our findings are a powerful reminder that the fight against preventable hearing loss must remain a national priority, especially in a child’s early years.”
Effective checklist to detect hearing problems
To support early detection, a new study3 from the National Acoustic Laboratories (NAL), the research division of Hearing Australia, showed the effectiveness of a free and easy to use five-minute checklist
The PLUM (Parent-evaluated Listening and Understanding Measure) tool was developed in 2018 by NAL with Aboriginal health and early childhood services from urban and remote communities to help identify serious hearing issues.
NAL analysed more than 15,000 hearing appointments of First Nations children under seven, many of whom were seen through the HAPEE program.
It found PLUM to be 91% accurate in identifying children’s longer-term hearing status. The findings also showed:
- 82% of children with significant otitis media-related hearing loss lasting for three or more months received a ‘not yet on track’ result – a clear sign they needed ear health and hearing support.
- Children flagged as ‘not yet on track’ were 46 times more likely to have significant, sustained hearing loss than if they received an ‘on track’ result, underscoring the need for urgent follow-up.
“These findings from NAL are valuable as they show the PLUM tool identifies children who are both likely – and not likely – to have long term ear health and hearing trouble,” Cross said.
“This will help health practitioners to know when to give reassurance to families and when prompt action is needed to reduce the impact of otitis media.”
Hearing Australia said it was working with local communities and healthcare providers to prioritise regular ear health checks – and use tools like PLUM to help detect common, often-overlooked hearing issues that can lead to serious developmental delays.
“We’re proud to work with more than 400 health organisations across the country, and close to one-third are Aboriginal Community Controlled Health Organisations,” Cross said.
“We’re tailoring our support and coordinating services with Ear, Nose and Throat specialists where possible so that children can get the help they need.”
Ms Lorna Watson, CEO of the Australian Society of Otolaryngology Head and Neck Surgery (ASOHNS) said that working with Hearing Australia, GPs, Aboriginal health practitioners and audiologists, ENT specialists could focus on children with ear health issues needing surgery.
“Every health check is an opportunity to screen ear health, as early identification has an impact on hearing, speech and language,” she said.
Checks recommended six monthly
Experts recommend that young Aboriginal and Torres Strait Islander children have ear health checks every six months.4 But Hearing Australia said checks were often prompted by parents or caregivers.
“Identifying hearing problems shouldn’t fall solely on families. Often there are no signs of ear trouble which is why it’s important that ear health checks are a routine part of care,” Cross said.
“Through the HAPEE program, our team has supported the upskilling of more than 1,000 health workers in hearing health. It means that more kids can be screened regularly and those who are identified as having a possible hearing problem can then be prioritised and seen by an audiologist.”
Outreach Worker and Care Coordinator at Karadi Aboriginal Corporation, Ms Maree Marney, said her training in ear and hearing health including the use of the PLUM tool, had transformed her community’s approach to managing hearing health.
“We’ve implemented a new approach at Karadi: hosting community-based, impromptu screenings two weeks prior to the scheduled visits from Hearing Australia audiologists,” she said. “This proactive strategy allows us to triage clients more effectively and identify any concerns early, ensuring better outcomes for our community.”
Mr Kim Terrell, Hearing Australia managing director said: “We’re fortunate to have the support of many incredible partners who share our commitment to prevent long-term ear disease and hearing loss among First Nations children. The HAPEE program and tools like PLUM are critical to ensure children get the help they need.”
Hearing Australia is striving to halve the rate of hearing loss in Aboriginal and Torres Strait Islander children by 2029.
“We’re working with communities and local services to build primary health workforces across Australia,” Terrell said. “Our hope is that more First Nations children with ear health problems will be identified and connected with support early, so that ear trouble doesn’t stop them from learning and thriving.”
REFERENCES
- The HAPEE Program
- World report on hearing. World Health Organization, 2021.
- S Harkus, M Ward, J Nash, J Gavrillis, J Monaghan, I O’Keeffe, L Campbell, T Rankmore, L Austin, V Marnane, M Clapin, V Easwar.(2025) PLUM in practice: supporting early detection of significant, longer-term OM-related hearing loss in young Aboriginal and Torres Strait Islander children.[Unpublished manuscript] Communication Sciences, National Acoustic Laboratories.
- S Harkus, V Marnane, I O’Keeffe, C Kung, M Ward, N Orr, J Skinner, K Kong, L Fonua, M Kennedy and M Belfrage, Med J Aust 2023; 219 (8): 386-392. || doi: 10.5694/mja2.52100. Routine ear health and hearing checks for Aboriginal and Torres Strait Islander children aged under 6 years attending primary care: a national consensus statement
