Amplification Outcomes: What determines the success of fitting amplification to Aboriginal and Torres Strait Islander children with persistent otitis media?

Project goals and methodology

Aboriginal and Torres Strait Islander children have a high rate of ongoing ear problems, known as persistent otitis media (pOM), which can cause a mild to moderate hearing loss. These ear problems often start within the first few months of life and can affect a child’s listening and communication skills development.

Referral for Ear Nose and Throat (ENT) specialist care is often recommended to manage the ear condition. However, access to ENT specialist care is difficult across the country involving complex referral pathways and long wait times. ENT surgery is not always possible or appropriate and for many children the middle ear condition returns after surgery.

The Otitis Media Guidelines for Aboriginal and Torres Strait Islander Children recommend referral for hearing aid(s) if surgery is likely to be delayed for longer than six months, unavailable or unsuccessful, and there is a mild or greater hearing loss for longer than three months. Hearing Australia (HA) provides hearing aids and hearing rehabilitation services to Aboriginal and Torres Strait Islander children with hearing loss related to pOM through the hearing rehabilitation (Community Service Obligation) program. However, there was a lack of evidence around the outcomes of these fittings and the factors that influence outcomes.

Our aim was to explore the outcomes or benefits of hearing aids provided for pOM to Aboriginal and Torres Strait children by Hearing Australia and to make recommendations to improve service provision.

We acknowledge that, for many children and their families, getting the best use out of hearing devices is made more difficult by factors such as limited access to in-person Hearing Australia services and funded early speech/language support services.

We undertook this project with the guidance of the NAL Aboriginal and Torres Strait Islander Research Leadership Group, Hearing Australia collaborators, and with ethical approval from Aboriginal Health Research Ethics committees across the country.

Key findings

Currently, there are limited tools available, appropriate for Aboriginal and Torres Strait Islander children with persistent OM-related hearing loss, that help audiologists understand the benefits of rehabilitative hearing services, including the fitting of hearing aids. Therefore, we looked for evidence of whether children were using their hearing aids as an indication that the child is benefitting from the hearing aid.

We found that a child is more likely to use their hearing aid, if the child has:

• – Hearing loss in both ears
• – Very poor hearing in one ear (even if hearing in the other ear is normal)
• – Parent or carer accompanying them to the hearing appointment

We found that a child is less likely to use their hearing aid, if:

• – There is a longer interval between the hearing aid fitting and the next appointment.
• – Hearing aid is fitted at school without the attendance of a parent or carer.