Promoting ear health for all Australians

I always knew that I wanted a job where I could help people. I got into audiology to become a part of a team in improving the ear health of Indigenous people. I wanted to be of value and benefit to other Indigenous people, their families and their communities. I too had grown up with middle ear issues as a child and had grommets; this was definitely an impetus for me getting into audiology.

Hearing loss and ear disease is highly prevalent in Indigenous children. Seventy per cent of Indigenous children between the ages of 0-14 throughout Australia are identified as having ear disease or hearing concerns. The most common ear disease among Indigenous children is Otitis Media (OM). OM is the inflammation and/or infection of the middle ear caused by viruses and/or bacteria. In Indigenous children, OM often begins within weeks of birth, occurs repeatedly, and can persist well into adolescence and beyond. It is typically managed medically with antibiotics or for more severe cases, with surgical intervention such as grommets. OM can have lasting implications to the health and wellbeing of Indigenous children. Ear disease and hearing loss are significant factors in poor educational attainment, greater unemployment and, can lead to delinquency and increased contact with the criminal justice system.

I work for Australian Hearing, a Commonwealth Government Department, and have done so for the last two-and- a-half years. I find the work both exciting and challenging. Australian Hearing provides rehabilitative audiology services to Indigenous and non-Indigenous children and young adults under the age of 26 years, and to older, eligible adults.

There are generally two types of hearing aids available to children, standard air conduction hearing aids and bone conduction hearing aids. Bone conduction aids are the ones we are very familiar with, that sit behind the ear. Bone conduction hearing aids are often used for hearing losses arising from hearing issues in the middle ear. These are often used with children with persistent OM to aid communication.

There is a known age differential in the age of initial hearing aid fitting between Indigenous and non- Indigenous children.

Non-Indigenous children are fitted at an earlier age, typically within the first couple of years of life however Indigenous children, despite more prevalent hearing concerns, are generally fitted at early school age. This discrepancy is due to issues accessing diagnostic hearing services in many rural and remote communities and the fact that many hearing programs commence at school meaning that earlier diagnoses is missed. One of our aims when we are out on outreach trips is to make contact with families of children aged 0-4 years to make earlier diagnoses of hearing loss, and to provide earlier prevention and treatment.

I am lucky enough to have the opportunity to travel to provide hearing services to children and adults in rural and remote Aboriginal communities on outreach trips. I am incredibly passionate about providing these services. It’s a very humbling experience and a privilege to be a part of people’s hearing journey. Hearing and good communication are of innate importance throughout all aspects of people’s lives. However, we often overlook the significance of hearing in a person’s life, health, wellbeing and self-esteem. Often, hearing is not considered important until there is a problem or it has gone. I want to change that outlook to ‘hearing matters’, which is the catch-phrase of the national Hearing Awareness week held annually in August.

Image: Ethan, 3 years old from Mornington Island

This reminds me of a young girl we fitted a bone conduction hearing aid to in north-western Queensland. She had a moderate conductive hearing loss in both ears and was having difficulties at school. She was behind in class and was extremely shy when we first met her. We tested her hearing and were able to fit a bone conduction aid at that initial meeting due to the severity and type of hearing loss. As soon as we switched the device on we could see the spark in her eye and she went from having her head bowed down to being held high and quite proud in her stance. Immediately we knew that she was able to hear well and that the hearing device was doing her justice. She felt confident in her ability to be able to hear again. This is ultimately what I attempt to get my clients feeling again. Hearing is about confidence and self-determination. By enabling our clients to have better hearing and providing tactics to overcome hearing deficits, we really are arming people with confidence, self-esteem and empowering them to create their best selves.

My hope for Indigenous ear health is for us to be able to tackle early prevention more effectively and for there to be more Indigenous audiologists. There are currently only a handful of Indigenous audiologists in Australia. I believe that Indigenous audiologists are in a unique position to offer a different perspective to ear health to create an inclusive approach whilst breaking down service and audiological barriers. We must inspire and lead our young generation of Indigenous health professionals, whilst also promoting audiology as a possible career opportunity.

For parents out there, the take-home message is to have an awareness of hearing and ear health in Indigenous children so that if there are concerns, they are identified early. From awareness comes knowledge and responsibility to be able to act in the child’s best interest. Whilst there has been some initial progress in Indigenous ear health there is still a long way to go to close the gap between Indigenous and non-Indigenous children. I am committed in my role as an audiologist to do all that I can do to achieve this.

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