Hearing loss a serious issue

Many children who appear unresponsive and isolated or have difficulties learning language and speaking are actually suffering hearing loss that leads to entrenched disadvantage, according to Kelvin Kong, Australia’s first indigenous surgeon.

“If you’re not hearing, you can’t learn, you can’t hear the song lines, you can’t hear the stories, you can’t sing along, you can’t dance,” he said.

Ninety per cent of Aboriginal children in the Northern Territory under the age of three have ear disease, and most of them will experience hearing loss affecting early brain development, research shows.

Now a landmark public/private partnership between the Northern Territory and Australian governments and the Balnaves Foundation aims to tackle ear diseases among children in remote Territory communities.

Announced in August, Hearing for Learning is a five year program of the NT Government, founded on research by scientists at the Darwin-based Menzies School of Health Research.

The $7.9 million program will focus on employing and training community members to assist the diagnosis and treatment of ear disease and hearing problems, dove-tailing the Territory Government’s Local Decision Making policy to transition service delivery and decision-making to regional and local control.

The Menzies-run program aims to intervene early to reduce the need for fly-in-fly-out specialists and the time children wait to be diagnosed and treated.

The program is expected to reach 5000 children with a focus of those under three.

It will start at four remote sites and is expected to be rolled out to up to 20 communities, employing up to 40 Aboriginal Clinical Support Officers.

Those sites have not yet been identified.

Associate Professor Kong, the son of a Woromi woman in New South Wales who is co-leader of the program, said a key to the program’s success will be that it is community-based and driven by locals.

“We will be behind whatever the community needs,” said Associate Professor Kong, the head of ear, nose and throat surgery at John Hunter Hospital, University of Newcastle.

“Where we can guide is to say, well that doesn’t work so well, why don’t we try it this way? Let’s go back and forth until we get the balance right?,” he said.

Professor Amanda Leach, head of the Menzies’ Ear Health Research, who will co-lead the program, said otitis media, the medical term for middle ear infections, is difficult to detect as it is often painless.

“We are still learning how to help families identify family members suffering hearing loss,” she said. 

“People can easily misinterpret a child’s behaviour as being naughty when in fact they are suffering hearing loss.”

In remote NT communities children as young as one month have been found to have otitis media, a bacterial infection commonly known as bulging eardrum, glue ear or runny ear.

The longer the infection is left untreated the more risk it poses to hearing.

Experts say hygiene is vital to containing its cross infection and overcrowded housing and exposure to tobacco smoke increase the risk of cross infections.

There are vaccines to prevent particular strains of the bacteria.

And many otitis media episodes can be prevented by breastfeeding during the first six months of a baby’s life, although despite high rates of breastfeeding, early infections and ear disease can still occur, experts say.

Prevention strategies include reducing exposure to smoke and frequent washing of hands and faces.

Professor Leach said regular ear checks by local experts in their community will help detect infections, allowing them to be treated early.

Follow-up checks to ensure the ears are healthy and hearing will be critically important.

Professor Leach pointed to research showing that around 90 percent of people incarcerated in Northern Territory jails have hearing loss which may have influenced why they ended up there and made it difficult for them to communicate within the justice system.

She said chronic ear disease and associated hearing loss are the most prevalent barrier to being ready for school and in educating the Territory’s Aboriginal children.

“This early and persistent disease throughout childhood is depriving children the opportunity to learn, to have self-esteem and to reach their full potential,” Professor Leach said.