Ear and hearing health of Aboriginal and Torres Strait Islander people 2024

The Hearing Assessment Program – Early Ears (HAPEE) is a preventive health program that provides free ear health checks and hearing tests for First Nations children aged 
 under 6 who do not yet attend full-time school. The HAPEE is an Australian Government program developed through a collaboration between Aboriginal Community Controlled Health Service representatives, the Department of Health and Aged Care, representatives from the First Nations hearing health sector and Hearing Australia (Hearing Australia 2021).

As part of the HAPEE:

• primary health care professionals do initial ear health checks, to identify children who need a hearing test
• Hearing Australia audiologists provide hearing tests to First Nations children aged under 6 found to be at risk of hearing loss. Hearing tests are provided at various locations such as Aboriginal Community Controlled Health Services, government clinics, other mainstream primary care clinics, and early childhood education centres.
• Hearing Australia will report back to the primary care clinic if further referrals are recommended, and other Australian Government programs may help families gain timely access to follow-up treatment, for example from ear nose and throat specialists, speech therapy and surgery.

HAPEE also provides training and support for primary health care professionals to do ear health checks, for in-service training for health and education staff, and for community talks to help parents and carers identify signs of hearing loss and maintain good hearing health in their children, manage and monitor potential hearing loss in young children (Hearing Australia n.d.).

Ear health checks and hearing tests

Overview

In Jan–Jun 2023, around 5,300 ear health checks and hearing tests were provided to 4,800 First Nations children aged under 6.

Age

The rate of ear health check or hearing test services to First Nations children increased with age from 19 per 1,000 population among those under 1 year old (around 225 children), to a peak of 147 per 1,000 population among 4-year-olds (1,600 children). The rate of First Nations children receiving an ear health check or hearing test then fell to 67 per 1,000 among 5-year-olds (around 710 children) (Figure SCREENING 14). Note, children can receive multiple HAPEE services within a year and are counted separately each time.

State and territory

Most HAPEE ear health checks or hearing tests were delivered in New South Wales (2,200), Queensland (1,500) and the Northern Territory (680) (Figure SCREENING 15). Across states and territories, the rate of First Nations children who had an ear health check or hearing test through the HAPEE in 2022–23 was highest in the Northern Territory at 155 per 1,000 population and lowest at 21 per 1,000 population in South Australia and 24 per 1,000 population in the Australian Capital Territory (Figure SCREENING 16).

Children with hearing loss

Overview

In 2022–23, nearly 19% of First Nations children aged under 6 who had a hearing test through the HAPEE were found to have some hearing loss. Nearly 17% of those tested (790 children) had mild hearing loss, and 2.3% of those tested (about 110) had moderate, severe or profound hearing loss (Data table 2.4.2a).

Age and sex

About 18% of First Nations boys and about 19% of First Nations girls aged under 6 who had a hearing test through the HAPEE were found to have some hearing loss (Data Table 2.4.2c). 

Among First Nations children aged under 6 who had a hearing test:

• 9.7% of children aged 1 or under were found to have hearing loss
• 17% of 2-year-olds, and 20% of 3- and 4-year-olds, were found to have hearing loss
• nearly 28% of 5-year-olds were found to have hearing loss (Figure SCREENING 17).

It is difficult to test very young children for hearing problems (Mount Sinai 2024). For 23% of First Nations children aged 2 and under who had a hearing test through the HAPEE, the testing was unable to determine whether the child had hearing loss.

State and territory

The proportion of First Nations children found to have some hearing loss after having a hearing test through the HAPEE varied across states and territories. Excluding states and territories with relatively small numbers of program participants (South Australia, Tasmania and the Australian Capital Territory), the proportion with hearing loss ranged from 13% in New South Wales to 34% in the Northern Territory.

Moderate or more severe hearing loss was diagnosed among 6.1% of First Nations children who had a hearing test through the HAPEE in the Northern Territory, compared with 1.2% in New South Wales (Figure SCREENING 18).