Ear and hearing health of Aboriginal and Torres Strait Islander people 2025

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

During the 2023–24 financial year, 10,935 ear health checks and hearing tests were provided to 8,279 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 15.4 per 1,000 population among those under 1 year old (369 children), to a peak of 108.6 per 1,000 population among 4-year-olds (2,297 children). The rate of First Nations children receiving an ear health check or hearing test then fell to 63.3 per 1,000 among 5-year-olds (1,341 children) (Figure SCREENING 12). 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 (3,495), Queensland (2,116) and the Northern Territory (1,158) (Figure SCREENING 13). Across states and territories, the rate of First Nations children who had an ear health check or hearing test through the HAPEE in 2023–24 was highest in the Northern Territory at 144.1 per 1,000 population and lowest at 9.1 per 1,000 population in South Australia and 16.1 per 1,000 population in the Australian Capital Territory (Figure SCREENING 13).

Children with hearing loss

Overview

In 2023–24, 21.9% of First Nations children (996 children) aged under 6 who had a hearing test through the HAPEE were found to have some hearing loss. Of those tested 19.3% (877 children) had mild hearing loss, and 2.6% of those tested (119 children) had moderate, severe or profound hearing loss (Data table 2.4.2a).

Age

For First Nations children aged under 6 who had a hearing test, the proportion of children with some form of hearing loss increased with age. The proportions of children with hearing loss were: 10.6% for children aged 1 or under (15 children),18% for 2-year-olds (76 children), 21.4% for 3-year-olds (271 children), 22.7% for 4-year-olds (381 children), and 24.6% for 5-year-olds (253 children) (Figure SCREENING 14).

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 and the Australian Capital Territory), the proportion with hearing loss ranged from 11.3% in Tasmania (15 children) and 13.6% in New South Wales (259 children) to 37.6% in Western Australia (112 children) and 41.2% in the Northern Territory (245 children).

Among First Nations children who had a hearing test through the HAPEE, moderate or more severe hearing loss was diagnosed in 1.7% of children in New South Wales (33 children), compared with 4.4% in the Northern Territory (26 children), and 5.7% in Western Australia (17 children) (Figure SCREENING 15).