Summary

Ear and hearing health is vital for overall health and quality of life. Ear disease and associated hearing loss can have long-lasting impacts on education, wellbeing and employment.

Aboriginal and Torres Strait Islander children are more likely than non-Indigenous children to experience ear and hearing problems. A number of factors contribute to the poorer ear and hearing health of Indigenous children, including lack of access to health services, household overcrowding and second-hand smoke exposure.

Since 2012, the Australian Government has funded the Northern Territory Government to deliver hearing health outreach services to Indigenous children and young people aged under 21 in the Northern Territory—mainly through the National Partnership on Northern Territory Remote Aboriginal Investment (for children aged under 16); and through the Healthy Ears—Better Hearing, Better Listening Program. These outreach services include audiology services, ear, nose and throat (ENT) Teleotology services, and Clinical Nurse Specialist (CNS) services.

This report presents new data for hearing health outreach services provided in 2021, and includes time trends for the period July 2012 to December 2021.

How many children received services?

  • In 2021, 125 training sessions for hearing health education, promotion and prevention activities were provided to health-care staff.
  • A total of 1,987 Indigenous children and young people received at least 1 audiology, Clinical Nurse Specialist (CNS), or ear, nose and throat (ENT) teleotology service in 2021. From July 2012 to December 2021, a total of 37,804 services were provided to more than 9,500 children and young people.
  • In 2021, 2,290 outreach audiology services were provided to 1,979 Indigenous children and young people. From July 2012 to December 2021, a total of 20,851 services were provided to a total of 9,401 children and young people.
  • 703 ENT teleotology services were provided to 635 Indigenous children and young people in 2021. From July 2012 to December 2021, a total of 8,245 services were provided to a total of 4,144 children and young people.
  • In 2021, CNSs conducted 1,139 visits to 1,018 children. From July 2012 to December 2021, a total of 8,708 services were provided to a total of 5,572 Indigenous children.

Figure 1: Number of Indigenous children and young people who received audiology, CNS or ENT teleotology service in 2021

The infographic shows that in 2021, 1,979 children and young people received audiology services, 1,018 received CNS services and 635 received ENT teleotology services.

Source: Tables S2. 1, S2.3, S2.5

Hearing health is improving among children and young people who received outreach services between 2012 and 2021.

The percentage of Indigenous children and young people with at least 1 ear condition decreased by 10 percentage points, from 66% (483 of 727 children and young people) to 56% (1,113 of 1,987 children and young people).

Among children and young people who received audiology services, the proportion with hearing loss decreased by 16 percentage points, from 55% (388 of 710 children and young people) to 39% (776 of 1,979 children and young people).

Figure 2: Ear and hearing health improvements between 2012 and 2021

The infographic shows that, between 2012 and 2021, the proportion of children with at least 1 hearing conditions decreased from 66%25 to 56%25. In the same time period, the proportion of children and young people with hearing loss decreased from 55%25 to 39%25.

Sources: Tables S3.1 and S3.6

Among 4,334 Indigenous children and young people who received at least 2 audiology services between 2012 and 2021, 3,063 had hearing loss at their first service, and of those, 1,943 (63%) had improved—this is a change from bilateral to unilateral hearing loss or from unilateral hearing loss to no hearing loss.

Between 2012 and 2021, among 1,944 Indigenous children who received at least 2 audiology services and had hearing impairment at their first service, 1,414 (73%) had improved—moving to a lower degree of hearing impairment or to no hearing impairment.

Many children and young people are still waiting for hearing health services

At December 2021, there were 3,403 Indigenous children and young people on the audiology waiting list. Among them, 1,571 were new referrals and 1,832 were recalled for further follow-up after receiving an initial audiology service. There were 1,835 children and young people on the waiting list for ENT teleotology services. Among them, 1,190 were new referrals and 645 were recalled for further follow-up after receiving initial ENT teleotology services. Large number of new referrals may be the result of increased awareness of the importance of early detection of ear disease.

What was the impact of COVID-19?

Across audiology, CNS and ENT, the number of services received dropped slightly between 2019 and 2020. This was largely due to a decrease in services between March and April 2020, coinciding with the introduction of restrictions imposed to control the spread of COVID-19. The number of services increased again in 2021, especially between February and May 2021.

Figure 3: Number of services increased in 2021

The infographic shows that between 2020 and 2021, the number of services increased in all service types. In 2020, 2,010 audiology services were received by children and young people, compared to 2,290 in 2021. In 2020, 1,004 CNS services were received by children and young people, compared to 1,139 in 2021. In 2020, 701 ENT teleotology services were received by children and young people, compared to 703 in 2021.

Source: Tables S2.1, S2.3, S2.5

Is the Hearing Health Program meeting its benchmarks?

Health outcomes in this program are measured every 3 years (July 2012 – June 2015, July 2015 – December 2018 and January 2019 – December 2021). All benchmarks in the first 2 periods were met.  In 2021, all 3 service delivery targets were exceeded and the hearing impairment target was met. Of the 4 targets related to middle ear conditions, 2 targets –children aged 0–5 with chronic suppurative otitis media (CSOM) and 6–15 with chronic suppurative otitis media (CSOM) – were met.

Progress against benchmarks is presented in Table 1.

Table 1: Progress against benchmarks, 2021
Target Outcome

Service delivery targets

At least 1,700 audiology services per year

2,290 audiology services provided in 2021

At least 700 children receiving CNS services per year

1,018 children received CNS services in 2021

At least 60 hearing health promotion or training services/activities per year

125 hearing health promotion or training services and activities provided in 2021

Health outcome targets—hearing impairment

Less than 7.5% of children tested with moderate/severe conductive hearing impairment, Jan 2019– December 2021

2.6% of children tested with moderate/severe conductive hearing impairment, Jan 2019–Dec 2021

Health outcome targets—middle ear conditions

Less than 7% of children (0–5) with CSOM, Jan 2019– December2021

6.1% of children (0–5) with CSOM, Jan 2019–Dec 2021

Less than 7% of children (6–15) with CSOM, Jan 2019–December 2021

5% of children (6–15) with CSOM, Jan 2019–Dec 2021

Less than 5% of children (0–5) with dry perforation, Jan 2019– December 2021

6% of children (0–5) with dry perforation, Jan 2019–Dec 2021

Less than 9% of children (6–15) with dry perforation, Jan 2019– December 2021

13.1% of children (6–15) with dry perforation, Jan 2019–Dec 2021

CNS=Clinical Nurse Specialist; CSOM=chronic suppurative otitis media