NACCHO Aboriginal Health and #HearingAwarenessWeek A/Prof @KelvinKongENT is working to #closethegap in ear health for Aboriginal and Torres Strait Islander kids by finding better treatments and preventative approaches so kids are not limited by their hearing.

I aim to make a national profile of the problem of ear disease and hearing loss. It is an important issue for all Australian levels of government, policy makers and health service providers.

The severe impact imposed by hearing loss needs greater acknowledgement, especially in communities where a majority of people are affected, such as the Aboriginal and Torres Strait Islander communities.

We are also seeing too many children in our urban, regional and rural communities being affected and waiting too long for access to specialist care.

This is a health problem that costs our nation a great deal of money, not just in medical treatments but in the social cost of people not receiving enough education to get a good job and provide security for themselves and their families in the future.

Associate Professor Kelvin Kong : Read interview full BIO Part 2

Read over 40 Aboriginal Health and Ear Hearing articles published by NACCHO

 “ Up to nine in every ten Aboriginal and Torres Strait Islander children under the age of three in the Northern Territory, suffer from otitis media, or “glue ear”, in one or both ears. If left untreated this can have a devasting impact on a child’s entire life trajectory.

The Hearing for Learning Initiative will increase early detection of otitis media, by training local community members to become ear experts that support on the ground health and education services. This will decrease the need for fly-in fly-out specialists, reduce the treatment waiting period and create employment opportunities for up to 40 community-based workers in the Northern Territory. ” 

Download Menzies Press Release 

Media release Hearing for learning a focus on Bathurst Island

World Hearing Day was on 3 March 2020. The theme this year is “Don’t let hearing loss limit you”.

World Hearing Day coincides with Hearing Awareness Week in Australia (1 to 7 March).

This year’s theme is “Don’t let hearing loss limit you”. This theme highlights how timely and effective interventions can help people with hearing loss reach their full potential.

World Hearing Day coincides with Hearing Awareness Week in Australia (1 to 7 March).

Hearing loss in Australia

In Australia, almost 4 million people have some form of hearing loss. This continues to grow as our population ages.

The most common causes of hearing loss are:

  • age-related
  • excessive exposure to loud noise

Hearing loss caused by exposure to loud noise is preventable. The best interventions for hearing loss are early interventions, no matter how old you are.

If you or someone you know is worried about hearing loss, we encourage you to have your hearing checked.

The Healthdirect website provides more information on the signs of hearing loss and ways to help prevent hearing loss.

Hearing Services Program

The Australian Government is working to reduce hearing loss and the consequences of hearing loss in Australia.

The Government’s $581 million Hearing Services Program provides high quality hearing services and devices to some of our most vulnerable people.

In 2018-19, the program delivered services to over 785,000 clients, including:

  • older Australians
  • veterans
  • young children
  • Aboriginal and Torres Strait Islander people
  • people living in rural and remote areas

The Australian Government has also committed $4 million in funding for up to 600,000 free online hearing tests for children. Parents of children aged between four and 17 can visit the Sound Scouts website for more information.

Find out more about hearing and hearing loss on the Hearing Services Program website.

Part 2 Interview with Associate Professor Kelvin Kong

From HERE

Ear disease in Australian Indigenous populations is deplorable. I am working to closing the gap in ear health to bring all Indigenous Australian children to the same level of well-being and health care access as their non-Indigenous counterparts.

The rates of ear disease are higher for Aboriginal and Torres Strait Islander children across Australia, with some communities having 90% of young children affected. This causes hearing loss leading to massive disadvantage in early learning and development of language and social skills, which can have devastating repercussions throughout life.

Our Newcastle ear research team works to understand the pathophysiology of chronic ear disease in Australian Indigenous and non-Indigenous sufferers to understand the nature of ear infections and find better treatments and preventative approaches in early childhood.

Unfortunately, some babies will acquire infections within the first months of life and go on to have recurrent infections that impact upon their ability to hear and learn. Importantly missing on hearing the voices (and stories) of their family members at this vitally important period of early development.

I aim to make a national profile of the problem of ear disease and hearing loss. It is an important issue for all Australian levels of government, policy makers and health service providers.

The severe impact imposed by hearing loss needs greater acknowledgement, especially in communities where a majority of people are affected, such as the Aboriginal and Torres Strait Islander communities. We are also seeing too many children in our urban, regional and rural communities being affected and waiting too long for access to specialist care.

This is a health problem that costs our nation a great deal of money, not just in medical treatments but in the social cost of people not receiving enough education to get a good job and provide security for themselves and their families in the future.

The journey of solving the ear health issues must be community led and translated into models of care that have a holistic approach. Our research must also have capacity and ensure any solutions are sustainable.

 

Why did you get into research?

It was heartbreaking growing up in the Worimi community enduring the health disparities first hand. I have always had a passion to help address the inequality and have been lucky enough to be afforded the opportunities to allow me to complete the full circle and be a care giver.

As an ENT surgeon I have treated people all across Australia, including people in Newcastle (Awabakal country), with terrible states of ear disease.

The lack of access to health care and the escalation of a problem that should have been addressed long ago, is a driver to increase the momentum of a solution.

The impact of research into the causes and interventions, cannot be overestimated, so that young babies will not progress to the stage where surgery is desperately needed to restore some hearing so they can participate in a normal childhood and have aspirations and dreams not limited by their hearing.

What would be the ultimate goal for your research?

The ultimate goal is for all Australian children, both Indigenous and non-Indigenous, to have the same chance of having healthy ears, no matter where they reside in Australia.

We need everyone to have enough awareness of the problems, to put the time and resources into finding treatments and interventions, so that no child should expect to go through life suffering the loneliness, loss of self-esteem and lack of education that many children experience with ear disease and as adults in later life.

Biography

Kelvin graduated from the University of NSW in 1999. He embarked on his internship at St. Vincent’s Hospital in Darlinghurst and pursued a surgical career, completing resident medical officer and registrar positions at various attachments. Along the way, he has been privileged in serving the urban, rural and remote communities.

He was awarded his fellowship with the Royal Australasian College of Surgeons in 2007. Once completed he pursued further training in Paediatric ENT surgery, being grateful and honored by his fellowship at The Royal Children’s Hospital, Melbourne in 2007-8. He is now practising in Newcastle (Awabakal Country) as a Surgeon specializing in Paediatric & Adult Otolaryngology, Head & Neck Surgery (Ear, Nose & Throat Surgery).

He has joined an outstanding group of surgeons at Hunter ENT and together they provide a varied comprehensive practice. He has a very broad adult and paediatric Otology, Rhinology and Laryngology practice, whilst having special interests in Paediatric Airway, Adult and Paediatric Cochlear Implantation, Voice and Swallow disorders and Head & Neck Cancer management.

He is an active member of RACS and ASOHNS, serving on the Indigenous Health and Fellowship Services Committees. He has published articles and presented on a variety of ear, nose and throat conditions as well as Indigenous health issues both nationally and internationally.  He is active in reviewing articles for publication, lecturing and teaching allied health professional, medical students at several universities and both unaccredited and advanced medical and surgical trainees. His commitment and professionalism was recognised in July 2017 when he was appointed the Secretary of the Australian New Zealand Society of Paediatric Otolaryngology. He was also honored to have won the Australian Indigenous Doctor of the year in 2017.

As Australia’s first Indigenous surgeon, Assoc. Prof. Kong is committed to improving the ear health of Indigenous children and has often participated in news articles and television interviews to bring the attention of the Australian public to the disparity in Indigenous and non-Indigenous child health. He makes regular trips to Australia’s remote regions to provide ear health services that would otherwise not be available.

Kelvin hails from the Worimi people of Port Stephens, north of Newcastle, NSW, Australia. Being surrounded by health, he has always championed for the improvement of health and education. Complementing his practice as a surgeon, he is kept grounded by his family, who are the strength and inspiration to him, remaining involved in numerous projects and committees to help give back to the community.

Future Focus

Being able to hear is such a privilege often taken for granted. The quality of life through the enjoyment if sound and education is a human right. I want everyone to understand the importance of ear disease in childhood and particularly how vital it is that we stop this problem from affecting so many Australian Indigenous children. We need to work together to raise the standards of living and access to medical care so that our First people are not living from one generation to the next in sub-standard circumstances.  We need to see our children finishing their education, able to gain employment and live alongside non-Indigenous Australians with the same opportunities and the same quality of life. We need see them to strive toward their dreams.

Specialised/Technical Skills

  • Consultant ear, nose and throat surgeon
  • Causes of ear infections
  • Paediatric Airway
  • Adult and Paediatric Cochlear Implantation
  • Voice and Swallow disorders
  • Head & Neck Cancer management
  • Randomised controlled trials
  • Aboriginal and Torres Strait Islander health
  • Educator
  • Policy development
  • Mentor
  • Father, Husband, Brother, Worimi man

Affiliations

 

 NACCHO Aboriginal Hearing Health : #OMOZ2018 Ear Health Project Officers will spearhead a new $7.9 million #HearingforLearning program to fight hearing loss among Aboriginal and Torres Strait Islander childre

Hearing for Learning aims to dramatically lift the capacity for communities to identify ear disease within the first few months of life.

Infants rarely show signs of ear pain, so infections are not detected and diseases like otitis media persist and progress.

By 12 months of age, only five per cent of First Nations children in remote communities have bilateral normal hearing, compared with over 80 per cent of children in the rest of Australia.

Children with undiagnosed hearing loss tend to fall behind at school due to delayed speech and language development.

This can have a huge impact on their early years, future employment opportunities and their chance of a happy and successful life.”

Indigenous Health Minister Ken Wyatt AM

The Territory Labor Government promised to put children at the centre of our decision-making, because we want a brighter future for our kids – a future filled with opportunity.

When we focus on the first 1000 days of a child’s life, we know we get better outcomes for their future, and that’s what this partnership aims to do.

Hearing health has an enormous impact on a child’s development, and by addressing this at a community level, the entire community will benefit.” 

NT Chief Minister Michael Gunner

Watch video 

 

Read over 40 Aboriginal Ear and Hearing articles published by NACCHO over last 6 years

Hearing is essential for strong early childhood development and chronic hearing problems in children cause education difficulties leading to entrenched disadvantage.

The Hearing for Learning Initiative is a ground-breaking 5-year investment combining public and private funding to solve this serious health and education problem “

Professor Alan Cass Director Menzies School of Health Research

When we learned about the chronic nature of ear disease in children living in remote communities in the Northern Territory, we could not ignore the fact that this likely leads to profound disadvantage in health, education and employment outcomes.

We believe more must be done and the next step is to support the community to deliver a solution.

Philanthropy plays a unique role in recognising and piloting new approaches, however, it requires partnership with government to deliver these approaches at scale.

The Government is to be applauded for putting this unique partnership together to solve what has now become a serious epidemic.

Neil Balnaves AO, Founder, The Balnaves Foundation and Chancellor, Charles Darwin University

Dozens of local Ear Health Project Officers will spearhead a new $7.9 million program to fight hearing loss among Aboriginal and Torres Strait Islander children in the Northern Territory.

The Hearing for Learning initiative will be established in 20 urban, rural and remote sites, where up to 40 local people will strengthen and complement the work of fly-in fly-out (FIFO) ear specialists.

“This is an exciting new opportunity to remove the preventable blight of hearing loss from current and future generations,” said Indigenous Health Minister Ken Wyatt AM.

“These local ear health warriors will integrate with existing primary care services, to help protect the hearing of up to 5,000 children from birth to 16 years old.

“Lifting the capacity of local families to recognise, report and treat ear problems early promises to help our children reach their full potential.”

The initiative will be implemented by the Menzies School of Health Research and co-led by Professor Amanda Leach and Associate Professor Kelvin Kong.

The Hearing for Learning is a ground-breaking 5-year initiative by the Northern Territory Government, founded on scientific research by Northern Territory scientists at Menzies School of Health Research, combining public and private funding to solve this serious health and education problem.

$2.4 million from NT Government

$2.5 million from The Balnaves Foundation

$3 million from the Federal Government

Hearing for Learning aims to dramatically lift the capacity for communities to identify ear disease within the first few months of life,” said Minister Wyatt.

“Infants rarely show signs of ear pain, so infections are not detected and diseases like otitis media persist and progress.

“By 12 months of age, only five per cent of First Nations children in remote communities have bilateral normal hearing, compared with over 80 per cent of children in the rest of Australia.”

“Children with undiagnosed hearing loss tend to fall behind at school due to delayed speech and language development,” Minister Wyatt said.

“This can have a huge impact on their early years, future employment opportunities and their chance of a happy and successful life.”

The Menzies School of Health Research aims to make Hearing for Learning a care model that can be replicated across the nation.

Hearing for Learning will complement the Government’s existing ear health programs, including Healthy Ears, which together will receive funding of $81.8 million over four years from 2018–19.

This includes $30 million for a new outreach program to provide annual hearing assessment, referral and follow-up treatment for Aboriginal and Torres Strait Islander children before they start school.

NACCHO Aboriginal Hearing Health : 94 per cent of Indigenous inmates in the NT have significant hearing loss

 

” Eighty four per cent of adults and 96 per cent of juveniles detained in the Northern Territory are Indigenous, though they only make up 25 per cent of the population.

In my research I found that hearing-impaired Aboriginal people are more likely to be arrested and charged with crimes because they cannot explain themselves to police or give adequate instructions to their solicitor, are less likely to be viewed as a credible witnesses in court, and tend to have misunderstandings with corrections staff.”

Psychologist Dr Damien Howard ( see his PowerPoint presentation below ) 

 

 ” Ministers agreed that the ear and hearing health of Aboriginal and Torres Strait Islander children is an important issue that impacts on their health, education, and employment outcomes.

Accordingly, Ministers agreed to explore the feasibility of a national approach to reducing the burden of middle ear disease and associated hearing loss on Aboriginal and Torres Strait Islander people. This is an important step towards achieving Closing the Gap targets. “

COAG Health Council Communique  24 March 2017

Read over 30 previous NACCHO articles Ears and Hearing

When Aboriginal prisoners appear before a magistrate waiting to be sentenced in Darwin, a guard is usually sitting in the dock right beside them. Troy Vanderpoll used to be one of those prison officers.

Article originally published

The Aboriginal inmate is asked a few questions. He nods in agreement with the magistrate, repeating, “yes”, over and over again.

The session finishes, the inmate stands, and the court moves on to the next case.

The man turns to the guard: “How much did I get?”

Mr Vanderpoll is Indigenous himself, and used to work as the Aboriginal Liaison Officer in Northern Territory prisons.

He spent a lot of time with Aboriginal inmates, and noticed that some of the men seemed withdrawn, and did their best to avoid interacting with guards, parole officers and judges — even when it was in their best interests.

Hidden epidemic

In 2010, Mr Vanderpoll spoke to a local psychologist, Damien Howard, who had a theory on why that was — a hidden epidemic of hearing loss.

Damien had studied the impact of hearing loss on Indigenous people for more than two decades, but had never seen research published on hearing levels of adult prisoners in the Northern Territory.

Before Mr Vanderpoll became a prison guard, he was a medic in the Australian Army, where he learned how to conduct hearing testing. In the defence forces, biannual checks are mandatory.

In response to Mr Vanderpoll and Dr Howard’s interest, Robert Miller — then acting superintendent of Darwin Correctional Centre and Mr Vanderpoll’s stepfather — commissioned the pair to conduct hearing testing for Aboriginal inmates.

Mr Vanderpoll tested the hearing of volunteers at correctional centres in Darwin and Alice Springs, and Dr Howard helped compile the results.

The findings made news headlines: 94 per cent of the inmates tested had significant hearing loss.

The result reflected a wider public health issue: in remote communities, up to 45 per cent of Aboriginal people have hearing loss, often due to preventable childhood ear diseases.

Presentation  : Health practitioners improving communication with Indigenous patients and family members with hearing loss.

Mr Miller had by then worked in Corrections for over 25 years. The result was a revelation.

“I think it shocked all of us that the hearing loss was so great,” he says.

“The doors open and the memory goes back: some prisoners seemed to be not talking to you, ignoring what you’re saying. You understand now that he’s got a hearing problem, no wonder he couldn’t hear what I was saying.

“If you don’t know about it then you may just think that the prisoner is being ignorant or rude in not responding to something that you’ve said.”

Then there were the inmates who Mr Vanderpoll realised must have been deaf in one ear.

“Sometimes you’re talking to someone and they completely ignore you because they’re facing the wrong way,” he says.

 

Photo: 94 per cent of Indigenous inmates in the Northern Territory have significant hearing loss. (ABC RN: Jake Duczynski)

Aboriginal men in NT prisons regularly use hand gestures — but Mr Vanderpoll and Dr Howard say that was no clear indication of hearing loss. Aboriginal spoken languages in the Northern Territory include signing, and many inmates speak English as a second or third language.

“The boys are always signing. Always, whether they can hear or not, they’re still signing,” Mr Miller says.

If Mr Vanderpoll and Dr Howard were shocked by the results, so too were the inmates. Most prisoners had no idea they had hearing problems before the study.

“They’d grown up with it. That had been their whole life,” Mr Vanderpoll says.

But whether they know they have it or not, hearing loss impacted their experiences in the justice system.

Mr Vanderpoll began having conversations with prisoners who admitted avoiding interacting with the parole board because of their hearing loss, giving up a chance for a reduced sentence.

“Anything that put them in a position where they had to talk to a stranger or be reviewed by a stranger was so shocking or so scary to them, that they’d rather stay in prison and complete their full time without any chance of parole,” he says.

“If you’ve got hearing issues, you don’t want to be put into that position.”

Interpreter shortage

While most hearing impaired and deaf Aboriginal inmates Mr Vanderpoll worked with didn’t ask for an interpreter in legal situations, the service might not have been available for them anyway.

There is only one professionally-qualified Auslan interpreter available for inmates across the entire Northern Territory, meaning that many deaf people miss out.

The interpreter, Liz Temple, readily admits that she does not have fluency in the local Aboriginal sign languages that most prisoners with hearing loss use.

She often relies on Aboriginal consultants, such as Jody Barney, a deaf Indigenous woman who often works in the region and has knowledge of multiple Aboriginal sign languages. However, funding for such services is limited.

Instead, corrections officers often play quasi-interpreters for inmates, says Mr Vanderpoll.

“You’d listen to the magistrate and you’d just lean over to the prisoner and just tell him what’s happening as it’s happening in real time. I think the reason that works is because they’re more comfortable.”

Their findings led Robert Miller to wonder whether hearing loss plays a role not only in Aboriginal people’s experience of prison, but also contributes to them ending up there in the first place.

“You can understand why Indigenous incarceration is so high. I’m not saying it’s the only reason, but I think it had quite an impact,” he says.

Eighty four per cent of adults and 96 per cent of juveniles detained in the Northern Territory are Indigenous, though they only make up 25 per cent of the population.

In his research, Howard found that hearing-impaired Aboriginal people are more likely to be arrested and charged with crimes because they cannot explain themselves to police or give adequate instructions to their solicitor, are less likely to be viewed as a credible witnesses in court, and tend to have misunderstandings with corrections staff.

Signs of change

Once the report was released, Mr Vanderpoll and Dr Howard were hopeful things would begin to change.

Mr Miller cobbled together funding for eight hearing aids, as he recalls — at a cost of less than $2,000.

“It wasn’t huge, but when you’re spending government money it’s got to be justified,” he says.

He had hoped that the small pilot program would eventually be funded by the government.

“There was no money in the Darwin Correctional Centre budget for hearing assistance,” he says.

Before the Darwin trial, in his eight years in NT prisons, Mr Vanderpoll says he saw only two people wearing hearing aids.

He recalls watching inmates putting on the new devices, realising what they had been missing.

“They could understand what they were supposed to be hearing in the first place,” he says.

Mr Vanderpoll hoped to implement a comprehensive training program for guards, who he says often had good relationships with inmates.

“I don’t think you can highlight that enough, that when they’re in prison, the officers aren’t their enemies.”

Still, there were correctional officers who got it, and those who didn’t, the ones who are “coming in yelling and screaming”.

The officers with the best rapport with the prisoners, Mr Vanderpoll observed, were those who made an effort to communicate.

“There’s a lot of knowledge. Some have 30 years of dealing with Indigenous inmates and they have developed a really good set of listening skills and speaking skills. We were trying to map that out so we could disseminate that in some form of training.”

Hope and disappointment

Their 2011 report made a number of recommendations that they believed could improve the way the justice system caters for hearing-impaired Aboriginal people — including routine testing of new inmates’ hearing, better access to hearing aids, and improved training for police, the judiciary and correctional staff.

Mr Vanderpoll’s biggest hope was to see records of inmates’ hearing levels shared between police and the courts.

“So that when [police] deal with someone, they bring that person up and say, ‘All right, he’s deaf in the left ear,’ and they can be aware of that when they’re dealing with them,” he says.

Mr Vanderpoll left the NT Department of Correctional Services in 2013, and now works for the state’s Department of Trade, Business and Innovation, while Mr Miller has retired.

To Dr Howard’s knowledge, none of the 2011 report’s recommendations have been implemented.

The NT Department of Corrections never contacted him about the report.

The Department of the Attorney General and Justice said that as part of an initial training program, correctional officers learned to deal with prisoners with impairments, including hearing loss.

Mr Vanderpoll’s idea of record sharing went nowhere. “That’s the most disappointing part,” he says.

Hearing loss remains ‘the smoking gun’

In the aftermath of the abuse of Aboriginal teenagers by guards at Don Dale Youth Detention Centre in 2016, Dr Howard told the royal commission that hearing loss amongst Aboriginal adults and young people continues to be the “smoking gun” contributing to very high rates of detention — and communication problems with police and guards.

“With rare exceptions, governments and corrections agencies in all jurisdictions, as well as the criminal justice research organisations, have displayed a perplexing disinterest in this important issue,” Dr Howard says.

“A common response of government and Corrections is to classify Aboriginal hearing loss only as a “health problem”.

When asked if audiological testing was now conducted for adult prisoners entering the correctional system, the NT Department of the Attorney General and Justice referred the ABC to the Department of Health.

The Department of Health says adult prisoners are asked if they have hearing issues when they enter prison. Yet as Mr Vanderpoll and Dr Howard’s research found, many inmates are unaware of their hearing loss.

The NT Department of Corrections provides prisoners with a hearing aid if they have a referral from a medical practitioner.

Juvenile detainees in Darwin and Alice Springs are now given a hearing screening test undertaken by a nurse. The service began this year.

Mr Miller says people in the Department of Corrections “try really hard” to deliver services under increasingly strained resources.

“The government’s on you every year to be tight … people are not interested in prisoners at all,” Mr Vanderpoll says.

“I think that a lot of the problems that we face today, like Don Dale, was because the money’s been stripped from Corrections, over and over again, and people don’t want to hear about it.

“The prison is always run well because of communication. When it doesn’t run well, when there’s riots and stuff like that, it’s because of a lack of communication.

“You can have all of the foundation skills-type training in the world. You can have mathematics, English, et cetera. You can send people to alcohol rehabilitation courses.

“You can do all these things with people, but if they can’t even hear what you’re saying, how is it going to make a difference?”

Ear trouble training for teachers

NACCHO Aboriginal #Ear Health : #ClosingtheGapDay and hearing loss: an invisible barrier obstructs progress

 

“Avoidance is a way of coping with anxiety about being shamed. Repeated avoidance results in limited engagement and poor outcomes for programs designed to Close the Gap.

The use of hearing loss responsive communication strategies can help to deal with this barrier

 These strategies can be as important as culturally appropriate processes in programs.

Indeed, there is an overlap between the two. For those with hearing loss, what is said in culturally familiar language within a culturally familiar process is easier to understand.”

Hearing loss among Indigenous Australians is a largely unseen barrier to Closing the Gap programs, according to Dr Damien Howard and Jody Barney, who explain how to be “hearing loss responsive” in service delivery and communications.

Originally published

 ” Indigenous Australians have one of the highest levels of ear disease and hearing loss in the world.

Rates are up to ten times more than non-Indigenous Australians and the National Aboriginal Community Controlled Health Organisation estimates Indigenous healthcare is currently 30 to 50 years behind the rest of the country “

Read or Share all NACCHO Ear and Hearing Articles HERE

This weeks NACCHO Aboriginal Health News Alerts will  include

Tuesday Save a date Wednesday Job alerts Thursday NACCHO Members Good News

How to submit ? Email to Colin Cowell NACCHO Media   4.30 pm  day before publication

Communication difficulties caused by the widespread unidentified hearing loss among Indigenous people in Australia continue to undermine the effectiveness of Closing the Gap programs.

An Aboriginal worker with mild hearing loss once commented: “You see that look, the look that tells you they are thinking you are some stupid blackfella and you don’t want to say you don’t understand; ‘Can you tell me it again?’

“You just want to get away and never want to work with them again if you can help it.”

Many people act on these kinds of feelings. They seek to avoid people, situations and service providers because of these reactions. The everyday communication difficulties caused by their hearing loss contribute to anxiety and disengagement. They will often seek to avoid education, health and employment support services designed to help them.

For instance, people may not go to health clinics, or do not comply with provided treatment. Avoidance of specialist medical appointments is one feature of this. In some specialist medical visits to remote communities, 50% of patients do not attend booked appointments. This can have dire health implications for individuals. It is also an immense waste of resources.

When hearing loss begins early in life, it has greater impact than the late onset hearing loss that is experienced by non-Indigenous Australians who are hard of hearing. Their hearing loss is generally caused by occupational noise exposure and ageing.

Indigenous hearing loss is usually caused by endemic childhood middle ear disease. Children with current ear disease often have a temporary hearing loss. Repeated infections can cause lasting damage and some level of permanent mild to moderate hearing loss. Up to 70% of Indigenous people are affected — fewer in urban communities, more in remote communities.

The impact of this hearing loss is pervasive.

We know that school attendance rates for Indigenous children with hearing loss are below those for other students. We know they experience more difficulty with learning when they do attend school. We know they display more behavioural problems when at school. We know Indigenous workers with hearing loss have difficulty securing and holding jobs, have greater performance difficulties and frequently avoid participation in workplace training.

There is also increasing concern about hearing loss as a factor in the over-representation of Indigenous people in the criminal justice system; 94% of prison inmates in the Northern Territory have been found to have a significant degree of hearing loss.

Those familiar with Indigenous disadvantage may wonder why they have not heard about the incidence and impact of hearing loss among adults. One reason is that early onset conductive hearing loss is mostly invisible.

First, most Indigenous people who are hard of hearing are not aware that their hearing is not normal. The early origin of their hearing loss means it is something they have experienced for most of their life. For them, what they how they hear is ‘normal’. If asked, they would deny having a hearing loss.

Second, service providers (teachers, nurses, doctors, trainers, health professionals, social workers and police among them) are unlikely to recognise poor hearing as an issue for people they work with. Communication difficulties arising from hearing loss are generally attributed only to language and cultural differences, or to limited intelligence or poor motivation. The latter two perceptions, when noticed by clients astute in reading body language, can further compound disengagement.

It is easy to imagine that hearing aids are all that is needed to resolve issues. They can help some, but will not resolve all communication difficulties.

The communication issues experienced by an adult with early onset hearing loss are the result of both current hearing loss and the ‘legacy effects’ of unidentified hearing loss since childhood. These may include a preference for visual communication strategies, anxiety related to an intense fear of being ‘shamed’ and a limited store of contextual knowledge that helps with understanding what is said.

A store of contextual knowledge is what people normally acquire through fully hearing what is said to them, and around them. Without a store of relevant contextual knowledge — the big picture — what is said in any situation is harder to understand. So people with early onset hearing loss not only have trouble hearing what is said, but they also frequently have difficulty understanding what they hear.

Avoidance is a way of coping with anxiety about being shamed. Repeated avoidance results in limited engagement and poor outcomes for programs designed to Close the Gap.

The use of hearing loss responsive communication strategies can help to deal with this barrier. These strategies can be as important as culturally appropriate processes in programs. Indeed, there is an overlap between the two. For those with hearing loss, what is said in culturally familiar language within a culturally familiar process is easier to understand.

Other key components of hearing loss responsive service provision include the following:

  • using highly visual communication strategies
  • minimising background noise during conversations
  • using the language clients know best
  • using ‘pre-learning’ – providing information in advance to help explain the context, so people can better understand what will be discussed
  • services having amplification devices to use as part of service delivery
  • training staff in the use of more effective communication strategies — this includes training workers to recognise hearing loss, develop necessary skills and avoid responses that prompt shame, anxiety and disengagement

We believe Closing the Gap programs will continue to fall short of targeted outcomes until they are designed to be responsive to the needs of those with hearing loss.

NACCHO Save a dates Register your event here

22 March2017 Indigenous Ear Health Workshop  in Adelaide

asohns-2017-ieh-workshop-22march2017-adelaide

The 2017 Indigenous Ear Health Workshop to be held in Adelaide in March will focus on Otitis Media (middle ear disease), hearing loss, and its significant impact on the lives of Indigenous children, the community and Indigenous culture in Australia.

The workshop will take place on 22 March 2017 at the Adelaide Convention Centre in Adelaide, South Australia.

The program features keynote addresses by invited speakers who will give presentations aligned with the workshop’s main objectives:

  • To identify and promote methods to strengthen primary prevention and care of Otitis Media (OM).
  • To engage and coordinate all stakeholders in OM management.
  • To summarise current and future research into OM pathogenesis (the manner in which it develops) and management.
  • To present the case for consistent and integrated funding for OM management.

Invited speakers will include paediatricians, public health physicians, ear nose and throat surgeons, Aboriginal health workers, Education Department and a psychologist, with OM and hearing updates from medical, audiological and medical science researchers.

The program will culminate in an address emphasising the need for funding that will provide a consistent and coordinated nationwide approach to managing Indigenous ear health in Australia.

Those interested in attending may include: ENT surgeons, ENT nurses, Aboriginal and Torres Strait Islander health workers, audiologists, rural and regional general surgeons and general practitioners, speech pathologists, teachers, researchers, state and federal government representatives and bureaucrats; in fact anyone interested in Otitis Media.

The workshop is organised by the Australian Society of Otolaryngology Head and Neck Surgery (ASOHNS) and is held just before its Annual Scientific Meeting (23 -26 March 2017). The first IEH workshop was held in Adelaide in 2012 and subsequent workshops were held in Perth, Brisbane and Sydney.

For more information go to the ASOHNS 2017 Annual Scientific Meeting Pre-Meeting Workshops section at http://asm.asohns.org.au/workshops

Or contact:

Mrs Lorna Watson, Chief Executive Officer, ASOHNS Ltd

T: +61 2 9954 5856   or  E info@asohns.org.au

NACCHO Aboriginal Children’s Ear Health : Innovative partnership tackles hearing and speech barriers for Aboriginal kids

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When kids can’t hear in school and can’t properly participate in society it creates all kinds of problems. Their language skills don’t develop as quickly, they don’t sleep well, they have to take more time off, they can misbehave and their education can fall behind,”

“I’m really pleased that we are no longer just talking about the problems; instead we are helping to change the record for hundreds of kids and their families thanks to the HEALS program. This offers a model to help close the gap that has been shown to work – it’s a good news story for improving urban Aboriginal child health “

CEO of Campbelltown’s Tharawal Aboriginal Corporation Mr Darryl Wright said delivering ENT and speech-language services to at-risk Aboriginal children was life-changing.

Picture above : SEARCH participant Marla Rai Lett

The SEARCH partners are: The Aboriginal Health & Medical Research Council, the Sax Institute, leading researchers across Australian universities and four Aboriginal Community Controlled Health Services:

Tharawal Aboriginal Corporation (Campbelltown),  Awabakal Ltd (Newcastle), Riverina Medical and Dental Aboriginal Corporation (Wagga Wagga) and Aboriginal Medical Service Western Sydney (Mt Druitt).

Hundreds of urban Aboriginal children have benefited from an innovative partnership program established to tackle speech and hearing difficulties, in a model that could be part of a broader solution for long-term health.

Established in 2013, the Hearing EAr health and Language Services (HEALS) program is a partnership between Aboriginal community controlled health services, researchers and hospitals in NSW. Funded by NSW Health, it has delivered over 7000 speech and language services and ear operations to almost 800 urban Aboriginal children. These services have been delivered by the Sydney Childrens’ Hospitals Network.

A new research paper published today in the Australian and New Zealand Journal of Public Health shows it is a model that could be scaled up to benefit even more Aboriginal kids and families.

HEALS is an outcome of the largest ongoing study of urban Aboriginal children ever conducted, the Study of Environment on Aboriginal Resilience and Child health (SEARCH). SEARCH, which involves 1600 urban Aboriginal children and their families, provided the first robust data that over 40% of children under 8 had significant speech and language impairments and/or ear health problems.

The study was able to identify children attending the participating community controlled health services who were in most need of hearing and speech services.

SEARCH directly addresses the huge information gap about the health of urban Aboriginal families, which exists even though more than three quarters of Aboriginal people in NSW live in urban areas.

Dr Hasantha Gunasekera, a paediatrician from The Children’s Hospital at Westmead, co-ordinates HEALS delivery of surgery and speech and language services.

“Indigenous children experience middle ear disease earlier, more often and with more complications than non-Indigenous children. Left untreated it can lead to hearing loss, speech and language delays and hamper the kids’ ability to learn,” he said.

“The partnership model in this program is what makes the HEALS model work so effectively. Working together, and with funding from the NSW Ministry of Health, we have almost eliminated the waiting lists at the centres where we are working.”

SEARCH Study Director Dr Sumi Mutthaya who is based at the Sax Institute – one of SEARCH’s founding partners – said the success of the HEALS program showed the importance of developing long-term research partnerships like SEARCH, to improve Aboriginal health and wellbeing.

“SEARCH aims to do much more than better understand the causes of ill-health and disease among urban Aboriginal children – it’s designed so that the information is actually put to use to drive real improvements in services and health outcomes for Aboriginal people. This is exactly what is happening with the HEALS program.”

Find out more

About SEARCH

The Study of Environment on Aboriginal Resilience and Child Health (SEARCH) is creating a long-term platform for closing the gap. The largest ongoing study of urban Aboriginal children ever conducted, SEARCH aims to do two equally important things: better understand the causes of health and disease among urban Aboriginal children and their families; and use this information to drive real improvements in services and health outcomes for Aboriginal people. It is an active partnership between Aboriginal health services and researchers, where health services set the research priorities and guide how data is collected, interpreted and used.

The SEARCH partners are: The Aboriginal Health & Medical Research Council, the Sax Institute, leading researchers across Australian universities and four Aboriginal Community Controlled Health Services: Tharawal Aboriginal Corporation (Campbelltown), Awabakal Ltd (Newcastle), Riverina Medical and Dental Aboriginal Corporation (Wagga Wagga) and Aboriginal Medical Service Western Sydney (Mt Druitt).