The hidden harm of fluctuating ear disease in First Nations Children

Following NAIDOC Week 2025 (6–13 July), renewed attention is being drawn to the issue of preventable ear disease among Aboriginal and Torres Strait Islander children. 

New findings from Hearing Australia show that more than one in three (35 per cent) young First Nations children experience fluctuating ear disease, with 8 per cent living with persistent ear trouble.

These findings have prompted calls for a sustained, nationwide effort to improve early detection and treatment ensuring that children do not miss out on critical speech, learning and social development opportunities.

Middle ear infection, or otitis media, remains one of the most common health conditions affecting First Nations children in the early years, often without obvious symptoms. It can cause significant impacts on a child’s ability to hear, speak, and participate in early learning.

“It can often start in infancy without clear signs, which is why regular ear health checks are so important,” said Kirralee Cross, a Yorta Yorta woman and Partnership Specialist at Hearing Australia.

“Our findings are a powerful reminder that the fight against preventable hearing loss must remain a national priority especially in a child’s early years.”

Since 2019, the government-funded Hearing Assessment Program – Early Ears (HAPEE) has provided hearing services to over 10,000 First Nations children aged 0–6 each year. Data from the program shows that 26 per cent of children assessed have undiagnosed ear disease, and 20 per cent have undiagnosed hearing loss.

To support early identification, researchers from the National Acoustic Laboratories (NAL) the research division of Hearing Australia have validated a simple five-minute tool: the PLUM (Parent-evaluated Listening and Understanding Measure) checklist. Analysing more than 15,000 hearing appointments for children under seven, the study found:

• PLUM was 91 per cent accurate in predicting long-term hearing outcomes.
• Children rated as ‘not yet on track’ were 46 times more likely to have significant, ongoing hearing loss than those rated ‘on track’.
• 82 per cent of children with significant, persistent otitis media were correctly flagged by the tool.

“PLUM helps identify children who both are and are not likely to have long-term ear health issues,” said Kirralee. “This is critical for giving reassurance where appropriate and taking urgent action where needed.”

Hearing Australia works with over 400 health organisations nationwide, including nearly one-third that are Aboriginal Community Controlled Health Organisations (ACCHOs).

At Karadi Aboriginal Corporation in Tasmania, Outreach Worker and Care Coordinator Maree Marney said community training and tools like PLUM have transformed how hearing health is managed locally.

“We now host community-based screenings two weeks ahead of scheduled audiologist visits. It helps us triage more effectively, identify issues early and achieve better outcomes.”

The Australian Society of Otolaryngology Head and Neck Surgery (ASOHNS) supports these integrated, proactive approaches. CEO Lorna Watson said:

“ENT specialists rely on partnerships with GPs, Aboriginal health workers and audiologists to ensure children needing surgery are prioritised. Every health check is an opportunity.”

Experts recommend that young Aboriginal and Torres Strait Islander children receive ear health checks every six months. Through HAPEE, more than 1,000 health workers have been upskilled in ear and hearing screening.

“Hearing checks shouldn’t rely on parents alone to notice signs,” said Kirralee. “Many children have no visible symptoms. Regular checks must be routine.”

Hearing Australia Managing Director Kim Terrell reaffirmed the agency’s goal to halve the rate of hearing loss in First Nations children by 2029.

“We’re fortunate to work with incredible partners who share our commitment to preventing hearing loss,” he said. “Our aim is to identify ear issues early, so nothing holds these children back from learning and thriving.”

To learn more about Hearing Australia’s First Nations services, visit here.

Fluctuating ear disease refers to intermittent forms of otitis media that change over time.

PLUM was developed by the National Acoustic Laboratories in partnership with First Nations communities and services to support culturally responsive screening in early childhood settings.