Health and well-being are holistic concepts that are perceived to be inseparable for Aboriginal and Torres Strait Islander peoples. We examined relationships between parent-reported ear symptoms for 787 Indigenous children at two time points (age 2–3 years, age 4–5 years) and two parent-reported speech and language outcomes one year later (age 5–6 years). Most parents (80.2%) reported no concern about their child’s expressive language and (93.8%) receptive language. Binary logistic regression models examined ear health as a predictor of children’s expressive and receptive speech and language adjusting for sociodemographic and health covariates. For children without parent-reported ear symptoms, there were lower odds of parental concern about expressive speech and language (aOR = 0.45; 95% CI 0.21–0.99) and receptive language (aOR = 0.24; 95% CI 0.09–0.62). Parents were less likely to have concerns about the child’s expressive speech and language if their child was female, lived in urban or regional areas, had excellent or very good global health, or had no disability when aged 2–5 years. Since parent-reported ear health and speech and language concerns were related, Aboriginal and Torres Strait Islander children could benefit from culturally safe, strength-based, and family-centered integrated speech, language, and ear health services.

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Background Ear and hearing care programs are critical to early detection and management of otitis media (or middle ear disease). Otitis media and associated hearing loss disproportionately impacts First Nations children. This affects speech and language development, social and cognitive development and, in turn, education and life outcomes. This scoping review aimed to better understand how ear and hearing care programs for First Nations children in high-income colonial-settler countries aimed to reduce the burden of otitis media and increase equitable access to care. Specifically, the review aimed to chart program strategies, map the focus of each program against 4 parts of a care pathway (prevention, detection, diagnosis/management, rehabilitation), and to identify the factors that indicated the longer-term sustainability and success of programs. Method A database search was conducted in March 2021 using Medline, Embase, Global Health, APA PsycInfo, CINAHL, Web of Science Core Collection, Scopus, and Academic Search Premier. Programs were eligible or inclusion if they had either been developed or run at any time between January 2010 to March 2021. Search terms encompassed terms such as First Nations children, ear and hearing care, and health programs, initiatives, campaigns, and services. Results Twenty-seven articles met the criteria to be included in the review and described a total of twenty-one ear and hearing care programs. Programs employed strategies to: (i) connect patients to specialist services, (ii) improve cultural safety of services, and (iii) increase access to ear and hearing care services. However, program evaluation measures were limited to outputs or the evaluation of service-level outcome, rather than patient-based outcomes. Factors which contributed to program sustainability included funding and community involvement although these were limited in many cases. Conclusion The result of this study highlighted that programs primarily operate at two points along the care pathway—detection and diagnosis/management, presumably where the greatest need lies. Targeted strategies were used to address these, some which were limited in their approach. The success of many programs are evaluated as outputs, and many programs rely on funding sources which can potentially limit longer-term sustainability. Finally, the involvement of First Nations people and communities typically only occurred during implementation rather than across the development of the program. Future programs should be embedded within a connected system of care and tied to existing policies and funding streams to ensure long term viability. Programs should be governed and evaluated by First Nations communities to further ensure programs are sustainable and are designed to meet community needs.

Issue addressedAboriginal and Torres Strait Islander child ear health is complex and multiple. We examined relationships between parent‐reported sociodemographic, child health, health service access factors and ear symptoms among Aboriginal and Torres Strait Islander children aged 3 to 7 years.MethodsThe Longitudinal Study of Indigenous Children is a large child cohort study with annual parent‐reported data collection. Generalised linear mixed model analyses examined Wave 1 (1309 children 0‐5 years; 2008) predictors of being free of parent‐reported ear symptoms in both Waves 2 and 3.ResultsA total of 1030 (78.7%) had no reported ear symptoms in either Wave 2 or 3. In the fully adjusted model, children who had been hospitalised in the past year (aOR = 2.16; 95% CI 1.19‐3.93) and those with no ear symptoms (aOR = 2.94; 95% CI, 1.59‐5.46) at Wave 1 had higher odds of no ear symptoms in both the subsequent waves. There were also relationships between parent main source of income–government pension or allowance as well as parents who reported no history of their own ear symptoms and higher odds of no ear symptoms in Waves 2 and 3 after partial adjustment for sociodemographic factors.ConclusionThese findings suggest relationships between different sociodemographic and health factors and parent‐reported ear symptoms among Aboriginal and Torres Strait Islander children that warrant further investigation.So what? Children with parent‐reported ear symptoms during the early years need holistic support to prevent future ear symptoms that impact health, social and educational life trajectories.

Background Ear and hearing care programs are critical to early detection and management of otitis media which disproportionately impacts First Nations children, affecting speech and language development, social and cognitive development and, in turn, education and life outcomes. This review aimed to identify ear and hearing care programs to chart program approaches, sustainability, and areas focus across the care pathway. Method A systematic search was conducted using Medline, Embase, Global Health, APA PsycInfo, CINAHL, Web of Science Core Collection, Scopus, and Academic Search Premier. Search terms included First Nations children, ear and hearing care, and health programs, initiatives, campaigns, and services. Results Twenty-seven articles met the criteria to be included in the review and described total of twenty-one ear and hearing care programs. Programs focussed on connecting patients to specialist services, ensuring cultural safety of services, and increasing entry into ear and hearing care pathways. Conclusion The majority of programs focus on detection of otitis media and hearing loss, however gaps remain within and across the care pathway which continue to create system fragmentation. Cultural safety is often considered a priority, yet engagement in programs is primarily taking place at an operational level. Programs should ensure that cultural engagement takes place at all stages of program design, operation, and evaluation. The majority of studies (and programs) do not report outcome measures, but rather short-term outputs as indicators for program success limiting an understanding of their effectiveness at mitigating longer-term impacts of middle ear disease and hearing loss. Factors relating to program sustainability include government funding and Indigenous Health Worker or community involvement which is not always considered at a program design stage.