Routine ear health and hearing checks for Aboriginal and Torres Strait Islander children aged under 6 years attending primary care: a national consensus statement

Abstract

SummaryThis consensus statement provides new recommendations for primary care assessment of ear health and hearing status of young Aboriginal and Torres Strait Islander children who are not known to have, or are not being actively managed for, ear health and hearing problems. Any child identified with otitis media should be actively managed. This national consensus statement extends existing treatment and management guidelines.Main recommendations Undertake checks at least 6‐monthly, commencing at 6 months until 4 years of age, then at 5 years. Undertake checks more frequently in high risk settings for children under 2 years, when acceptable to families, or in response to parent/carer concerns. Ask parents/carers about concerns, signs, and symptoms; check children's listening and communication skills; and assess middle ear appearance and mobility. Otoacoustic emissions testing is suggested when equipment is available, primary health practitioners have capability and confidence to use the equipment, and there is local preference for its use. Video otoscopy is suggested for health promotion purposes, and/or for sharing images with other health practitioners. Audiometry should be done as per existing guidelines: when there are parent/carer concerns, signs of persistent/recurrent otitis media, or when listening and communication development is not yet on track. Changes in management as a result of this statement Key practice changes include routine use of tympanometry, and listening and communication skills checklists. Implementation will require access to equipment and training; clear information on immediate, practical actions for families; timely pathways to referral services; and a change management process that shifts perception and tolerance of otitis media and its impacts and raises expectations that Aboriginal and Torres Strait Islander children can have healthy ears and hearing.

Development of the national consensus statement on ear health and hearing check recommendations for Aboriginal and Torres Strait Islander children aged under 6 years attending primary care: systematic scoping review and e-Delphi

“…Three recommendations (4, 5, and 8) are conditional, or relevant in certain circumstances, including those relating to the use of video-otoscopy and otoacoustic emissions, and when more frequent checks may be required. These are outlined in Table 5 and the companion paper provides further detail on the recommendations [ 23 ].…”

“…This project has achieved this to some extent through involvement of policymakers in the consensus process, through provision of early feedback on project findings, and through inviting input on implementation of the recommendations into practice in primary health care. A companion paper is available that provides a detailed overview of the recommendations and summarises barriers to implementation cited by key experts during the project [ 23 ]. This body of work provides Aboriginal and Torres Strait Islander and mainstream primary health services with best available information on when and how to check young Aboriginal and Torres Strait Islander children’s ear health and hearing.…”

“…This paper focuses on the process undertaken to develop the recommendations. A companion paper that describes the recommendations in detail as well as key practice changes required for implementation is also available [ 23 ].…”

Hearing loss at 6-monthly assessments from age 12 to 36 months: secondary outcomes from randomised controlled trials of novel pneumococcal conjugate vaccine schedules

“…This has practical implications that support the shift from screening programs to surveillance, commencing within first year of life. [25]…”

“…This has practical implications that support the shift from screening programs to surveillance, commencing within first year of life. [25] A strength of our study is that all hearing tests were performed in sound-treated facilities by paediatric audiologists at scheduled study visits, regardless of clinical presentation. However, the majority of hearing tests were VROA for which the minimum test level varies according to test environment and child.…”