Aboriginal and Torres Strait Islander Services: 216/17 in review Aboriginal and Torres Strait Islander adults and children access Australian Hearing s services in a wide range of locations: in Hearing Centres, visiting sites and in communities through our Outreach program. An increasing number of both adults and children are taking up our services, and are also taking up hearing aid use. Ear infection and hearing loss occur more often for Aboriginal and Torres Strait Islander people than for non- Indigenous Australians. In the past, the number of community members accessing our services was low. Identifying and lowering barriers to easy and early access continues to be a key focus for the program. Services to Aboriginal and Torres Strait Islander Adults Indigenous Eligibility clients represent most Aboriginal and Torres Strait Islander adults. They include clients aged over 5 years, and remote community members who are participants in the Community Development Program. In 216/17 there was a 15.6% increase in the number of adults who took up services. Similar increases had been seen over the previous two years. The average number of appointments attended by each client per year is also gradually increasing. See Figure 1. This growth suggests an increasing number of Aboriginal and Torres Strait Islander adults are taking up hearing aid use. For the first time, just under half of adult clients were seen at Outreach sites and just over half were seen at Hearing Centres. In the past, a greater proportion were seen at Outreach locations. This is likely to relate to both an improvement in asking clients about Aboriginal and Torres Strait Islander origin, and an increase in clients choosing to access services at mainstream sites. Aboriginal & Torres Strait Islander adults seen and services provided, 216/17 12 1 8 6 4 2 End Q4 213/14 End Q4 214/15 End Q4 215/16 End Q4 216/17 Number clients seen Number services provided Figure 1: Numbers of Adult clients seen and services provided for the 216/17 financial year.
Our Audiologists regularly collect information about usage, satisfaction and benefit from aided adult clients. To date, 35 Aboriginal and Torres Strait Islander clients have provided us with feedback, from urban, regional and remote locations across the country. In summary: 61% of respondents wear their aids for most or all of the day 91% say they hear a lot (6%) or quite a bit (31%) better 95% are very happy (61%) or quite happy (34%) with their aids 83% of respondents enjoy time with family and friends a lot more (53%) or quite a bit more (3%) 75% report feeling no shame about wearing hearing aids, and 16% report feeling shame, but still wear them. 7% say they feel a lot safer (48%) or quite a bit safer (22%) when they wear their aids. 82% say they are a lot better (56%) or quite a bit better (26%) at doing business when they are wearing their hearing aids. 82% report their family says they are hearing better with their hearing aids. In response to the question What has been the BEST thing about getting hearing aids, clients talk about a wide range of benefits. These include being able to do their job better, being able to hear family, including children and grandchildren, connecting socially and feeling included, feeling safer, more confident and empowered, and being able to hear sounds they haven t heard since childhood. Services to Aboriginal and Torres Strait Islander Children and Young Adults In 216/17, we saw 4,944 Aboriginal and Torres Strait Islander children and young adults aged under 26. This represents 14.6% of the total number of children and young adults who received services from Australian Hearing during the year. All children seen for the first time by Australian Hearing are unaided. A proportion of these will go on to have hearing aids fitted and become aided. When children are referred for a hearing test and there are no concerns that the child may need hearing aids, we encourage referral to a diagnostic hearing service or the use of a self-test apps like Sound Scouts, if appropriate. Overall, there has been a 5% increase in the total number of Aboriginal and Torres Strait Islander children seen. The number of aided children seen in 216/17 increased by 11.8%, suggesting we and our referrers are doing better at targeting services and referrals. Over the last few years, we have seen a steady increase in the proportion of children that go on to get a hearing aid. Figure 2. Aboriginal & Torres Strait Islander aided and unaided children seen 216/17 5 4 3 2 1 End Q4 213/14 End Q4 214/15 End Q4 215/16 End Q4 216/17 Aided children seen Unaided children seen Figure 2: Aboriginal & Torres Strait Islander Aided and Unaided children over the last 3 years
Australian Hearing is implementing a new approach to evaluating outcomes for Aboriginal and Torres Strait Islander aided children. Early results, predominantly from urban areas, show that two thirds of children wear their aids for eight hours or more daily. Most parents/carers observe either a lot or a little better listening behaviour in a variety of quiet and noisy situations. Parents report valuing hearing aid use for their child s safety and for the benefits for learning and relationship building. Children aged five years and under: the Dragonfly Project It s important to identify hearing loss and assist children to hear well at the earliest opportunity. However, it is not easy for primary health staff to identify children with hearing loss for referral. Access to ageappropriate hearing testing presents a second hurdle. The Dragonfly Project is about reducing the age of first hearing aid fitting for Aboriginal and Torres Strait Islander children, to within the first five years of life. The project has three aims: 1. Supporting our Outreach Audiologists to connect with families with young children 2. Supporting our referrers to recognise hearing loss in young children and refer early 3. Raising awareness of parents, carers and community of the importance of hearing aids, fitted earlier. The Dragonfly Project is a long-term project. There are several activities underway: Some social research has recently been carried out to help us understand more about families perceptions and knowledge of hearing loss and hearing aids in -5 year olds. Small focus groups and individual interviews were held with families in three urban, two regional and two remote locations around Australia. Ethics approval has been received to proceed with a trial of a listening behaviour scale called the PLUM: the Parent-evaluated Listening and Understanding Measure. A child s everyday listening behaviour can tell us a lot about how they are hearing. If effective, we hope this will help primary health and others identify important hearing loss in -5 year olds earlier, in urban, regional and remote communities. We are trialling service delivery strategies that help us connect faster with -5 year old children and their families in remote communities. One example is TeleFIT, a program trialled last year with Deadly Ears, where bone conduction devices are fitted via tele-health with the assistance of the Deadly Ears audiologist in the community. This resulted in a tripling of fittings for this age group. We have started talking with another diagnostic audiology service about opportunities for a TeleFIT partnership. Over the past nine years, our data shows that the overall numbers of Aboriginal and Torres Strait islander children being fitted for the first time in their first five years of life has increased which is very encouraging to see, however we think that there is much potential for improvement. See Figure 3.
Number of Aboriginal & Torres Strait Islander children aided for the first time, by calendar year 14 12 1 8 6 4 2 <1 year 1 year 2 years 3 years 4 years 5 years 28 29 21 211 212 213 214 215 216 Figure 3: Number of -5 year old Aboriginal and Torres Strait islander children aided for the first time for the last eight years, by year of age. The Outreach Program Through our Outreach program, we deliver rehabilitative hearing services in communities. These services are individually negotiated with each community. The Outreach service overcomes a range of barriers that stand in the way of accessing Hearing Services, including distance, language and cultural safety. In 216/17, 116 audiologists took part in the Outreach program, up from 113 last financial year. Two of our Outreach Audiologists are Aboriginal. In Hearing Centres with large Outreach programs, specialist Outreach Administrative staff ensure smooth running of the program. They are a key contact for communities, and make most arrangements for the trips, including for the Audiologists travelling to do the work. One of our Outreach Administrative staff is Aboriginal. Through the Outreach program, we visited 238 communities in 216/17. Overall we have seen a steady growth in the number of communities visited annually. See Figure 4. Number of communities visited by financial year 24 235 23 225 22 215 21 25 2 211/12 212/13 213/14 214/15 215/16 216/17 Figure 4: Number of urban, regional and remote Aboriginal and Torres Strait Islander communities visited annually, by financial year.
The average number of visits made to each community per year has also been steadily increasing from an average of 3.8 visits in 213/14 to 4.5 visits in 216/17. In the 216/17 financial year, 6% of communities visited were remote, 23% rural, and 17% urban. Hear for School Our Outreach Audiologists are starting to offer a new professional development program for teachers in schools with high numbers of Aboriginal and Torres Strait islander students with ear trouble, called Hear for School. It starts with a self-assessment, to reduce the likelihood of duplicating the work of our partner hearing services and Hearing Advisory Teachers. Hear for School is a systematic, targeted program that aims to build the capacity and capability of schools to support all students to hear well, to contribute to achieving better learning outcomes. For more information, click here. Masters of Audiology Scholarships for Aboriginal and Torres Strait Islander graduates There are estimated to be fewer than six Aboriginal Audiologists in Australia, and this is a figure we would like to see grow. Australian Hearing and three Australian universities have signed contracts to provide and promote a Masters of Audiology scholarship for Aboriginal and Torres Strait Islander graduates in each location. Each scholarship will be to the value of $15,, and includes the opportunity to join one of our remote Outreach trips in the student s second year of study. For more information, click here.