Abstract
BackgroundIndigenous infants and children in Australia, especially in remote communities, experience early and chronic otitis media (OM) which is difficult to treat and has lifelong impacts in health and education. The LiTTLe Program (Learning to Talk, Talking to Learn) aimed to increase infants’ access to spoken language input, teach parents to manage health and hearing problems, and support children’s school readiness. This paper aimed to explore caregivers’ views about this inclusive, parent-implemented early childhood program for 0–3 years in an Aboriginal community health context.MethodsData from in-depth, semi-structured interviews with 9 caregivers of 12 children who had participated in the program from one remote Aboriginal community in the Northern Territory are presented. Data were analysed thematically. Caregivers provided overall views on the program. In addition, three key areas of focus in the program are also presented here: speech and language, hearing health, and school readiness.ResultsCaregivers were positive about the interactive speech and language strategies in the program, except for some strategies which some parents found alien or difficult: such as talking slowly, following along with the child’s topic, using parallel talk, or baby talk. Children’s hearing was considered by caregivers to be important for understanding people, enjoying music, and detecting environmental sounds including signs of danger. Caregivers provided perspectives on the utility of sign language and its benefits for communicating with infants and young children with hearing loss, and the difficulty of getting young community children to wear a conventional hearing aid. Caregivers were strongly of the opinion that the program had helped prepare children for school through familiarising their child with early literacy activities and resources, as well as school routines. But caregivers differed as to whether they thought the program should have been located at the school itself.ConclusionsThe caregivers generally reported positive views about the LiTTLe Program, and also drew attention to areas for improvement. The perspectives gathered may serve to guide other cross-sector collaborations across health and education to respond to OM among children at risk for OM-related disability in speech and language development.
Highlights
Indigenous infants and children in Australia, especially in remote communities, experience early and chronic otitis media (OM) which is difficult to treat and has lifelong impacts in health and education
This paper has explored the views of parents towards the LiTTLe Program, a program designed to prevent disability in terms of poor speech and language skills associated with OM in Indigenous children living in remote communities in northern Australia
The caregivers were mostly keen on the interactive strategies they were modelled in the program for supporting the children’s language and communication, and considered that the program very much helped them prepare their children for formal schooling
Summary
Indigenous infants and children in Australia, especially in remote communities, experience early and chronic otitis media (OM) which is difficult to treat and has lifelong impacts in health and education. In Australia, urban and remote Aboriginal and Torres Strait Islander children experience OM at very high rates in comparison to non-Indigenous Australian children [5, 6]: in 2001 the prevalence of OM among 709 Aboriginal children aged 6–30 months across 29 remote communities from northern and central Australia was 91% (95% CI 88, 94), and perforated eardrums (an OM complication) affected 40% of children 0–18 months of age [7]. In Australia, the public health burden is acute for Aboriginal and Torres Strait Islander children for whom OM tends to occur earlier in life (often by 8 weeks of age [9]), is more severe, and persists longer (cumulatively for 2.7 years on average, versus 3 months for non-Indigenous children [5, 10]). Among Aboriginal and Torres Strait Islander children, OM prevalence peaks at an early age: 72% at 5–9 months in Western Australia, according to a 2008 study [11]
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