Abstract
BackgroundThe prevalence of otitis media (OM) and related hearing loss has remained persistently high among some groups of Australian Aboriginal children who are also reported to have poor academic outcomes. The general literature remains inconclusive about the association between OM-related hearing loss and academic performance in primary school. This study aimed to investigate this association in Aboriginal children living in the Northern Territory (NT) of Australia.MethodsA retrospective, observational cohort study was conducted for 2208 NT Aboriginal children, aged about 8 years, living in remote and very remote communities. The explanatory variable was audiometrically determined hearing level as recorded in the Remote Hearing Assessment dataset. The outcome variable consisted of scale scores in the five domains of the National Assessment Program – Literacy and Numeracy (NAPLAN) for Year 3. Other linked datasets used in the study included school attendance records, perinatal records and community level information on relative remoteness, socioeconomic disadvantage and housing crowdedness. Fixed effects linear regression models were used for statistical analyses.ResultsCompared with children with normal hearing and after controlling for a range of covariates, children with mild hearing impairment (HI) scored lower in Writing and Spelling by 15.0 points (95% CI: − 22.4 to − 7.6, p < 0.0005) and 5.0 points (95% CI: − 9.6 to − 0.3, p = 0.037), equivalent to 7.3 and 2.1% of the mean score, respectively. Children with moderate or worse HI scored lower in Writing and Numeracy by 13.4 points (95% CI, − 24.8 to − 1.9, p = 0.022) and 15.2 points (95% CI, − 27.6 to − 2.7, p = 0.017), both equivalent to 6.3% of the mean score the respective domain. Other factors associated with poorer NAPLAN results included being male, lower Year 2 school attendance, low birthweight, average household size> 5 persons, living in a very remote community and speaking English as a second language.ConclusionsOM-related HI was independently associated with poorer early year academic achievement in Aboriginal children living in remote NT communities. Interventions to improve academic outcomes for Aboriginal children must incorporate actions to address the negative impact associated with HI through early detection, effective treatment and ongoing support for affected children.
Highlights
The prevalence of otitis media (OM) and related hearing loss has remained persistently high among some groups of Australian Aboriginal children who are reported to have poor academic outcomes
OM-related hearing impairment (HI) was independently associated with poorer early year academic achievement in Aboriginal children living in remote Northern Territory (NT) communities
Interventions to improve academic outcomes for Aboriginal children must incorporate actions to address the negative impact associated with HI through early detection, effective treatment and ongoing support for affected children
Summary
The prevalence of otitis media (OM) and related hearing loss has remained persistently high among some groups of Australian Aboriginal children who are reported to have poor academic outcomes. The impact of hearing loss on educational performance can be mediated in two ways: firstly, OM and hearing loss may persist from early childhood to the school years; or secondly, hearing loss during critical periods of neurological development in early childhood may result in difficulties with auditory processing skills [12] In this latter case a child’s hearing may return to normal but auditory processing problems still compromise learning, especially in noisy classrooms. In the Northern Territory (NT) of Australia, the lack of hearing assessment data is, in part, the result of a majority of NT Aboriginal children living in remote communities where there is a high turnover of health care staff [18] and limited access and long waiting times for specialist ear health services [19]. Even when specialist ear health services are provided locally, they have not been accessed universally [20]
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