Hearing checks for Aboriginal children – Screening that actually improves Mental Health outcomes!

Rather than wasting resources on mental health screening for three year olds, Australian governments would get better value addressing the Aboriginal child hearing loss pandemic.

Mental Health screening typically involves completing behavioural check lists. They are about as ‘scientific’ as a Cosmopolitan Magazine personality quiz. At their best they may help to identify that a child is ‘failing to thrive’ but don’t identify the underlying causes of any problematic behaviour and can lead children on a dangerous pathway of misdiagnosis and overprescribing.

In contrast appropriate physical health screening, including hearing and sight screening, can identify problems early and prevent a lifetime of underachievement and suffering.

All Australian children deserve access to appropriate screening services but tragically the greatest concentration of unmet need is amongst Aboriginal children. Rather than wasting resources on mental health screening for three year olds,¹ Australian governments would get better value addressing the Aboriginal child hearing loss pandemic.²

Four out of ten Aboriginal and Torres Strait Islander (ATSI) children “acquire middle ear disease immediately after birth.  One in three ATSI children has a perforated eardrum before the age of two…On average ATSI children have middle ear infections for two and a half years of childhood; non-ATSI children have it for three months.”³

These shocking statistics have disastrous consequences. Untreated middle ear infection frequently results in hearing loss which in turn frequently leads to “significant problems with learning, academic achievement, and other psychological and social issues”.  It is also “associated with future behavioural disturbances such as restlessness and fidgetiness, frequent disobedience, impaired task orientation in the classroom, inattention, short attention span and/or distractibility, and restricted social interaction”.⁴

The potential for undetected hearing loss to be misdiagnosed as ADHD is obvious.⁵ As is the potential for children with hearing loss to be ‘medicated’ with amphetamine like stimulants in order to ‘control’ problematic behaviours.

The long term consequences of undetected and untreated hearing loss can be catastrophic both for the individual and society. “Two recent studies conducted within the past two years investigated the prevalence of hearing loss among inmates in Northern Territory correctional facilities. They found that more than 90% of Australian Indigenous inmates had a significant hearing loss of >25dB. A third study in a youth detention centre in the Northern Territory demonstrated that as many as 90% of Australian Indigenous youth in detention may have hearing loss, whilst yet another study found that almost half the female Indigenous inmates at a Western Australian prison had significant hearing loss, almost ten-fold that of the non-Indigenous inmates.”⁶ From both a public health and ‘law and order’ perspective screening and early intervention for Aboriginal children’s hearing loss makes absolute sense.

In my home state, Western Australia, the Earbus Mobile Children’s Ear Clinics provide “a network of mobile ear clinics providing an ear health screening, surveillance and treatment program” to some Aboriginal children.⁷  In 2011 the existing Earbus Mobile Children’s Ear Clinics screened 3,344 children. 50.5% passed all tests 34.4% failed at least one aspect of the hearing tests and 14.9% required immediate treatment by either a GP or an Ear Nose and Throat Specialist.⁸

But there is significant unmet need. The Telethon Speech & Hearing Centre for Children is seeking financial support, an additional $4.5m per year, when the Earbus program is fully rolled out across Western Australia.

This investment in some of the most disadvantaged Australian children would be repaid many times with better long term mental health, educational, social, economic, justice and legal outcomes.

 Related Media – Experts blast kids’ mental tests by Cathy O’leary in the West Australian 15 August 2012