Copyright Australian Hearing Demographic Details

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1 1 Demographic Details Of young Australians aged less than 26 years with a hearing impairment, who have been fitted with a hearing aid or cochlear implant at 31 December 2013

2 2 Summary This circular contains summary data on children and young adults fitted with hearing aids or cochlear implants in Australia, who were under the age of 26 years at 31 December 2013 and who were provided with audiological and hearing aid or speech processor support services through Australian Hearing. On January 1, 2012, the upper age limit for eligibility for Australian Hearing s paediatric program was extended from 21 to 26 years of age. While the demographic data in this document can be considered to cover all young Australians under the age of 21 who use a hearing aid or cochlear implant, the same cannot be said for those in the older age group, since some of this older age group may have elected to continue services with their existing private provider or may have not yet established contact with Australian Hearing. The data provides information at national and State / Territory level and has been collated from Australian Hearing s electronic client and record management system databases (as a snapshot ) and includes: o Number of hearing impaired children o Number of newly fitted children in the 2013 calendar year o Fitting rates of children and young adults with hearing impairment o Hearing loss distribution of aided/implanted children and young adults Differences in other data and calculations shown for similar birth years in previous reports prior to 2007 are due to the timing of the snapshot nature of the report (data were previously collated on 31 March each year) i.e. the dynamics of the child population characteristics and demography in the database, updated information and calculation rounding at the time the report was compiled. In particular, actions across the organization that have taken place to review and update the information on all aided child clients in the database, have also affected the snapshot counts and calculations. The major characteristics of the report show: All aided and implanted children and young adults less than 26 years of age at 31 December 2013 who are identified as being current and active as at 31 December 2013 Data on children and young adults who were first fitted with hearing aids from 1 January to 31 December Care should be taken when comparing information from previous reports, and particularly prior to 2007, due to their differing parameters. Taking the above comments into account this report shows that on 31 December 2013, Australian Hearing provided audiological services, hearing aid and cochlear implant support to 20,865 citizens and permanent residents under 26 years of age, of which 1,757 (8.4%) were Aboriginal or Torres Strait Islanders were aged under 21 years; o 52.5% were male o 1,850 (9.5%) were Aboriginal or Torres Strait Islander 2,450 were aged from 21 to under 26 years o 48.9% were male o 96 (3.9%) were Aboriginal or Torres Strait Islander

3 3 During 2013 a total of 2, 520 clients were fitted with hearing aids for the first time. 295 of these were children born in Of the clients first fitted during 2013: 2,386 were aged under 21 at the time of first fitting 134 were aged 21 to <26 years at the time of first fitting

4 4 Profile of the total client base At 31 December 2013, Australian Hearing supported 20,865 citizens and permanent residents under 26 years of age. Figure 1 and Table 1 show the distribution of clients by state/territory of residence at 31 December Tables 2 displays the distribution of clients aged less than 21 years, which can be assumed to represent all aided/implanted children. Table 3 displays the distribution of clients aged years, but may not necessarily represent all Australians with hearing loss in that age group, since some may not have returned to receive service following the extension of eligibility during Figure 1: Aided/Implanted Young Australians less than 26 years of age, by state/territory Quantity NSW VIC QLD WA SA TAS ACT NT National Number Percentage Table 1: Distribution of Aided/Implanted Young Australians under 26 years of age, by state/territory Quantity NSW VIC QLD WA SA TAS ACT NT National Number Percentage Table 2: Distribution of Aided/Implanted Young Australians aged less than 21 years by state/territory Quantity NSW VIC QLD WA SA TAS ACT NT National Number Percentage Table 3: Distribution of Aided/implanted Young Australians aged from 21 to less than 26 years by state/territory

5 5 Nationally 11.7% of clients are aged from years. The distribution by state/territory is shown in Figure 2. Figure 2: Proportion of total Aided/Implanted Young Australians in each state/territory who are aged 21 to under 26 years Table 4 provides further detail about the distribution of aided clients by year of birth, state and territory.

6 6 Birth Year NSW VIC QLD WA SA TAS ACT NT National Total Table 4: All clients aged less than 26 years who have been fitted with a hearing aid and/or cochlear implant, National Summary by State/Territory and Birth Year Gender While over half (52.5%) of the total client base is male, this ratio differs slightly for the clients aged 21 25, of whom 48.9% are male. (Tables 5-7). Gender NSW VIC QLD WA SA TAS ACT NT National Male Female Data Unavailable Table 5: Gender of aided/implanted clients under 26years of age by State/Territory as a percentage of the client base.

7 7 Gender NSW VIC QLD WA SA TAS ACT NT National Male Female Data Unavailable Table 6: Gender of aided/implanted clients under 21years of age by State/Territory as a percentage of the client base. Gender NSW VIC QLD WA SA TAS ACT NT National Male Female Table 7: Gender of aided/implanted clients 21 to <26 years of age by State/Territory as a percentage of the client base. Hearing Loss The vast majority of clients who use amplification have a 3 Frequency Average Hearing Loss (3FAHL) of 0 to 60 dbhl; that is their better ear hearing loss ranges from within normal limits to a moderate degree (Figure 3). Figure 3: Distributionof hearing loss amongst total aided clients aged under 26 yearsat 31 December 2013

8 8 The hearing loss profile for each state and territory is shown in Tables 8 & 9. Latest 3FA NSW VIC QLD WA SA TAS ACT NT National Data Unavailable Total Table 8: Latest 3FA Hearing Loss of aided/implanted young Australians under 26 years of age Latest 3FA NSW VIC QLD WA SA TAS ACT NT National Data Unavailable Total Table 9: Latest 3FA Hearing Loss of aided/implanted young Australians under 26 years of age, Percentage distribution The hearing loss distribution amongst clients aged differs from that of the younger age cohort, showing a higher proprotion of clients with more severe hearing losses in the older cohort. Figure 4: Hearing Loss distribution according to age cohorts (under 21 years vs 21 to <26 years)

9 9 Clients first fitted with hearing aids in 2013 While Australian Hearing s demographic data can be considered to represent all young Australians under the age of 21 who use hearing aids, personal FM systems or a cochlear implant, the same cannot be said for those aged from 21 to 25 years, since some of this older age group may have not yet re-established contact with Australian Hearing since the change in eligibility criteria on January 1, During 2013, a total of 2,520 clients under 26 years of age were first fitted with amplification. 2,386 were aged less than 21 years at the time of first fitting whilst 134 were aged from 21 to <26 years. The distribution of clients by state and territory is found in Tables 11 & 12, with a more detailed analysis according to year of birth, state and territory in Table 13. Clients first fitted by state & territory Quantity NSW VIC QLD WA SA TAS ACT NT National Number Percentage Table 11: Distribution of children under 21 years of age and fitted for the first time in by state and territory Quantity NSW VIC QLD WA SA TAS ACT NT National Number Percentage Table 12: Distribution of clients aged years of age and fitted for the first time in 2013 by state and territory

10 10 Birth Year NSW VIC QLD WA SA TAS ACT NT National Total Table 13: Clients less than 26 years of age who were first fitted with hearing aids in 2013, National Summary by State/Territory and Birth Year

11 11 Figure 6: Clients first fitted with hearing aids during 2013, according to age & year of birth The impact of Universal Newborn Hearing Screening continues to be apparent in the fitting profile of children shown in Figure 6, with children in their first year of life (birth year 2013) showing the highest number of new fittings. A second peak in fittings occurs in early primary school. As can be seen in Figure 7, the vast majority of children who receive their first hearing aids in primary school have a mild or unilateral hearing loss (Better Ear 3FAHL < 40 dbhl). A more detailed analysis by Birth Year and 3FAHL is found in table 14 Late hearing aid fittings may be due to a number of factors including: Late onset or progressive sensorineural hearing loss Children who develop a chronic conductive hearing loss due to Otitis Media, Children with a mild or unilateral hearing loss that was either o Diagnosed at an early age, but who did not require assistance with hearing until school entry o Not detected until school entry. Figure 7: Hearing profile of clients first fitted in 2013 by age, better ear 3FAHL at 31 December 2013.

12 12 Birth Year Unknown Total Percentage Total Table 14: Clients first fitted in 2013, by birth year and better ear 3FAHL category

13 13 Early hearing aid fitting The national rollout of Universal Newborn Hearing Screening was completed during The following tables show the number of fittings expected, based upon a rate of 1.1 per thousand babies born with a moderate or greater bilateral hearing loss, for National, State and Territory data. Note that the nubmer of children fitted under 12 months of age includes those who were fitted before six months of age and that the actual number fitted includes all degrees of hearing loss. Tables 15 23: Expected and Actual numbers of children fitted before 6 months and 12 months of age. Births from ABS CAT except 2013, which is an estimate. AUST Expected Fit.<6mth Fit.<12mo <6mo <12mo NSW Expected Fit.<6mth Fit.<12mo <6mo <12mo Table 15: National Table 16: NSW VIC Expected Fit.<6mth Fit.<12mo <6mo <12mo QLD Expected Fit.<6mth Fit.<12mo <6mo <12mo Table 17: Victoria Table 18: QLD

14 14 Tables 14 22: Expected and Actual numbers of children fitted before 6 months and 12 months of age. Births from ABS CAT except 2013, which is an estimate. WA Expected Fit.<6mth Fit.<12mo <6mo <.12mo SA Expected Fit.<6mth Fit.<12mo <6mo <12mo Table 19: Western Australia Table 20: South Australia TAS Expected Fit.<6mth Fit.<12mo <.6mo <.12mo ACT Expected Fit.<6mth Fit.<12mo <.6mo <.12mo Table 21: Tasmania Table 22: Australian Capital Territory NT Expected Fit.<6mth Fit.<12mo <6mo <12mo Table 23: Northern Territory

15 15 As can be seen from Figure 8, the number of children fitted with hearing aids before 3 and 6 months of age, expressed as a fitting rate per thousand live births (KLB), has increased significantly in the years since Universal Newborn Hearing Screening rollout commenced in NSW at the end of However fitting rates for older children appear to have stabilised. Figure 8: Fitting rates per Thousand Live Births (per KLB) for selected birth years form 2000 (pre-unhs rollout) to 2012 Figure 9 shows the fitting rate per KLB according to the better ear initial 3 Frequency Average Hearing Loss, for children who received their first hearing aid before 12 months of age, and clearly shows the impact of UNHS on detection and fitting of milder hearing losses at an early age. Fitting rates have increased most dramatically for children with a 3fAHL less than 40dBHL Fitting rate per KLB Year of birth Figure 9: Fitting rates for children fitted before 12 months of age according to year of birth & Initial 3FAHL

16 16 Aboriginal and Torres Strait Islander clients The proportion of aided/implanted clients who are Aboriginal and Torres Strait Islander has remained essentially stable over the past two years, comprising 8.4% of the total aided/implanted client base, and in the NT accounting for 83.8% of newly fitted children. Consistent with previous years data, the peak age for fitting Aboriginal and Torres Strait Islander children occurs during the primary school years, compared with the total client base, where the peak fitting age is in the first year of life (Figure 10). This is likely to reflect the fact that many outreach services are school-based programs. Table 24 shows the distribution of Aboriginal and Torres Strait Islander clients by birth year and state. Figure 10: First fitting profile of Aboriginal and Torres Strait Islander clients compared with profile of total new fittings for 2013.

17 17 Birth Year NSW VIC QLD WA SA TAS ACT NT National Total Table 24: Aboriginal and/or Torres Strait Islander clients aged less than 26 years who have been fitted with a hearing aid and/or cochlear implant, National summary by State/Territory and Birth Year

18 18 Table 25 shows the distribution of Aboriginal and Torres Strait Islander clients who were first fitted with hearing aids during Birth Year NSW VIC QLD WA SA TAS ACT NT National Total Table 25: Aboriginal and/or Torres Strait Islander clients first fitted with hearing aids in 2013, National Summary by State/Territory and Birth Year

19 19 Figure 11: - Comparison of Hearing Loss distribution for aided/implanted young Australians aged under 26 years at 31 December 2013 Aboriginal & Torres Strait Islander clients compared to total client base The hearing loss profile of Aboriginal and Torres Strait Islander clients shows a higher proportion of hearing losses in the mild range. Fitting rates for Aboriginal and Torres Strait Islander children are heavily influenced by higher rates of conductive hearing loss due to chronic middle ear disease, which is the most likely reason for the preponderance of mild hearing loss. Data from the Australian Hearing client bases suggests that at least twice as many Aboriginal and Torres Strait Islander children are fitted with personal hearing aids because of conductive hearing loss, compared with the total number of children who are aided because of conductive hearing loss. This figure will underestimate the number of Aboriginal and Torres Strait Islander children who require amplification due to conductive hearing loss because a significant proportion of these children may be assisted by the use of sound field systems in their classroom, rather than by a personal device. Further information can be found in the summary tables in Appendix A.

20 APPENDIX A SUMMARY TABLES 20

21 Birth year 21 Clients under 26 years of age who have been fitted with a hearing aid and/or cochlear implant, by birth year and calendar year first fitted Year first fitted Total Total

22 22 DETAILS OF ABORIGINAL AND TORRES STRAIT ISLANDER CLIENTS UNDER THE AGE OF 26 YEARS WHO ARE FITTED WITH A HEARING AID OR COCHLEAR IMPLANT First fitting age (months) Latest 3FAHL (dbhl) State 12 to 18 to Total <3 3 to <6 6 to < Unknown <18 <24 NSW VIC QLD WA SA TAS ACT NT National DETAILS OF ABORIGINAL AND TORRES STRAIT ISLANDER CLIENTS UNDER THE AGE OF 21 YEARS WHO ARE FITTED WITH A HEARING AID OR COCHLEAR IMPLANT First fitting age (months) Latest 3FAHL (dbhl) State 12 to 18 to Total <3 3 to <6 6 to < Unknown <18 <24 NSW VIC QLD WA SA TAS ACT NT National

23 23 DETAILS OF ABORIGINAL AND TORRES STRAIT ISLANER CLIENTS AGED 21 TO UNDER 26 YEARS WHO ARE FITTED WITH A HEARING AID OR COCHLEAR IMPLANT First fitting age (months) Latest 3FAHL (dbhl) State 12 to 18 to Total <3 3 to <6 6 to < Unknown <18 <24 NSW VIC QLD WA SA TAS ACT NT National

24 DETAILS OF PERSONS UNDER THE AGE OF 26 YEARS WITH HEARING IMPAIRMENT WHO ARE FITTED WITH A HEARING AID OR COCHLEAR IMPLANT AUSTRALIA Birth year First fitting age (months) Latest 3FAHL (dbhl) Total Births <3 3 to <6 6 to <12 12 to <18 18 to < fitted RatePer1000Births Unknown Total Births from ABS CAT except 2013, which is an estimate 24

25 DETAILS OF PERSONS UNDER THE AGE OF 26 YEARS WITH A HEARING IMPAIRMENT WHO ARE FITTED WITH A HEARING AID OR COCHLEAR IMPLANT 25 Birth year Births NSW First fitting age (months) Latest 3FAHL (dbhl) Total Rate Per 1000Births <3 3 to <6 6 to <12 12 to <18 18 to < fitted Unknown Total Births from ABS CAT except 2013, which is an estimate

26 DETAILS OF PERSONS UNDER THE AGE OF 26 YEARS WITH A HEARING IMPAIRMENT WHO ARE FITTED WITH A HEARING AID OR COCHLEAR IMPLANT 26 Birth year Births VICTORIA First fitting age (months) Latest 3FAHL (dbhl) Total <3 3 to <6 6 to <12 12 to <18 18 to < fitted RatePer1000Births Unknown Total Births from ABS CAT except 2013, which is an estimate

27 DETAILS OF PERSONS UNDER THE AGE OF 26 YEARS WITH A HEARING IMPAIRMENT WHO ARE FITTED WITH A HEARING AID OR COCHLEAR IMPLANT 27 Birth year Births QUEENSLAND First fitting age (months) Latest 3FAHL (dbhl) Total <3 3 to <6 6 to <12 12 to <18 18 to < fitted RatePer1000Births Unknown Total Births from ABS CAT except 2013, which is an estimate

28 DETAILS OF PERSONS UNDER THE AGE OF 26 YEARS WITH A HEARING IMPAIRMENT WHO ARE FITTED WITH A HEARING AID OR COCHLEAR IMPLANT WESTERN AUSTRALIA 28 Birth year Births First fitting age (months) Latest 3FAHL (dbhl) Total <3 3 to <6 6 to <12 12 to <18 18 to < fitted RatePer1000Births Unknown Total Births from ABS CAT except 2013, which is an estimate

29 29 Birth year Births DETAILS OF PERSONS UNDER THE AGE OF 26 YEARS WITH A HEARING IMPAIRMENT WHO ARE FITTED WITH A HEARING AID OR COCHLEAR IMPLANT SOUTH AUSTRALIA First fitting age (months) Latest 3FAHL (dbhl) Total <3 3 to <6 6 to <12 12 to <18 18 to < fitted RatePer1000Births Unknown Total Births from ABS CAT except 2013, which is an estimate

30 DETAILS OF PERSONS UNDER THE AGE OF 26 YEARS WITH A HEARING IMPAIRMENT WHO ARE FITTED WITH A HEARING AID OR COCHLEAR IMPLANT TASMANIA 30 Birth year Births First fitting age (months) Latest 3FAHL (dbhl) Total <3 3 to <6 6 to <12 12 to <18 18 to < fitted RatePer1000Births Unknown Total Births from ABS CAT except 2013, which is an estimate

31 DETAILS OF PERSONS UNDER THE AGE OF 26 YEARS WITH A HEARING IMPAIRMENT WHO ARE FITTED WITH A HEARING AID OR COCHLEAR IMPLANT ACT 31 Birth year Births First fitting age (months) Latest 3FAHL (dbhl) Total <3 3 to <6 6 to <12 12 to <18 18 to < fitted RatePer1000Births Unknown Total Births from ABS CAT except 2013, which is an estimate

32 32 Birth year Births DETAILS OF PERSONS UNDER THE AGE OF 26 YEARS WITH A HEARING IMPAIRMENT WHO ARE FITTED WITH A HEARING AID OR COCHLEAR IMPLANT NT First fitting age (months) Latest 3FAHL (dbhl) Total <3 3 to <6 6 to <12 12 to <18 18 to < fitted RatePer1000Births Unknown Total Births from ABS CAT except 2013, which is an estimate