Copyright Australian Hearing Demographic Details

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Isaac Leonard
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1 1 Demographic Details Of young Australians aged less than 26 years with a hearing loss, who have been fitted with a hearing aid or cochlear implant at 31 December 2016

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 2016 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 o o o Number of hearing impaired children Number of newly fitted children in the 2016 calendar year Fitting rates of children and young adults with hearing impairment 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. In 2016 Australian Hearing undertook a periodic review of the client base, removing duplicate records and changing the status of children and young adults who had ceased using their hearing aid or cochlear implant. The major characteristics of the report show: All aided and implanted children and young adults less than 26 years of age at 31 December 2016 who are identified as being current and active as at 31 December 2016 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 2016 Australian Hearing provided audiological services, hearing aid and cochlear implant support to 23,203 citizens and permanent residents under 26 years of age, of which 2,054 (8.9%) were Aboriginal or Torres Strait Islanders. 20,384 were aged under 21 years; o 51.9% were male o 9.5% were Aboriginal or Torres Strait Islander 2,819 were aged from years o 48.0% were male o 3.9% were Aboriginal or Torres Strait Islanders During 2016 a total of 2949 clients were fitted with hearing aids for the first time. 326 of these were children born in Of the clients first fitted during 2015, 2713 were aged under 21 at the time of first fitting 236 were aged years at the time of first fitting

3 3 Profile of the total client base. At 31 December 2016, Australian Hearing supported the hearing rehabilitation needs of 23,203 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 Table 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 from Australian Hearing 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

4 Quantity NSW VIC QLD WA SA TAS ACT NT National Number 880 740 576 257 201 65 51 49 2819 Percentage 31.2 26.3 20.4 9.1 7.1 2.3 1.8 1.7 100.

4 4 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 Nationally 12.1 % of clients are Young Adults aged from years. The proportion of the aided client base who are Young Adults has increased slightly since this new eligibility category was introduced in January 2012 (Figure 2). This is consistent with expectations; in the early years this client group comprised mainly clients who had left service after turning 21, and who had chosen to return when the new eligibility was announced. Now the majority are clients who have transitioned from the Aided child program to the Aided Young Adult program. Figure 2: Proportion of total Aided/Implanted Young Australians in each state/territory who are aged 21 to under 26 years comparison between first year of the new eligiblity criteria (December 2012) and current client base.

5 5 Table 4 provides further detail about the distribution of aided clients by year of birth, state and territory. Birth year NSW VIC QLD WA SA TAS ACT NT National Total Table4: 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 at 31 December 2016 While over half (51.5%) of the total client base is male, this ratio is not preserved for the clients aged 21 25, of whom 48.0% are male. (Tables 5-7) Gender NSW VIC QLD WA SA TAS ACT NT National Male Female Intersex Unknown Table 5: Gender of aided/implanted clients under 26years of age by State/Territory as a percentage of the client base.

6 6 Gender NSW VIC QLD WA SA TAS ACT NT National Male Female Intersex Unknown Table 6: Gender of aided/implanted clients under 21years of age by State/Territory as a percentage of the client base. NSW VIC QLD WA SA TAS ACT NT National Male Female Intersex Unknown 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 years at 31 December 2016 (3-Frequency Average Hearing Loss in the better ear) The hearing loss profile for each state and territory is shown in Tables 8 & 9.

7 7 Better Ear 3FAHL (dbhl) NSW VIC QLD WA SA TAS ACT NT National Unknown Total Table 8: Latest 3FA Hearing Loss of aided/implanted young Australians under 26 years of age Better 3FAHL NSW VIC QLD WA SA TAS ACT NT National Unknown 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 in the older cohort with more severe hearing losses. This is most likely to be because children who are fitted to help manage mild or unilateral hearing loss in an education setting, cease device usage when they leave school. Figure 4: Hearing Loss distribution according to age cohorts (under 21 years vs years)

8 8 Cochlear Implants The data base indicates that 2,827 children and young adults use a cochlear implant speech processor in one or both ears. While Australian Hearing supports maintenance and provides upgrade and replacement speech processors for these clients, the fitting and programming of the speech processors is undertaken by external clinics. Thus the data below are reliant upon the provision of information from external clinics and may not necessarily reflect the total number of clients who use a speech processor. The distribution of clients by year of birth and state/territory is shown in Table 10. Birth year NSW VIC QLD WA SA TAS ACT NT National Total Table 10: Clients who have been fitted with a cochlear implant in one or both ears, by state/territory and birth year 1. 1 Data likely to under-estimate cochlear implantee numbers

9 9 Clients first fitted with hearing aids in 2016 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/digital 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 re-established contact with Australian Hearing since the change in eligibility criteria on January 1, During 2016, a total of 2,949 clients under 26 years of age were first fitted with amplification, an increase of 2.9% from the previous year. 2,713 were aged less than 21 years at the time of first fitting whilst 236 were aged from 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 2016 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 National Summary by State/Territory and Birth year.

11 11 Figure 6: Clients first fitted with hearing aids during 2016, 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 the birth year 2016 showing the highest number of new fittings (11.1% of the total 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 Were not detected until school entry.

12 12 Figure 7: Hearing profile of clients first fitted in 2016 by age, better ear 3FAHL at 31 December 2016.

13 13 Birth year 0-40 dbhl dbhl dbhl 91+ dbhl Unknown Total Percentage Total Table 14: Clients first fitted in 2016, by birth year and better ear 3FAHL category

14 14 Aboriginal and Torres Strait Islander clients. Aboriginal and Torres Strait Islander children comprise 8.9% of the total aided/implanted client base, and accounted for 80.8% of newly fitted children in the Northern Territory. 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 8). This difference is likely to reflect several factors: that ear disease, the predominant cause of hearing loss in this group of children, starts after neonatal hearing screening and that across Australia, activities aimed at screening hearing in Aboriginal and Torres Strait Islander children are often school-based rather than health centre-based. Table 24 shows the distribution of Aboriginal and Torres Strait Islander clients by birth year and state, while Table 25 shows the distribution of Aboriginal and Torres Strait Islander clients first fitted in Figure 8: Age distribution of children first fitted in 2016, as a proportion of total new fittings Aboriginal and/or Torres Strait Islander clients vs. total client base.

15 15 Birth year NSW VIC QLD WA SA TAS ACT NT National Total Table 15: 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

16 16 Birth year NSW VIC QLD WA SA TAS ACT NT National Total Table 16: Aboriginal and/or Torres Strait Islander clients first fitted with hearing aids in 2016, National Summary by State/Territory and Birth Year. Further information can be found in the summary tables in Appendix A.

17 17 APPENDIX A SUMMARY TABLES.

18 Birth year Copyright Australian Hearing 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, at 31 December 2015 Year first fitted Total Total

19 19 DETAILS OF ABORIGINAL AND TORRES STRAIT ISLANDER CLIENTS UNDER THE AGE OF 26 YEARS WHO ARE FITTED WITH A HEARING AID OR COCHLEAR IMPLANT AT 31 DEC State First fitting age (months) 12 to <3 3 to <6 6 to <12 <18 18 to <24 Latest 3FAHL (dbhl) Total Unknown 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 AT 31 DEC.2015 First fitting age (months) Latest 3FAHL (dbhl) State 12 to 18 to Total <3 3 to <6 6 to < <18 < Unknown NSW VIC QLD WA SA TAS ACT NT National

20 20 DETAILS OF ABORIGINAL AND TORRES STRAIT ISLANER CLIENTS AGED YEARS WHO ARE FITTED WITH A HEARING AID OR COCHLEAR IMPLANT AT 31 DEC 2015 First fitting age (months) Latest 3FAHL (dbhl) State 12 to 18 to Total <3 3 to <6 6 to < <18 < Unknown NSW VIC QLD WA SA TAS ACT NT National

21 21 Birth year DETAILS OF PERSONS UNDER THE AGE OF 26 YEARS WITH HEARING IMPAIRMENT WHO ARE FITTED WITH A HEARING AID OR COCHLEAR IMPLANT AT 31 DEC.2015 AUSTRALIA 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 for 2016 which is an estimate

22 22 Birth year DETAILS OF PERSONS UNDER THE AGE OF 26 YEARS WITH A HEARING IMPAIRMENT WHO ARE FITTED WITH A HEARING AID OR COCHLEAR IMPLANT AT 31 DEC 2015 NSW Births 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 for 2016, which is an estimate

23 23 Birth year DETAILS OF PERSONS UNDER THE AGE OF 26 YEARS WITH A HEARING IMPAIRMENT WHO ARE FITTED WITH A HEARING AID OR COCHLEAR IMPLANT AT 31 DEC VICTORIA 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 for 2016 which is an estimate

24 24 Birth year DETAILS OF PERSONS UNDER THE AGE OF 26 YEARS WITH A HEARING IMPAIRMENT WHO ARE FITTED WITH A HEARING AID OR COCHLEAR IMPLANT AAT 31 DEC QUEENSLAND 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 for 2016, which is an estimate

25 25 Birth year DETAILS OF PERSONS UNDER THE AGE OF 26 YEARS WITH A HEARING IMPAIRMENT WHO ARE FITTED WITH A HEARING AID OR COCHLEAR IMPLANT ATA 31 DEC WESTERN AUSTRALIA 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 for 2016, which is an estimate

26 26 Birth year DETAILS OF PERSONS UNDER THE AGE OF 26 YEARS WITH HEARING IMPAIRMENT WHO ARE FITTED WITH A HEARING AID OR COCHLEAR IMPLANT AT 31 DEC SOUTH AUSTRALIA Births First fitting age (months) 12 to <3 3 to <6 6 to <12 <18 Latest 3FAHL (dbhl) 18 to < Total fitted RatePer1000Births Unknown Total Births from ABS CAT except for 2016 which is an estimate

27 27 Birth year DETAILS OF PERSONS UNDER THE AGE OF 26 YEARS WITH A HEARING IMPAIRMENT WHO ARE FITTED WITH A HEARING AID OR COCHLEAR IMPLANT AT 31 DEC TASMANIA 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 for 2016 which is an estimate

28 28 Birth year DETAILS OF PERSONS UNDER THE AGE OF 26 YEARS WITH A HEARING IMPAIRMENT WHO ARE FITTED WITH A HEARING AID OR COCHLEAR IMPLANT AT 31 DEC ACT 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 for 2016 which is an estimate

29 29 Birth year DETAILS OF PERSONS UNDER THE AGE OF 26 YEARS WITH HEARING IMPAIRMENT WHO ARE FITTED WITH A HEARING AID OR COCHLEAR IMPLANT AT 31 DEC NT 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 for 2016 which is an estimate

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