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AIM To investigate the association between hearing impairment (HI) and measures of early childhood development in Aboriginal children at age 5 years. METHODS An observational cohort study (n = 1037) of children aged 4.0-7.3 years (median 5.4 years), living in remote Northern Territory (NT) communities, was conducted using multiple linked administrative datasets, including the NT Perinatal Data Register, Remote Hearing Assessment records (2007-2015) and Australian Early Development Censuses (AEDC, 2009, 2012 and 2015). Outcome measures were summary and domain-specific AEDC results using both dichotomous and continuous variables (domain scores). RESULTS Compared with normal hearing children, after adjustment for selected confounding factors, those with moderate or worse HI had an adjusted odds ratio of 1.69 (95% confidence interval (CI), 1.03-2.77) for being developmentally vulnerable in two or more of the five AEDC domains. Children with mild HI and those with moderate to worse HI had lower domain score sum by -1.60 (95% CI, -3.02 to -0.18) and - 2.40 (95% CI, -4.50 to -0.30), respectively. There was also evidence for an association between HI and poorer outcomes in the 'language and cognitive skills', 'communication skills and general knowledge' and 'physical health and wellbeing' domains. CONCLUSIONS Otitis media-related HI is associated with increased risk for poorer outcomes in early childhood development and this risk appears to increase with higher levels of HI. Prevention and early treatment of otitis media will reduce both the disease and the associated negative impact on early child development, especially the development of language, cognitive and communication skills and physical health and wellbeing.

Objective: To investigate the association between hearing impairment (HI) and Year 1 school attendance in Aboriginal children in the Northern Territory (NT) of Australia. Methods: Observational cohort study (n=3,744) by analysing linked individual‐level information for Aboriginal children from the NT Government school attendance records, NT Perinatal Register and Remote Hearing Assessment dataset, and community level data for relative remoteness, socioeconomic disadvantage and housing crowdedness. Results: Children with unilateral hearing loss, mild HI and moderate or worse HI had significantly lower Year 1 attendance than those with normal hearing, attending 5.6 (95%CI, −9.10 ∼−2.10), 4.0 (95%CI, −7.17 ∼−0.90) and 6.1 (95%CI, −10.71 ∼−1.49) days fewer, respectively. Other variables that yielded significant association were: male gender, having attended preschool less than 20% of available days, speaking English as second language, twin birth and average household size >5. Conclusions: Aboriginal children with any level of HI are likely to have lower school attendance rates in Year 1 than their peers with normal hearing. Implications for public health: In this population, where the prevalence of otitis media and accompanying HI remains extremely high, the early detection and management of hearing loss on entry into primary school should be included in the measures to improve school attendance.

Objective: To identify risk factors and associations for sexually transmitted infections (STI) in young Aboriginal women presenting to an ED for non-genitourinary reasons, in order to better target opportunistic screening in this group. To determine the prevalence of chlamydia and gonorrhoea in women presenting to the Alice Springs Hospital ED. Methods: A cross-sectional study involving STI screening and participant interview between January 2007 and September 2007 was used. The participants were a convenience sample of Aboriginal women aged 16–35 years presenting to the Alice Springs Hospital ED for non-genitourinary reasons. The main outcome measures were the prevalence of gonorrhoea and chlamydia and significant associations for STI. Results: A total of 213 women were included in the study. The prevalence rates of women screened were 8.9% for chlamydia, 9.4% for gonorrhoea and 16.0% for gonorrhoea or chlamydia. Identified objective associations for positive STI diagnosis included presenting with an injury due to an assault (odds ratio [OR], 3.56), self-reported past history of an STI (OR, 2.53) and leucocytes on urinalysis (OR, 2.19). Conclusion: The prevalence of STI is high in young Aboriginal women presenting to Alice Springs Hospital ED. Screening is acceptable to these patients using low vaginal swabs, and may be targeted at those women with the identified associations. The results of the present study may have relevance to other hospital ED in areas with a high prevalence of STI. A prospective study is needed to confirm these findings.