Case Study


This case study shows how audiologists at Hearing Australia use the PLUM to support decision making about hearing aids, and later, evaluate whether the hearing aid is helping the child.

Tjandamurra, who had just turned three years old, was seen at a Hearing Australia clinic with a history of chronic ear disease. A hearing test seven months earlier had shown a mild conductive hearing loss.  He had been referred to an ENT and was on a waiting list for an initial consultation at the local public hospital.  He had also been referred to a speech pathologist and was diagnosed with a speech delay, and was receiving regular speech therapy.

On the day of the Hearing Australia clinic, Tjandamurra had a mild to moderate conductive hearing loss, and he had a PLUM score of 18, which indicated his listening skills were not on track.

Two weeks later Tjandamurra was fitted with a bone conduction hearing aid to help him hear while he waited for medical intervention.

We planned to see Tjandamurra a fortnight later to find out how he was going with his hearing aid, however his family could not come into the clinic, so we had a telephone catch up.  Mum reported that he really loved the device – they had videos of him crying at night when he had to take it off for bed.   They were noticing huge benefits, regarding listening and speech.  Tjandamurra went to his speech therapy with the hearing aid on, and she said he was much better, and the clarity of his speech was improving.  The PLUM was repeated with mum over the phone.  His initial PLUM was 18, however the PLUM two weeks after the hearing aid fitting was 26.  Tjandamurra was still not on track but this showed that he had made some improvement with his listening skills.

We were able to reassure Tjandamurra’s parents that he was making progress and that the hearing aid was worthwhile.

Shaira and Caleb

This case study shows how the PLUM and HATS tools can be used to help make decisions about when to fit young children with hearing aids.

My name is Meagan, I am an audiologist and I work for Hearing Australia. In 2019, I was running a telehealth clinic with the Deadly Ears Program, which is a Queensland State Health ear and hearing service that works in remote Aboriginal and Torres StraitIslander communities. Deadly Ears identifies young children with ongoing ear trouble and, if appropriate and after discussing with families, refers to us to work out whether they would benefit from a hearing aid.

Shaira and Caleb were two and a half years old. At this age, children’s hearing can be tricky to assess, and it was not possible to complete a hearing test with either of them. Both children had a middle-ear condition in both ears, and it was unclear how long they had the condition.

Using video conferencing, I met Shaira and her parents. Together with the Deadly Ears audiologist who was in the community with the family, we talked about their child’s hearing. I then did a PLUM and HATS with them. These tools were very suitable for using with telehealth, they were a lovely way to explore with a parent how their child was listening and talking at home.

Shaira had a PLUM score of 35, and a HATS score of 45. This showed that her communication and listening skills were on track for her age. I was able to reassure her parents that Shaira was doing well. I suggested that they should continue to attend the Health Clinic who would help them manage her ear health and monitor her listening and communication skills development, and Deadly Ears would review Shaira in three months’ time.

Next, I met Caleb and his parents. Caleb had a PLUM score of 21 and a HATS score of 15. This showed that his listening and communication skills were not yet on track. I talked with his parents about my concern that Caleb may have been having hearing trouble for some time, which has been affecting his development.
Caleb’s parents decided they would use the device, as it would help Caleb listen and understand better during storytime, and when they talk to him at home.

With the help of the Deadly Ears clinician, we showed the parents a bone conductor hearing aid and tried it on Caleb. He immediately brightened up, and for the first time in the appointment used his voice and started giggling. This is a reliable sign that he had been experiencing trouble hearing, and it helped his parents decide to take the hearing aid home and use it when they were talking with Caleb and for storytime.

The PLUM and HATS measured how each child’s listening and talking skills were developing. The results then guided me towards making the appropriate recommendations for each child to their parents. The PLUM and HATS questions also helped the parents to think about their child’s behavior, which assisted us to decide together what would meet their child’s needs.