A child who passes their hearing test at birth can still develop a hearing loss. We need a range of ways of identifying children who may need intervention as early as possible within their first five years.
The PLUM and HATS have been designed to screen listening and communication skills in children under 6 years of age.

The earlier that we pick up a child with hearing problems, the earlier we can help the child.
We know that if you pick up hearing loss and do something to make sure bub hears well before the age of three, it makes a big difference to listening and communication skills.

Some groups are particularly at risk of early hearing loss: about 30% of Aboriginal and Torres Strait Islander children experience long-term ear infections. These often start before a child is 1 year old.
Hearing Australia currently reports that the average age of first hearing aid fitting for Aboriginal and Torres Strait Islander children is around 6 years. This is much later than other Australian children, who receive their first hearing aids at around 6 months of age.

Parents and carers are key, so we need tools that can be easily used with them by primary health and early education workers.

Parents and carers know their child best, but it can be difficult to answer a simple question like “Do you have any concerns about your child’s hearing?” if you don’t know what to look out for.
The PLUM and the HATS are designed to ask parents and carers the right questions about their child’s listening and talking behaviour in everyday situations. They do not need to know anything about listening or communication behaviour in order to give us good information about their child. Answers to the questions assist with picking up children who need help.

These scales have been tested with Aboriginal and Torres Strait Islander children in urban, regional and remote areas, as well as a general population.

In summary, the main reasons the PLUM and HATS were developed include:

• To enable children who need help with developing listening skills to receive that help earlier.
• To ensure that the scales are appropriate to use with Aboriginal and Torres Strait Islander children
• To give parents and carers the right questions to answer about their child’s listening and communication behaviour.

The PLUM stands for the “Parent-evaluated Listening and Understanding Measure”

About the PLUM:

• The PLUM is 10 questions to ask parents or carers about the listening behaviours they are seeing in their child every day
• Age-appropriate Listening behaviours are a reliable indicator of hearing ability
• We did PLUM and hearing tests with 100 Aboriginal urban & remote children and found poor PLUM scores suggest a hearing problem
• The PLUM is good for screening for hearing problems in children
• The scores help to identify children who may benefit from a hearing test referral
• Generally, the PLUM takes about 10 minutes to complete

Administration

• Make sure you have a copy of the PLUM form.
• Explain to the parent:
Can I ask you a few questions about your child’s hearing and listening day to day? For each question, tell me whether your child does these things: ‘not yet or a little’, ‘Sometimes’, or ‘a lot or always’
• For each question think of an age-appropriate example –e.g. for a 10 month old baby: does your baby make happy babbling noises when you talk with them?”
• Encourage the parents to give examples as you talk about the questions. Remember the PLUM is designed to spark a conversation.
• Encourage the parent to choose an answer, like ‘So that sounds like ‘sometimes’ – or would you say ‘always’?

Scoring

• Every time a question is answered, circle the parents’ response on the form
• Add up the score (or the online or PDF versions score it automatically).
• Write the total score on to the score sheet
• Mark the child’s score in the appropriate age bracket
• When scoring, it may be appropriate to use a child’s adjusted age if they are premature or have an additional disability

Interpretation

• If a child scores in the clear area, then this indicates their listening skills are not on track
• If a child scores in the grey area, then their listening skills are borderline and need to be tested again in 3 months
• If a child scores in the dark area, then their listening skills are on track.

The HATS stands for the "Hearing and Talking Scale"

About the HATS:

• The HATS is 5 questions to ask parents or carers about the 'talking behaviours' they are seeing in their child every day
• We have done the HATS with many Aboriginal and Torres Strait Islander children and found poor HATS scores suggest a communication problem
• The HATS is good for screening and working out if a child could benefit from a speech referral at the health service.
• The HATS takes approximately 5 minutes to complete

Administration

• Make sure you have a copy of the HATS form.
• Find the age group of the child
• Explain to the parent:
Can I ask you five questions about how your child communicates? For each question tell me whether your child does these things 'not yet or a little', 'sometimes', or 'a lot or always'
• Ask the parent the five questions in that age bracket
• Encourage the parents to give examples as you talk about the questions.

Scoring

• Mark the appropriate box.
• Give each answer a score and add up the total (or the online or PDF versions score it automatically).
• Mark the child's score on to the HATS table on the score sheet.

Interpretation

• If a child scores in the clear area then this indicates their communication skills are not on track
• If a child scores in the grey area, then their communication skills are in the borderline range and need to be tested again in 3 months.
• If a child scores in the dark area their communication skills are on track.

• The PLUM is 10 questions to ask parents or carers about the 'listening behaviours' they are seeing in their child every day
• The HATS is 5 questions to ask parents or carers about the ‘talking behaviours’ they are seeing in their child every day
• The PLUM and HATS questions are designed for having a conversation with familie
• The PLUM and HATS can be used by health workers and educators to ask parents or carers about their children aged under 6

• The PLUM is 10 questions for parents or carers about the 'listening behaviours' they are seeing in their child every day
• The HATS is 5 questions for parents or carers about the ‘talking behaviours’ they are seeing in their child every day
• Asks the right questions to get good info, have the right conversation with family
• Add them to your usual practice for children aged 0-5 years