The Parents' evaluation of Listening and Understanding Measure (PLUM): Development and normative data on Aboriginal and Torres Strait Islander children below 6 years of age

Ear infection or otitis media (OM) occurs in many Aboriginal and Torres Strait Islander children at a young age and tends to persist over a long period of time. Chronic OM is associated with conductive hearing loss that reduces a child's access to sounds. This can have a negative impact on development of listening and communication skills. Primary health and early childhood workers are best positioned to detect children with hearing and listening problems. However, they lack appropriate tools to screen and triage young children for early referral. By using a co-design approach with Aboriginal primary health workers and early childhood teachers, we have developed the Parents' Evaluation of Listening and Understanding Measure (PLUM) listening skills questionnaire. The PLUM provides a systematic framework for front-line workers to explore a parent's observations of their child's listening behaviour in everyday situations to detect hearing and listening problems in young Aboriginal children. This paper reports the development of the scale. PLUM scores for 438 children from urban, regional and remote communities in Australia were collected. The internal consistency reliability was 0.87. Normative data from 235 children with normal hearing (hearing thresholds averaged between 0.5 and 4 kHz in the better ear to be no greater than 20 dB HL) were used to define the relationship between PLUM scores and age. The functions allow performance of individual children to be related to their normal-hearing peers.