In remote communities east of Katherine, in Australia’s Northern Territory, Sunrise Health Service provides healthcare to Aboriginal families. Many of the children experience early, chronic otitis media (middle ear infection) and resulting hearing loss.

In 2006, an innovative programme called ‘LiTTLe’ (Learning to Talk, Talking to Learn) was set up by husband and wife team Fred McConnel, a local GP, and Robin McConnel, a teacher of the deaf. LiTTLe provided a space for local Aboriginal parents and their babies and toddlers to hang out, chat, and play, while promoting the children’s hearing and early language development.

A recent evaluation conducted by 91���� researchers found that the programme, staffed by local Aboriginal women, has brought significant value to the community and beyond. Associate Professor Caroline Jones from The MARCS Institute at 91���� and her colleagues found the programme provided a way to identify children experiencing language difficulties caused by hearing problems, and connect the families with support.

Nationally, the situation is improving but 91���� children with hearing loss still typically don’t receive a hearing aid until the age of six years, compared to 12 months of age for non-91���� children. Through LiTTLe, some children with hearing problems were identified earlier, and able to access treatment and hearing aids. 

Jones and colleagues have published the lessons learned from LiTTLe in the international journal BMC Pediatrics, helping to inform services for families and infants.

LiTTLe was run by Sunrise Health Service — an Aboriginal controlled primary health service — and supported by Ian Thorpe’s Fountain for Youth, The Honda Foundation, and Communities for Children, with The Smith Family as Facilitating Partner. The programme was tuned to local languages and dialects, and for eight years, it provided a vital service to remote communities east of Katherine.

“It was really great that the programme worked across health and education sectors to improve
outcomes for kids,” Jones says. 

Jones, a language researcher who has worked with Aboriginal communities for more than 25 years, was invited by Sunrise Health to evaluate the LiTTLe programme through an ARC Linkage Grant with Macquarie University and the University of Otago. She and colleagues interviewed many of the parents and caregivers who had taken part in the programme over the years.

The goal was not to teach the children English, but to work with whatever language was used in their home and local environment, including Kriol, a creole language that is the first language of many Aboriginal adults and children in remote communities in the Katherine region.

“It supported parents to use home language with their kids,” Jones says.

Parents were encouraged to talk more to their children; for example, naming and talking about things they saw, and what they were doing. “The research around language development shows that the input matters a lot, so the more you talk to your kids, and the more caring responsive language that you use with kids, the quicker they learn,” Jones says.

 For some, this had a significant positive impact. Jones describes one child who wasn’t talking much at all when they started attending the sessions, causing his parents concern. With encouragement from staff, the parents started talking more to the little boy, which led to a major improvement in his language skills.

For some parents, simply meeting up with other parents and giving their child the chance to play was enough. “It was good all the way,” says one mother interviewed by Jones’ team. “When I brought her along every morning, she loved playing, talking, and having fun.”

Other parents and caregivers were keen to get the children familiar with a school environment and processes. “It was good to bring kids to the school, to let them learn, so when they are four or five they can go to Transition [the first compulsory year of schooling, similar to Kindergarten],” another interviewee told the researchers.

Jones and her team, including project officer, Eugenie Collyer, and Aboriginal researchers, Jaidine Fejo and Chantelle Khamchuang, have used what they learned during the LiTTLe evaluation process to develop a practical tool, the ERLI (Early Remote Language Inventory), a checklist of 120 typical first words and gestures for children in that multi-lingual region. 

“For instance, a child might know the word ‘dog’ in English, but they might also know it in Kriol or a traditional language, or even in a language from another part of the world, so the checklist allows parents to report on their progress in learning to talk,” Jones says. “The checklist respects the parent as the expert on their child, at age 0-3 years, when the parent knows most about the child’s language development”.

That checklist has attracted the attention of Australian Hearing and National Acoustic Laboratories (NAL), keen to validate their own hearing checklists against the ERLI language measure. Together, they have recently partnered with Wurli-Wurlinjang Aboriginal Health Service and Tharawal Aboriginal Corporation to trial the checklists as a package to identify children with language and hearing challenges. This project is funded by the ARC Centre of Excellence for the Dynamics of Language of which Western is a partner, and has recently received support to Australian Hearing, NAL from Prime Minister & Cabinet.

“We want to use the checklists to find the kids who have hearing and language problems earlier in life, work with the parents collaboratively, and see if it’s possible to provide support at much earlier ages,” explains Jones. “Our next step is providing and evaluating training for professionals in early childhood health and education to use the checklists themselves.”