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Hearing Implants Paediatric (Audiology)

PAEDIATRIC

If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or follow local emergency care protocols or seek emergent medical advice if in a remote region.


Adult

  • Hearing loss
    • Sudden loss or sudden deterioration of hearing (sudden = within 72 hours) (British Academy of Audiology, 2016)
  • Otitis media
    • Any suspicions of the complications of ASOM i.e. Mastoiditis (proptosis of pinna), meningitis etc
  • Vertigo/Vestibular
    • Recent sudden onset with neurological symptoms
  • Facial Nerve Palsy
    • Sudden onset facial weakness

Paediatric

  • Paediatric Hearing loss
    • Sudden loss or deterioration
  • Paediatric Otitis media
    • Any suspicions Mastoiditis (proptosis of pinna), meningitis or other complication of ASOM
    • Trauma
    • New onset facial nerve palsy
  • Other referrals to emergency not covered within these conditions (Paediatric)
    • Foreign body
    • ENT conditions with associated neurological signs e.g. facial nerve palsy, profound vertigo and/or sudden deterioration in sensorineural hearing
    • Acute and/or complicated mastoiditis
    • Auricular haematoma
    • Significant head injury
    • Congenital abnormality of the head/neck
    • Meningitis/encephalitis

  • Please note that a referral to audiology is required at the same time as referral to ENT for hearing implant. 
  • Hearing Implant services are not available at all locations
  • Hearing implants may include cochlear implant(s), bone conduction implant(s) or middle ear implant(s).
  • Some services may offer only cochlear implants or bone conduction implants 
  • Some services may offer post-surgery cochlear implant services only
  • Some services may not be funded for all referral types.  For example, cochlear implantation for single sided deafness is currently only available at the Queensland Children’s Hospital to children who meet eligibility criteria
  • Please refer to Health Pathways for information about the closest Hearing Implant service.
  • Chronic active ear disease will require adequate treatment prior 
  • For children born deaf or with severe hearing loss, having a cochlear implant fitted before the age of 18 months can be vital for developing age appropriate speech and language skills

Queensland public hospitals do not dispense conventional or standard hearing aids. Aids for children, veterans, pensioners, ADF or NDIS participants with hearing needs are fitted by local audiologists via application to the Australian Government Hearing Services Program (Hearing service program). For non-eligible patients with a symmetrical mild, moderate or severe hearing loss, refer to a local private hearing aid provider.

Exclusion criteria – Middle Ear/ Bone Conduction Implant

  • Children with single sided deafness that are referred for the purpose of the contralateral routing of signal to the normal hearing ear.  These children ear are not currently funded for support by Hearing Australia for the external portion of the device. 
  • Children under 5 years of age 
    • Not medically suitable for candidacy at < 5 yrs. due medical guidelines for children
    • Not yet eligible for candidacy via Hearing Australia
  • Children referred 16 years or older 
    • As candidacy may take up to 12 months children over 16 may be too old for surgery through Queensland Children’s Hospital (QCH) by end of candidacy process and will therefore be redirected to an adult’s program.

Queensland public hospitals do not dispense conventional or standard hearing aids. Aids for children, veterans, pensioners, ADF or NDIS participants with hearing needs are fitted by local audiologists via application to the Australian Government Hearing Services Program (Hearing service program). For non-eligible patients with a symmetrical mild, moderate or severe hearing loss, refer to a local private hearing aid provider.

Queensland Health Audiologists provide diagnostic hearing assessments which may result in a recommendation for hearing aids and/or an ENT opinion, but not the fitting of hearing aids. 

Clinical resources

Patient resources

Minimum Referral Criteria

  • Category 1
    (appointment within 30 calendar days)
    • Severe to profound bilateral SNHL in children with congenital deafness (< 4 years old)
    • Children with meningitis and sudden onset hearing loss
    • Children with significant vision impairment/Ushers’ Syndrome whose SNHL has deteriorated to severe to profound.
  • Category 2
    (appointment within 90 calendar days)
    • Limited or no benefit from wearing hearing aids with the following:
      • limited access to speech sounds / unable to meet prescriptive target gain with optimised hearing aids
      • significant speech and language delay
    • Children with progressive hearing loss who are aided with either of the following:
      • upon recommendation of their hearing aid dispensing audiologist
      • following significant deterioration in hearing thresholds
    • Single sided deafness
    • Severe to profound bilateral SNHL (acquired, progressive or in congenital deafness >4 years)
  • Category 3
    (appointment within 365 calendar days)
    • Children transferring from another program
    • Over 4 years of age at time of referral
    • Chronic mixed or conductive hearing loss
    • Unable for medical reasons to use a conventional Air Conduction (AC) hearing aid in the affected ear (e.g., conditions such microtia/ atresia, skin conditions, chronic suppurative otitis media).

Please insert the below information and minimum referral criteria into referral

1. Reason for request Indicate on the referral

  • To establish a diagnosis
  • For treatment or intervention
  • For advice and management
  • For specialist to take over management
  • Reassurance for GP/second opinion
  • For a specified test/investigation the GP can't order, or the patient can't afford or access
  • Reassurance for the patient/family
  • For other reason (e.g. rapidly accelerating disease progression)
  • Clinical judgement indicates a referral for specialist review is necessary

2. Essential referral information Referral will be returned without this

  • Previous audiograms/ hearing test results
  • Concurrent ENT referral if referral is for candidacy assessment
  • Otological/ENT history
  • Social modifiers i.e. effect on home schooling, out of home residence

3. Additional referral information Useful for processing the referral

  • Results of aetiological investigations (include reports/proof, including genetic results as necessary)
  • Additional and relevant diagnosis, co-morbidities, disabilities and medical issues
  • MRI (Brain/ cranial nerves) and CT (Temporal Bone) results if applicable

4. Request

Patient's Demographic Details

  • Full name (including aliases)
  • Date of birth
  • Residential and postal address
  • Telephone contact number/s – home, mobile and alternative
  • Medicare number (where eligible)
  • Name of the parent or caregiver (if appropriate)
  • Preferred language and interpreter requirements
  • Identifies as Aboriginal and/or Torres Strait Islander

Referring Practitioner Details

  • Full name
  • Full address
  • Contact details – telephone, fax, email
  • Provider number
  • Date of referral
  • Signature

Relevant clinical information about the condition

  • Presenting symptoms (evolution and duration)
  • Physical findings
  • Details of previous treatment (including systemic and topical medications prescribed) including the course and outcome of the treatment
  • Body mass index (BMI)
  • Details of any associated medical conditions which may affect the condition or its treatment (e.g. diabetes), noting these must be stable and controlled prior to referral
  • Current medications and dosages
  • Drug allergies
  • Alcohol, tobacco and other drugs use

Reason for request

  • To establish a diagnosis
  • For treatment or intervention
  • For advice and management
  • For specialist to take over management
  • Reassurance for GP/second opinion
  • For a specified test/investigation the GP can't order, or the patient can't afford or access
  • Reassurance for the patient/family
  • For other reason (e.g. rapidly accelerating disease progression)
  • Clinical judgement indicates a referral for specialist review is necessary

Clinical modifiers

  • Impact on employment
  • Impact on education
  • Impact on home
  • Impact on activities of daily living
  • Impact on ability to care for others
  • Impact on personal frailty or safety
  • Identifies as Aboriginal and/or Torres Strait Islander

Other relevant information

  • Willingness to have surgery (where surgery is a likely intervention)
  • Choice to be treated as a public or private patient
  • Compensable status (e.g. DVA, Work Cover, Motor Vehicle Insurance, etc.)

  • Please note that where appropriate and where available, the referral may be streamed to an associated public allied health and/or nursing service.  Access to some specific services may include initial assessment and management by associated public allied health and/or nursing, which may either facilitate or negate the need to see the public medical specialist.

  • A change in patient circumstance (such as condition deteriorating, or becoming pregnant) may affect the urgency categorisation and should be communicated as soon as possible.

  • Please indicate in the referral if the patient is unable to access mandatory tests or investigations as they incur a cost or are unavailable locally.

 

Version: 4
Last updated: 21 September 2022

© State of Queensland (Queensland Health) 2023

Except as permitted under the Copyright Act 1968, no part of this work may be reproduced, communicated or adapted without permission from Queensland Health. To request permission email ip_officer@health.qld.gov.au.

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