Clinical utility of the parent listening and understanding measure (PLUM) for Aboriginal and/or Torres Strait Islander and non-Aboriginal children with otitis media living in urban areas

Objective: This study evaluated the clinical utility of the Parent Listening and Understanding Measure (PLUM) questionnaire as a potential screening tool for otitis media (OM) and associated hearing loss in Aboriginal and/or Torres Strait Islander and non-Aboriginal children. Methods: A cross-sectional study was conducted in Perth, Western Australia, involving 203 children (148 Aboriginal and/or Torres Strait Islander, 55 non-Aboriginal) aged 7 months to 14.9 years (mean 4.28 ± 2.89 years). Caregivers completed the PLUM questionnaire, and children had a comprehensive audiological assessment including otoscopy, tympanometry, and age-appropriate audiometry. Results: The study found that 25.1% of children had hearing loss (>25 dB HL) and 44.8% had OM. PLUM scores did not significantly differ between children with and without OM (p = 0.530). However, children with hearing loss scored significantly lower on the PLUM (23.92 ± 10.18) compared to those without hearing loss (29.48 ± 7.94) (p < 0.001). Despite this difference, the PLUM demonstrated low diagnostic accuracy for both hearing loss (AUC = 0.337) and OM (AUC = 0.496). Conclusion: While the PLUM questionnaire revealed poorer parent-reported listening behaviours in children with hearing loss, it showed no significant difference for children with OM. The low diagnostic accuracy of the PLUM for OM and hearing loss suggests that it is not recommended as a screening measure for detecting hearing loss and/or OM in children. These findings highlight the need for more sensitive and specific screening tools to aid in the early detection of OM and/or hearing loss.