Validating the Parent-evaluated Listening and Understanding Measure (PLUM): caregiver observations reliably reflect long-term otitis media-related hearing status in young Aboriginal and Torres Strait Islander children

Objective: We aimed to establish how accurately the Parent-evaluated Listening and Understanding Measure (PLUM) identifies longer-term otitis media (OM)-related hearing status in young Aboriginal and Torres Strait Islander children. Design: Retrospective review of clinical data, designed with Aboriginal, Torres Strait Islander, and non-Indigenous researchers and clinicians. Study sample: De-identified audiological and demographic information gathered during 15,444 appointments with 6,716 Aboriginal and Torres Strait Islander children aged 7 years and younger. Results: PLUM effectively distinguishes persistent, OM-related hearing loss requiring specialist referral (>30 dB HL better ear for >3 months) from transient and/or milder loss. Eighty-two percent of children meeting these referral criteria were “not yet on track”, compared to 26% with comparable, but transient, loss. PLUM demonstrated strong performance: 82.4% sensitivity, 91.2% specificity, 98.6% negative predictive value, and 90.5% accuracy. Children “not yet on track” had 46 times higher odds of meeting hearing referral-level criteria (OR = 45.73, 95% CI: 12.60–165.93). Conclusions: PLUM draws on parent/caregiver observations to help practitioners identify–or exclude–persistent OM-related hearing loss >30 dB HL, early in children’s lives. A single assessment provides insight into longer-term hearing status, complementing point-in-time measures. This is the first accuracy evidence for a listening skills checklist using longer-term hearing as reference standard.