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Why can’t I hear you?

A story about otitis media by Team Tjina Maala


Ear Drum

Ear Canal

Infected Middle Ear

Inner Ear

‘Why Can’t I Hear You?’ is a story about otitis media, which is a middle ear infection also known as glue ear. Otitis media can lead to hearing loss. The loss of hearing may impact on language and speech development and may negatively impact on educational outcomes. Treatment of otitis media may include antibiotics and surgery.

The development of this resource was funded by a generous donation to the Tjina Maala project, which is an initiative of Ability Centre. The Tjina Maala project is supported by the Non-Government Centre Support (NGCS) scheme.

About the Illustrator My name is Carol Thompson and I am a Wongi from the Goldfields region. I worked in education as an Aboriginal and Islander Education Officer for a number of years. I love creating many types of art, my favourite being mixed media art journaling. My mum was an artist and as a little child I loved watching her paint. She has always been my inspiration.

My name is Jack. I like to play in the park with my family. Sometimes when I play, I can’t understand what my friends and family say, because I can’t hear them properly. Especially when there are lots of kids laughing and talking, or dogs barking, or trucks passing.

Mum, why can’t I hear what people say?

I’m not sure Jack. I have noticed that you ask ‘Please say that again!’ I forever get into trouble at school because I don’t do what my teacher tells me. Just this morning, Miss Stokes almost shouted at me, “Jack, I told you to take out your reader!” With all the scraping of chair legs on the floor, I just didn’t hear her.

What is glue ear?

Mum said she noticed I don’t always do things she asks - even fun things, like when she asked me if I wanted to go to the beach. She said I shout at everyone. Sometimes I feel like I might fall over - as if my balance isn’t right. I also complain to her that my ears are sore, and my nose is always runny. Mum says I might have glue ear.

Mum says it is an infection of the middle ear, so I need to go to the doctor to have my ears checked. The doctor checks my ears.

Yep, you were right. Jack has otitis media, also called glue ear. Here is a prescription for some eardrops with antibiotics to kill any germs that are in Jack’s ear...

Jack, this means that you have fluid in your middle ear that shouldn’t be there. You have to be extra careful to keep your ears clean and dry.

Mum put some eardrops in my ears. A few weeks later, my ears feel better, but I still can’t hear properly.

Mum, when I watch television or listen to my music, I need to turn up the volume really loud.

Mum says, “Just in case it is glue ear again, I will take you back to Dr Champion.� She takes me back to the doctor and she checks my ears again.

Dr Champion says, “Jack, you need to have an operation on your ears to help you hear properly again.� She shows me a picture of an ear so I can see the middle ear - what ears look like from the inside.


Ear Drum

Ear Canal

She tells me I will have an anaesthetic - an injection that will make me sleep through the whole operation. She shows me what she will do while I am asleep.

Infected Middle Ear

Inner Ear

I will make a tiny cut in your eardrums to drain the fluid, and then put grommets in your ears. A grommet is a tiny pipe that helps the fluid flow out of the middle ear. When your eardrum grows and the glue ear has gone away, the grommet will fall out by itself.


As soon as I have had the operation I can hear properly again!

Children with glue ear (otitis media) may:

A deeper understanding of otitis media

· Have sore ears

Otitis media (OM): is a middle ear infection that causes hearing loss. There are several main forms of the disease including (HealthInfoNet, 2017):

· Have a runny nose · Have discharge from their ears · Have trouble hearing · Not listen to people · Be hard to understanding when talking · Be grumpy or demanding · Vomit or lose interest in eating · Have a fever

If you think your child has a middle ear infection, please see your doctor. For more information: and_Otitis_media/ Listening-Troubles-and-Little-Kids.pdf

Acute otitis media (AOM): general term for acute otitis media both with or without perforation (a hole) in the eardrum Acute otitis media without perforation (AOMwoP): the presence of fluid behind the eardrum plus at least one of the following: bulging eardrum, red eardrum, fever, ear pain or irritability Acute otitis media with perforation (AOMwiP): discharge of pus through a perforation in the eardrum within the last six weeks Recurrent acute otitis media (rAOM): the occurence of three or more attacks of AOM within six months, or four or more in the last twelve months Chronic otitis media: a persistent inflammation of the middle ear that can occur with or without perforation, either as chronic suppurative otitis media, or as otitis media with effusion (respectively) Chronic suppurative otitis media (CSOM): persistent ear discharge through a perforation (hole) in the eardrum. Definition of CSOM varies in the duration of persitent ear discharge (from two to twelve weeks). The diagnosis of CSOM is only appropriate if the eardrum perforation is seen and if it is large enough to allow discharge to flow out of the middle ear space Otitis media with effusion (OME): an inflammation of the middle ear characterised by fluid behind the eardrum,

without signs or symptoms of acute otitis media; also sometimes referred to as serous otitis media, secretory otitis media, or ‘glue ear’ Dry perforation: perforation of the eardrum, without any signs of discharge or fluid behind the eardrum.

strategies to prevent and manage OM and hearing loss (HealthInfoNet, 2017). If you suspect that someone you know has OM please seek medical advice.

Three bacterial pathogens appear to be the main causes of otitis media; Streptococcus pneumonia, Haemophilius influenzae and Moraxella catarrhalis. Streptococcus pneumonia also refered to as pneumococcus is associated with the majority of otitis media cases particularly severe cases (HealthInfoNet, 2017).


Indigenous children have the highest prevalence of OM globally. Chronic OM was highest in Aboriginal and Torres Strait Islander populations with prevalence at 12-25% (WHO, 2006). Aboriginal and Torres Strait Islander people in Australia have high rates of OM in urban, rural and remote communities. In some remote communities up to 90% of Aboriginal children have some form of OM: 50% glue ear, 30% acute OM and 15% runny ears (Leach et al., 2015).

Leach, A. J., Wigger, C., Hare, K., Hampton, V., Beissbarth, J., Andrews, R., & Morris, P. S. (2015). Reduced middle ear infection with non-typeable Haemophilus influenzae, but not Streptococcus pneumoniae, after transition to 10-valent pneumococcal non-typeable H. influenzae protein D conjugate vaccine. BMC pediatrics, 15(1), 162. Retrieved from: http://www.

Children who have early-onset otitis media (under 12 months old) are at high risk of developing long-term speech and language problems (Williams & Jacobs, 2009). This impacts on educational difficulties in childhood and into employment problems in adults (WHO, 2006). Factors contributing to ear disease and hearing disorders among Aboriginal people are complex. Some of these factors include poverty, crowded housing conditions, poor nutrition, inadequate access to water and limited access to health services (HealthInfoNet, 2017). There are many medical (e.g. screening, antibiotics or surgery) and educational (e.g. classroom management, adapted teaching methods and student awareness)

HealthInfoNet (2017). EarInfoNet; Review of ear health and hearing among Indigenous Australians and What is known about ear health and hearing? Retrieved from: http://www.

Williams, C. J., & Jacobs, A. M. (2009). The impact of otitis media on cognitive and educational outcomes. Medical Journal of Australia, 191(9), S69. Retrieved from: au/journal/2009/191/9/impact-otitis-media-cognitive-andeducational-outcomes World Health Organization (2006). Prevention of health impairment from chronic Otitis Media. Retrieved from: http://

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Tjina Maala

Leaders in Disability. Specialists in Cerebral Palsy.


Tjina Maala, an initiative of Ability Centre

Why can't I hear you?  

‘Why Can’t I Hear you?’ is a story about otitis media, which is a middle ear infection also known as glue ear. Otitis media can lead to hear...

Why can't I hear you?  

‘Why Can’t I Hear you?’ is a story about otitis media, which is a middle ear infection also known as glue ear. Otitis media can lead to hear...