Aboriginal and Torres Strait Islander child health — formative SAQs

SAQ 1 (10 marks)

An Aboriginal family attends with a 3-year-old who has recurrent ear infections. Teachers say the child “does not listen.” The family left a previous clinic after feeling judged. [5] [9]

1. Define cultural safety and state how you will ask and record identity. (2) [2]
2. Outline the ear-health and hearing assessment priorities for this age group. (3) [8] [9]
3. List structural determinants you will explore and why racism history is clinically relevant. (3) [1] [5] [8]
4. Describe how you will partner with community-controlled care in the plan. (2) [2]

Model answer — SAQ 1

1. Cultural safety is care free of racism and power misuse as experienced by the Aboriginal or Torres Strait Islander person. Ask every child/family whether the child is Aboriginal and/or Torres Strait Islander; record the answer; never assume from appearance. [2]

2. Examine ears; assess hearing behaviour/language; arrange audiology when indicated; treat active disease; plan school supports; apply under-6 primary-care ear/hearing check principles. Do not attribute school concerns to behaviour before hearing is assessed. [8] [9]

3. Housing/overcrowding, smoke exposure, transport, food security, continuity of primary care. Racism is linked to worse health and destroys trust; acknowledge prior harm and redesign engagement. [1] [5] [8]

4. With consent, share the plan with the family’s ACCHO; involve an Aboriginal Health Worker; provide a written plan families can use; keep hospital/primary responsibility while partnering. [2]

SAQ 2 (10 marks)

A First Nations child from a high-burden region has had daily wet cough for two months and intermittent fevers. Growth is faltering. [12] [18]

1. Explain the pathophysiological concern with prolonged wet cough in this population. (3) [12]
2. Give your stepwise clinical management priorities today. (4) [12]
3. Name two post-streptococcal sequelae relevant to population risk and one nutrition-development link to consider. (3) [15] [18]

Model answer — SAQ 2

1. Recurrent lower respiratory infection and protracted bacterial bronchitis can progress toward bronchiectasis in high-burden Indigenous child populations. Prolonged wet cough is not “normal for the community.” [12]

2. Assess severity and red flags; characterise wet versus dry cough; treat infection-driven wet cough appropriately; address environmental drivers; plan early review; refer if chronic/severe for bronchiectasis pathway; link ACCHO follow-up; safety-net for deterioration. [12]

3. Acute rheumatic fever/rheumatic heart disease and acute post-streptococcal glomerulonephritis are key post-strep inequities. Early childhood anaemia has been associated with higher developmental vulnerability at school age in remote Aboriginal and Torres Strait Islander children — assess and treat nutrition contributors. [15] [18]