Aboriginal and Torres Strait Islander children suffer some of the highest rates of middle ear infections in the world.
The disease is going undetected among 26 per cent of First Nations children, while one-in five live with undiagnosed hearing loss, according to clinical data from Hearing Australia.
"Ear infections are really common in children but for First Nations children they are typically more regular ... and actually start very early in life and last a lot longer as well," Hearing Australia's Kirralee Cross said.
"When you have middle ear disease it's really difficult to detect, so there can actually be no symptoms; you don't necessarily have to have an earache or fever.
"There's a lot of kids suffering in silence."
Since 2019, Hearing Australia has assessed about 36,000 First Nations children, from newborns to age six, through its hearing assessment program called early ears.
After analysing about 19,000 of these assessments, Hearing Australia found children under two have more ear trouble than older ages.
It also found children who live in remote areas have more problems with ear health than those in the regions or cities.
Ms Cross, a Yorta Yorta woman said middle ear disease and hearing loss can have a huge impact on children's development and their learning.
She said it was also culturally important for children to be able to hear well, so they could learn songs and stories being passed down by elders.
"We see a lot of children come through who may be behind in school, or may have speech delays or may not understand instructions, which makes it really difficult in a classroom," Ms Cross said.
"When kids have middle ear disease it affects their ability to listen, to learn but also to yarn and connect with others.
"It can be quite isolating."
Ms Cross said at follow-up appointments about 60 per cent of children have better hearing health than when they were first assessed.
She said to tackle ear disease among First Nations children, more needed to be done to improve community awareness of ear health and health care providers must assess hearing early.
Ms Cross urged parents to get their children's ears checked regularly and not be afraid to speak up about their health.
"If you're concerned, reach out," she said.
"Never disregard any concerns you may have."
