Did not 'pass' hearing test

[by-the-lake]

Update post #15

DS is now 12 months. He has, among other issues, speech delay. His newborn hearing screening passed. However, because of his speech delay, his ST recommended a hearing test by an audiologist.
He had some 'normal' response, some 'near normal' response, and no response to one certain tone (?) no matter how many times and different ways the audiologist tried it. His right eardrum also had decreased motion on the tympanogram. We are reevaluating next month. Please, anyone have insight?

Edited by by-the-lake - 11/12/10 at 7:42pm

[nicky85]

My son had to "retake" ABR (auditory brainstem response) test. They administered it the first time in the hospital at two weeks old, about two days after he had a shunt put in for hydrocephalus associated with spina bifida and chiari II malformation. The audiologist said it might be because he had just had the shunt put in that we were getting an abnormal response. They said it could be that he had no hearing in one of his ears. But when we got him home, we noticed him reacting to noises and calming down to music. We took him in for a retest at 6 weeks old and he passed just fine. By that time, his body was used to the shunt. That was my experience. I'm hoping things go well for you and your son!

[askew]

My DD only passed in one ear in the hospital. We took 3 other tests at the audiologist and she had a hard time with each. She has really small ear canals. So it was determined that she had too much fluid and it was interfering with her hearing. We did tubes and she is all good now. She never had a ear infection, it was only her hearing that was affected.

[2boyzmama]

Hi!

In order to accurately guage hearing, he needs a "booth test" which is an audiogram. It takes two audiologists to do the test, and the wait list is often long, so I'd recommend requesting one NOW and not waiting another month before deciding.

For an audiogram, he will be in a sound-proof booth and will wear either probes in his ears or earphones. They will test his hearing at varying frequencies and decibels and map out his hearing. Anything 20dB or better is considered normal hearing. 25-40 (I think) is mild loss, 45-60 is moderate, etc. I hope I have the numbers right, it's something like that. Hearing loss is not measured in percentages, so if you hear someone say "I have 50% hearing loss" then that is not accurate.

I have to go, the oven just beeped at me. I'll be back later. Google audiogram so you can start reading on it.

[fairejour]

It is SUPER important that you follow up. The newborn hearing screen is just that, a screening. There are both false negatives, and false positives. You need to ask whoever did this last test to give you a paper audiogram, that is a frequency by frequency testing of each ear, and how loud the sounds had to be for the child to react at each frequency. For children, normal is 15db or softer in ALL frequencies (250 hz to 8000 hz). If there was "no response" at ANY point, your child would be defined as having a hearing loss.

PLEASE FOLLOW UP!!!!!!!! "Near normal" is NOT normal, and your child may need intervention (perhaps he needs ear tubes, maybe it is just a cold, or he could have a hearing loss).

Also, as soon as you do get the audiogram, feel free to post it and I can get more in depth and explain exactly what it says and what it means!

[by-the-lake]

Thank you everyone! I have more info as the audiologist sent me a report. I will interpret as best as possible.
The test was called "Visual Reinforcement Audiometry"
Hearing Loss in dB-marked between 30 and 20. (The report shows this as 'abnormal').
Frequency in Hertz-1000 satisfactory, 2000 (no response), 4000 satisfactory
Tympangrams- Right .4 ECV (Looks like a flat hill)
Left .6 ECV (Looks like a ski slope)

Sooo..this is Greek to me, so thank you for any insight. We have another of the same test next month. Do I get something else sooner?

Thank you everyone

[fairejour]

The tymp should have a peak, like this:

http://www.viasyshealthcare.com/prod...al_image32.gif

A normal audiogram would be 20 (or less) across all frequencies. Here is a visual representation of an audiogram with the speech sounds and common enviromental sounds:

http://www.hearingprofessionals.co.n...eech-Sound.gif

If you draw a line at the points at which your child reacted (30 db, etc), if the sound is ABOVE the line, he would be unable to hear it (at this point). What REALLY concerns me is the "no response". That would indicate a deep profound loss at that frequency, and that seems unlikely if the rest of the audiogram is accurate.

I think it would be resonable to wait a month if his tymp was not normal (since that indicates fluid in the ears and that would take time to resolve).

Were you in the booth? Did you see his reactions? Did you feel like the test was accurate?

[Marsupialmom]

Fluid in the ear can cause the tymp to be abnormal. Ear infection can cause this, you do not have to know about it.

I would not worry about the hearing test until after the next tymp.

Speech delay at 1? Is your son not making any noise?

If your child was not in a booth doing his test I would not consider his hearing test reliable at all!

[by-the-lake]

We were both is the booth.I was holding him and was told not to respond to the noises, so I did not. He did not hear that particular frequency (2000). I could tell.
He is not meeting his speech milestones. His sister did not either and she had significant speech delays and has autism.
Thanks!

[fairejour]

Do you feel like he has a hearing problem? Clearly he is not deaf, but do you feel like it makes sense with his behavior and the delays you are seeing?

For example, does he react to some things and not others? Is he making some sounds but not others? Does it seem like he has trouble understanding the things you say?

[by-the-lake]

Originally Posted by fairejour

Do you feel like he has a hearing problem? Clearly he is not deaf, but do you feel like it makes sense with his behavior and the delays you are seeing?

For example, does he react to some things and not others? Is he making some sounds but not others? Does it seem like he has trouble understanding the things you say?

Wow, when I read this my belly gave a thrill. He does react sometimes, not others, to the same things. He only makes some sounds, does not mimic, and he really does not understand the things I say. He gets body language, but I am concerned about these things you pointed out.

[2boyzmama]

Definitely re-do the booth test. Mild loss is common in fluid issues, which would explain the flat tymp. Is he seeing an ENT? Lots of things can cause fluid, and it's not always infection. Sometimes it's allergies, including food allergies. Sometimes the only symptom is some inflammation in the mucous membranes (inside the nose or in the throat) which can cause the eustacian tubes to not be as "open" as they should, so fluid accumulates. Tubes is one answer, many children respond really well to chiropractic and/or allergy meds. Since you caught this so young, you probably have the time to try things like chiro and addressing allergies before resorting to tubes (if you want to avoid surgery).

But, him not responding at all to 2000 Hz is very odd. I don't quite understand that.

If you want to approach the allergy possibility, often dairy is the biggest culprit (assuming it's dietary and not environmental) so it might be worth removing dairy from his diet for a month to see if there's any change. Consider chiro and cranial sacral massage, it really can help!

[fairejour]

Originally Posted by by-the-lake

Wow, when I read this my belly gave a thrill. He does react sometimes, not others, to the same things. He only makes some sounds, does not mimic, and he really does not understand the things I say. He gets body language, but I am concerned about these things you pointed out.

When my daughter was diagnosed with her hearing loss, it was still mild sloping to moderate. She could hear somethings, like clapping, but didn't turn to her name more than a foot away. When we were told she had a hearing loss, it explained everything we had been seeing. It made perfect sense. We had been referred to get a hearing test because we thought my daughter needed speech therapy at 15 months. She had passed her newborn screen but had a progressive loss. We knew she was hearing normally at 6 months, but by 18 months had mild-moderate loss.

[lach]

I'm sorry that I can't help you with any of the technical questions, but I just wanted to say that he sounds EXACTLY like my son. Not deaf (turned towards noise), great at following body language, no apparent receptive language (he knew his name, that was about it), did not mimic, did not have any words.

At his 15 month appointment, my ped recommended that I call EI and that we get his hearing tested. Just about EVERYONE I knew told me "ridiculous! He's fine. Some kids, especially boys, are late talkers."

Because it took so long to get the hearing test, he had his EI evaluation first. The results, in the words of my pediatrician, were "sparkling." All except in the communication section, where he was not even CLOSE to the line below which he was eligible for services. I don't have the numbers right in front of me, but it was something like 100 was the median, below 85 he would qualify... and he scored something like a 60.

According to his hearing test, he definitely wasn't deaf, though he did have poor hearing. He heard most of the beeps. But a few appointments with the ENT showed that he had severe fluid buildup. Because he was so young (the ENT, our speech therapist, and the social worker liason with EI have all told me individually that usually peds don't notice this problem until the 18 month appointment at the earliest, and that I'm very lucky to have such an on-the-ball one), they made his case a priority and he had ear tubes within the week.

That was in the last week of August, and the changes over the past month and a half have been really astounding. He has about 10 words now. His receptive language has really exploded: he seems to understand just about everything (within reason, obviously). And the interesting side effect is that he's really taken off on walking! He only took his first steps in mid-August, and I guess that with all that fluid in his ears his balance was really bad. He was a really late sitter too.

He has a speech therapist who comes once a week, but after the initial period it seems really unlikely to me that we'll need her. Her job is mainly to help us catch up on his receptive language. He's not actually totally out of the norm for talking, but he missed a pretty valuable window of receptive language learning. Luckily, he seems to be catching up quickly.

So that's our story, and it had a very happy ending. The ear tube surgery was a little scary for me going into it... my poor little baby put to sleep and laid out on the operating table But the surgery itself took all of 10 minutes (seriously), and he woke up a bit grumpy but within a few hours was back to his normal self. He also discovered popsicles while in the hospital room, and that if he cried the nurses would keep bringing them to him! So I think he actually had a pretty good time of it, all things considered

Hopefully your situation is similar to ours, and the resolution just as simple. It's great that you noticed it so early.

[by-the-lake]

Update

Redid the visually reinforced audiometry booth test today and he heard everything! The audiologist attributed the first test to 'auditory fatigue'. He is currently receiving OT for sensory integration. He will get another test around age 3. However, his issues remain

[by-the-lake]

* double post

Edited by by-the-lake - 11/13/10 at 9:16pm

[journeywooz]

why is everyone acting like hearing loss is such a horrible thing?  that there's nothing normal about it?  and that the child would need some serious 'intervention'?  i think it's the parents who need the intervention and gentle understanding of the child's needs. 

what we need is a different perspective on disability.

[by-the-lake]

Excuse me? Way out of left field and way too judgemental on your part!!! I would qualify use of hearing aids as 'serious' interventions. Serious is pretty subjective. The cost alone makes me think 'serious'. I know and understand my child and will do anything in order for him to reach his potential. Keep your judgments to yourself.

[fairejour]

My daughter has a hearing loss....does yours? My daughter did need "serious intervention". She needed her family to learn an entirely new language for her to access. That is serious. It takes a lot of effort and time, and often, money. Why on earth would I ignore my child's special communication needs? I know exactly what my child needs, and since you do not know her, how on earth could you???

[journeywooz]

I'm sorry you feel that way.  I may have come across as harsh, but I think you misunderstood me. As a matter of fact, I'm deaf.  My DH is deaf.  Our DD is deaf as well.  We communicate in american sign language.  Hearing aids never worked well for me, but I read lips very well.  DH wears them occasionally and speaks very well, but finds that he gets his point across way clearer communicating through asl.  Our 18 month old can communicate her needs very well through sign language (along with lots of fun words and thoughts).  We function just like every other member of society with help of a few accommodations.  We socialize with both hearing and deaf peers.

As for your case, there are resources and services that will provide free hearing aids and molds.

But remember, hearing aids don't always work for everyone.  There will be bits and pieces missed.  When we go to sleep, we're deaf.  When we run out of hearing aid batteries, we're deaf.  When we go swimming, we're deaf.  I think you get the picture.  I was forced to wear hearing aids and go through extensive speech therapy during grade school, and they were such a pain.  Hearing aids were just noisy messes and I could never stay focused.  The audiologists and teachers kept telling me that it was the best thing for me, and I was required to keep them on at all times during school hours. All that auditory research and twiddling around with my ears growing up didn't do squat.  The best thing that happened to me (and many other deaf people) was access to language.  Remember, language isn't only spoken.  It's also through hands, eyes, body language, and so much more.  Our minds need expanding, and there are so many different ways to communicate. 

It's so important that parents learn sign language and work with their children.  Fairejour, I am so happy that you took the time (money, and effort) to learn sign language.  It's one of the best gifts you can give your child.. and family.  I look at any kind of (non-invasive) auditory technology and language as accommodations rather than interventions.  Children don't need interventions, we do.

I'm not pointing fingers here.  The point is that, I've met way too many parents give birth to a child, finds out that they've 'failed' the hearing test.  Many of them find themselves at loss of knowledge about deafness.  Most of them have never met another deaf adult.  And of course, with money and science in the picture--they end up trying to fix their child, withdrawing sign language and pushing auditory/verbal training on the kids under medical advice, in hopes that they'll be a "fully-functioning member of society"...only to get themselves bitten in the long run.  I really have seen that happen too often.  We need to focus on what we can do, rather than what we can't do.   I strongly believe that deafness (blindness, or many other disabilities) are beautiful gifts that do not need to be fixed... Instead, deaf children need to be listened to. 

My frustration is seeing that many people don't look at disabilities as a positive thing, an unique gift.  I understand that it does take extra work and nurturing, but as do everything else in life to a degree.  I did a search on mothering and could only find things about how hearing needs to be fixed... that it's oh-so sad that deaf people can't do this or that--rather than focusing on what we can do to unconditionally accept our individuality.  Attachment parenting works beautifully for me as a deaf mother of a deaf girl, and I really do wish I could find that common ground around here.

I'm offering perspective from the other side here.  This is not only my voice, but so many others' as well.