Question

You are the audiologist. Use the information listed to prepare a response to this family regarding your recommendations for their recently identified deaf son.

Baby M is 3 years old. He lives in a rural community. His parents are both teachers. He has two older siblings. Everyone in his family and extended family use English to communicate and have normal hearing. The nearest deaf school is four hours away. Both parents grew up in this community and all of their extended family live near by.

Case History: There is no family of history loss. Prenatal and birth history is unremarkable. Parent reports no significant history of ear infections. Parent requested further testing from a local audiologist due to significant speech/language delay and a history of a failed newborn hearing screening in both ears. Following the failed newborn hearing screening, Baby M was evaluated by the local Ear, Nose and Throat (ENT) doctor when he was 10 months of age. The Audiologist at the ENT clinic was unable to get a response from Baby M during routine behavioral audiology testing. Baby M is a happy, healthy child. He seems very social but his speech is unintelligible. He is frustrated when he can't communicate. He attends pre-school 1/2 day and spends the other half of his day with his grandma during the school year work week. Pre-school teachers report that he gets along well with others. He participates well in classroom routines. They notice that he often watches other students and follows along during activities. Teachers report concern about the lack of progress in speech development. Gross and fine motor skills appear to be normal. Parents report no obvious concern with his hearing, but they feel uneasy about his lack of speech development and the fact that normal hearing has not been confirmed. They feel that since he is the baby, everyone (grandma, older siblings, etc) take care of his every need without talking. They wonder if they are "babying" him too much.

Evaluation Information: The audiologist observed clear ear canals, no sign of ear infections. Otoacoustic emissions responses were absent in both ears. Tympanometry results revealed Type A tympanograms, which indicates normal middle ear function in both ears. Behavioral testing in the test booth revealed no response to sounds or speech in the test booth. An Auditory Brainstem Response (ABR) evaluation was recommended. ABR results revealed no response. M was diagnosed with severe/profound hearing loss in both ears at 3 years of age. His parents are devastated. They did not want to believe the results presented. They requested further testing from two different audiology clinics out of town, hoping the diagnosis was wrong. Both clinics confirmed the severe to profound sensorineural hearing loss in both ears.

Parents are back, three months later. They are ready to accept that their child has hearing loss. They want to discuss next steps as far as treatment and how they should raise a deaf child.

Consider the family's primary needs. Answer the following questions in your response.

Determine if further testing should be recommended, if so, what would you recommend?

What is the best communication approach to optimize the child's language development?

Is amplification needed, if so, what type of amplification will best meet the child's needs?

Should a cochlear implant be considered, why or why not?

Will the child's needs be met in an regular educational setting or will a specialized setting better serve this child? Consider educational placement options. What type of educational support would you recommend?

Should the family consider services from any other disciplines?

Answer 1

1.Tte further testing which can be recommended in advance is by doing a MRI Scan .This helps to identify any structural abnormality in the ear or any medical illness is the cause for the loss of hearing sense.

2.One of the best communication approach to optimizing the child's language development is by teaching lip reading ,sign language to the child to initiate communication.

3.The child can be provided am inner ear application hearing aid to support hearing and gain language development.

4.Sensorineural hearing loss which is severe to profound can be treated with the cochlear implant to access hearing .