In the blog post called 'Help, my 4 year-old child can't talk,' a concerned mother wanted to know the reason for her son's severe speech and language delay.

Why at this stage did her son have "almost no intelligible words?" 

After receiving a detailed response from one of Hearing Solutions' experienced Audiologists, the child's mother wanted to know how effective hearing aids or even cochlear implants could be for her son.

In this follow-up, find out what a hearing loss diagnosis means for this little guy.

Ask an Audiologist

Thank you very much for your response, it's actually very reassuring to know that he likely has hearing loss. It's been a really long road to get any sort of answers about his hearing, I was actually more worried that he could have normal hearing and then we would be back to no answers again. Auditory Neuropathy Spectrum Disorder (ANSD) actually fits really well with his symptoms and we are having an ABR (Auditory Brainstem Response) test done to check for that this month. 

if it is ANSD is there any way to determine the level of dysfunction he is hearing, based on what I've read I know that hearing cuts in and out or has a lot of white noise, like a bad radio signal. Does that in any way correlate to the level of hearing loss that is found during standard hearing tests? Would hearing aids be helpful for him? should we push for cochlear implants? I very much want for him to speak and understand us, is it reasonable for me to expect that will happen, once he is receiving proper amplification?

Read 'Help! My 4 year-old child can't talk'

Audiologist's Response

You are so welcome. It's so frustrating not having answers and I hope that you are close to getting them. It does sound to me like ANSD fits quite well with his symptoms, and that the ABR test should determine whether this is the case.

You are correct that ANSD can cause the hearing to fluctuate, such that he may have "good hearing days" and "bad hearing days," or that sound may cut in and out as you mentioned. The results from the standard hearing tests are a very important piece of the whole puzzle and will be considered in conjunction with the ABR results to determine a diagnosis. Unfortunately, detecting the severity of hearing loss through ABR is more difficult with ANSD than with other types of hearing loss.

I would suspect that hearing aids will very likely be a part of your son's treatment plan if this hearing loss is confirmed. I wouldn't necessarily push for cochlear implantation unless it's recommended by the specialist. Cochlear implant candidates are always very carefully evaluated before receiving a cochlear implant because the implant often destroys any remaining hearing in the ear, to replace the inner ear with electrodes. Typically the hearing loss has to be in the severe to the profound range (hearing thresholds of 70 dB+) for a cochlear implant to be considered. There may be special considerations made with ANSD. It's possible that a cochlear implant may be recommended at some point, but most patients begin with a trial of hearing aids since there is much less risk and no surgery involved. 

It's very hard to say when or if your son will be able to communicate verbally, but it sounds to me like you are doing everything you can to find a solution to help him. I would remain optimistic that once a diagnosis has been made, which is often the biggest hurdle, a combination of amplification and speech language therapy should improve the situation. Unfortunately, there is a wide range of outcomes with ANSD, as the disorder is a "spectrum" therefore unique to each patient - but the technology for diagnostic procedures and amplification are constantly improving with time and research.

Again, please let me know if you have any other questions. My thoughts are with you and your son.

All the best,

Stephanie is an Audiologist registered with CASLPO (College of Audiologists and Speech-Language Pathologists of Ontario). Stephanie currently sees patients at Hearing Solutions’ Carlingwood Shopping Centre location in Ottawa.


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