We received a copy of Daniel’s audiological evaluation from last week with the deaf school. I’ve been remiss in publicizing that it even happened, as I’ve been a little swamped since. Long story short, we started off with his hearing tests to work toward the hearing aid trial, and they found fluid behind his left ear drum, meaning they could not progress with hearing aids at this point. He also fell asleep during the hearing test – it was a behavioral test and, unlike the first one, we wanted him wide awake for it. He started out quite awake but then drifted off. We visited the ENT, who confirmed there is fluid there. Now, he had fluid there when we first visited the ENT 5-6 weeks ago too. If it doesn’t clear up in the next 6 weeks, he will be getting tubes to drain it and allow us to move forward with audiology.
But, back to the evaluation. It’s … interesting. I’ll skip the case history and report on the ear drum/fluid findings and get right to the meat & potatoes.
Daniel’s hearing sensitivity was assessed under insert earphones using behavioral observation audiometry (BOA). Responses to music in the soundfield were observed at 50 dB HL. Responses to monitored live voice (MLV) under insert earphones were observed at 65 dB and 60 dB HL for the right and left ear respectively. Daniel’s responses appeared to be reliable for the first part of the session but as the session progressed, Daniel did not respond to MLV stimuli until 90 dB HL at either ear. These results are inconsistent with previous ABR findings and necessitate further testing to determine hearing levels. Most likely Daniel’s attention exhausted during the session, but the possibility of a fluctuating hearing loss needs to be ruled out.
What does this mean? Not a clue. The ABR was wrong? He fooled us during the BOA and the timing of responses (which were just stopping sucking, eye movements, that sort of stuff) was coincidental? He has a fluctuating loss? His hearing is improving? (The audiologists at St. John’s, where he was diagnosed, said it wouldn’t happen – the audiologists at CID said they’ve seen it on rare occasion in CMV babies because the brain just hadn’t fully developed yet due to the virus. But we were told he passed his newborn screening, so would that be possible? But then, his case history on the report I just got said he had been referred for his newborn screen? AHHH, I’m so confused!)
I did look up fluctuating loss as it relates to congenital CMV babies. It’s not uncommon, though it’s a lot less likely to happen in symptomatic babies like Daniel. Also of note, the loss can deterorate over time in both stable and fluctuating loss – so if these findings are confirmed and his loss isn’t as bad as initially thought, that doesn’t mean it won’t become that bad over time.
My gut? I’m not sure. I’ve said this whole time that I wonder about his loss. Sometimes he seems like he hears stuff, we’ve had physical therapists and other professionals comment that he tracks voices well, occasionally a lady from daycare will say she swears he heard her. Other times, Eric will be screaming or crying and Daniel won’t show the slightest hint of reaction. He slept through the Fourth of July fireworks, though once or twice I thought he may have reacted. John joked once about it being a loose connection, tilt his head one way and he hears, tilt it another and he doesn’t. Of course, he didn’t mean it literally or anything of the sort – but maybe he wasn’t too far off?
I don’t know. I honestly don’t have a clue on this one. But there you have this week’s official word. His next audiological evaluation is set up for July 29, though if we go in on July 16 for his 4 month well visit and find the fluid has cleared from his left ear, they may move that up.
Jeez. Gotta love conclusive testing that gives you a firm sense of what’s going on. Right? Guh. More muddled waters…. blerg.
wow…. it’s like running in mud, you get no where fast. I guess time is really the only answer you have now.Wait and see and in the mean time, enjoy that beautiful little baby. I soooo cannot wait to give those two a big gramma hug . See you soon.
How frustrating. But to add a little perspective, Willa doesn’t react to Ada’s screeching either. The fireworks didn’t phase her either. The only hearing reaction we ever got out of Aleah was when Ada’s apnea monitor went haywire one night. I tend to put a lot of value on “mom’s gut”. Hopefully his loss is less than you’ve been told.