Hi. I am looking for advice or anyone in the same situation. My 4 month old has now failed his hearing test 4 times. He responds to us when we talk, he seems to respond to most sound, and he babbles A LOT. the ent recommended a sedated ABR so that’s the next step. they said he has no fluid or wax buildup so i’m curious as to what else could be the reason he’s failing his hearing tests or if he is deaf?? i am worried sick as he already has other needs we see many doctors for.
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Difficult to say. But a very common cause for deafness among babies (and also in my case) is the well-known irreversible ototoxicity of many types of antibiotics.
Did your baby get a large dose of these? Note that antibiotics are life-saving drugs, and sensitivity to this side-effect is genetic (ie it affects some more than others), so this problem is hard to avoid in all cases.
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This isn’t my area.
However: not everyone has the same level of evoked response (which they should have told you). If he’s actually responding to sounds when not looking at you, there’s a good chance it’s a false result.
Obviously follow it up, distraction testing is pretty easy: just ask him something (to look for a toy) from behind while someone else is holding/looking at him. The babbling is good (again not my area) but if he’s already trying out parts of words, he’ll be hearing himself too. Keep talking to him and reading to him to help him hear as many different sounds as possible.
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This might be helpful. The source is very well respected and credentialed.
https://health.mountsinai.org/blog/what-are-the-early-signs-of-hearing-loss-in-babies/
he is sadly still too young to start speaking words yet so we’re unsure of that and too young to ask him to look at a certain direction. thank you for your response though!
Just call him whilst he’s distracted or facing away. You’ll know pretty soon if he’s hearing.
As I said before not everyone has oto-acoustic emissions, even in perfectly normal hearing individuals.
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I was born with severe Left sided deafness. My hearing loss was due to being born 7 weeks prematurely. Hearing starts to develop in the fetus around 18-20 weeks gestation 2nd trimester, and continues to develop right through the 3rd trimester. Viruses eg CMV or Rubella can cause deafness, complications during delivery, also genetic reasons (family history of deafness) can all cause hearing loss.
There are so many causes of congenital deafness at this stage it would be anyone’s guess as to why. Your child could have unilateral hearing loss and this could be why your child appears to respond to some sounds.
Good luck to you and your child.
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I’m paediatric audiologist. There are many reasons why children might fail a newborn hearing screening. Often children might appear to hear some sounds but aren’t able to hear the entire range of pitches necessary for developing speech and language and they’ll fail the test repeatedly for this reason.
There are also conditions that affect other aspects of the hearing pathway that fall under the category of auditory neuropathy spectrum disorder which results in abnormal and/or inconsistent ABR results. In such cases it is necessary to wait until the infant can perform behavioural testing at 6 months developmental age to get a better idea of how they’re actually hearing.
Hearing well is important for cognitive and social development, both of these beginning from an early age. If there is a permanent hearing problem that will affect speech and language development addressing it during the first six months of life wherever possible reduces the risk of significant delays. This is even more important if your child might have other medical issues that could affect cognitive development as the two factors can compound to result in even greater delays.
Most children with permanent hearing problems are born to hearing parents, so even if there is no family history its important to persevere with the process until you have a solid idea of what is happening. Recent studies have shown that children with hearing loss in one ear perform at the same level as children with bilateral hearing loss when it comes to word learning, so even if they have a minimal hearing difficulty knowing about it know can help you make the right decisions.
Every child is born with inherent strengths and areas that require additional support. If your child has hearing difficulties the newborn tests are a great way of learning more about their needs and how you can best support them to reach their full potential. You won’t be alone in this process, there’s always a team of professionals guiding and supporting you along the way so you can make informed decisions for your family.
I hope this information is helpful to you.
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I know that you’re trying to help, but at four months of age most children aren’t going to be able to follow a complex instruction like looking for a named object. They don’t have sufficient neck control for VRA until around 6 months developmental age.
Distraction testing is quite difficult to do with any degree of accuracy and even experienced clinicians don’t do it on a regular basis in most countries so it’s not something I’d recommend. It can give parents a false sense of security, especially in the case of unilateral, mild or sloping hearing losses.
Something that we can always recommend to parents is to make a list of questions and concerns they might have so that they can raise them with their audiologist either prior to or at an upcoming appointment. Bringing a support person along to appointments can also be very helpful as it can be difficult to absorb all the information being provided, especially when an infant is unsettled.
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would it necessarily be unilateral though since he’s failing the test on both ears? thank you for your reply!
With that comment I meant to highlight the importance of getting results for both ears and completing the assessment even if it seems like your child is hearing ok. Below 6 months of age so many infant behaviours are reflexive making it difficult to interpret whether an infant is truly responding to sound, which is why we need to use objective tests like the ABR to assess hearing at this age.
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Fair enough: I did caveat the initial response (twice).
From what I’ve seen of distraction testing, it looks difficult to get consistent responses before a certain age like you say.
So, definitely ‘not my area’.
Thanks for the feedback.
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i have read that most babies who are deaf don’t typically babble or babble less than others. is that true?
The ABR will give you the answer.
If there is hearing loss, then it will have been caught early and the audiologist will guide you through all the next steps. You are doing exactly what you need to be doing by attending the appointments.
There is a higher risk of hearing loss when a child has certain other syndromes or illnesses. Hearing loss does add extra appointments in the first year.
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Young babies who are deaf babble the same as hearing babies for the first few months but then babbling declines.
But hearing loss can be anywhere on a continuum from very mild to very severe. Failing the OAE screening doesn’t mean that a child is hearing nothing at all.
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thank you for your reply!
Early vocalisations are reflexive and similar for all babies. True babble doesn’t start until later and declines if the child cannot hear their speech at all e.g. with severe to profound hearing loss.