We differ. If that was my child’s hearing loss I would get a CI as soon as possible and that would also be my professional recommendation. A hearing aid will never be able to provide what a CI can for this degree of hearing loss.Where I live, that child would have been implanted bilaterally by around age one and expectations would be near-normal language development with SLP support and good CI wear time. If it were my child now, I would be seeking a CI for at least the left ear on an urgent timeline followed by intensive language support.
At 4.5 this child is exiting his first critical window for language development and it sounds like he is very delayed. If a CI isn’t an option, I would continue working on oral language but I would also immerse with sign language immediately. This would mean moving to an area where a signing school was available as well as teaching the entire family a new language.