My daughter failed a hearing screening in her left ear at a routine health examination. She was referred to an audiologist. The air and bone conduction tests showed a loss of between 50 and 60 db in that ear, as well as the speech tests. The doctor then administered a test that checked the hairs in the ear (which didn’t require my daughter to respond) and told me that it showed there was no hearing loss. Does this mean that she was faking it? I watched the tests and she looked as if she was really trying. Is there an instance when the hairs are working correctly but there is still a loss? The audiologist suggested having a different audiologist recheck the results but I am not sure I should if they are going to charge me again and if my daughter is faking a loss.
I know with a conductive loss the hairs would be working but there are tests which may have been done at the screening to find out if it’s senso (inner ear) or conductive (middle ear)
Thank you for the reply.
Conductive can be caused by being slightly Ill with a cold or middle ear infection.
It usually temporary but not always.
how old is your daughter?
She is 14 and they checked for middle ear fluid with a timpanogram and it was normal. I just don’t know whether it is worth pursuing or just let it be. She doesn’t have trouble since the right ear hears normally.
I doubt that a 14yo female would fake a hearing test… how many 14yo girls want to have a hearing aid hanging out of their ear? What does she say? I think it’s worth a trip to an ENT if nothing else for peace of mind.
If the Tymps were normal then the middle ear is most likely normal.
If the Audiologist performed Otoacoustic emissions (Measures outer hair cell function) and they were normal then 1) hearing is most likely normal 2) there is no possibilty of conductive loss or middle ear problems.
I have had several teenagers over the years feign hearing loss for some reason or another. It is a difficult time of life for some.
If the audiologist is savy enough it is very easy to trick the patient with speech reception threshold by asking the patient questions at lower levels than the puretone test levels. This again suggests normal hearing and the patient may be feigning puretone responses.
Make sure insert headphone were used instead of over the ear. Sometime over the ear (TDH phones ) can collapse a small canal during testing.
Hope this helps!
Thank you for all the responses they were very helpful.
I’m going to respectfully disagree with Doc jake on this one. If there is going to be people who are not completely honest with their hearing, very frequently I find that it is young girls between 9-16. So much so that I have gotten to the point where I almost expect them to not be completely honest about it. Now, I’m not saying that they are doing it consciously…but it does happen frequently…I believe more for attention that the perceive having a hearing loss may give not for the end result of getting a hearing aid.
As for the results. It is considered to be pretty much impossible to have a hearing loss of 60dB and normal otoacoustic emissions, one possible exception being if she had normal inner hair cells (there are 3 rows of outer hair cells and 1 row of inner ones - OAE’s test only the outer 3) but damaged/absent outer hair cells, called auditory neuropathy, but it is kinda unlikely that she’s get to 14 and not have something pop up before now. It’s possible though.
If they repeat the hearing test, and the results are the same, I’d ask to have what’s called an ABR and that will either confirm auditory neuropathy or that she was not quite honest on the testing. When I’m testing I always give them an “out” so that if they are trying to pull the wool over my eyes the can see I’m onto them and reverse whatever their original responses were. BUT, it’s hard to gauge thresholds to tones and make their speech scores consistent. So faking a hearing loss and keeping the thresholds and speech scores the same or similar enough to not raise any red flags is difficult.
So if someone has a profound loss on air conduction, moderate loss on bone conduction, bad word discrimination score, and only a very slightly abnormal result on ABR, are they faking it? Have a friend I have doubts about being legit…
sorry didn’t realize teenage girls were that screwed up these days but now thinking about what I see at the mall, movies, etc… I guess anything goes… tattoo’s (which would make my wwii and korean guys blush) to all the metal in their lips, eyebrows and other places I’ve heard. Another perk of the VA no teenage girls to deal with.
Hi cprovance,
Sometimes, when we are watching the TV program, we “can not hear” somebody else talking to us. in some case, people did pass the ABR test but just “can not hear”. the problem could be in the brain (it is more likely a “software bug” that causes the left and right brain can not communicate with each other well, I guess)
I just found a similar case, maybe you can try to browse it at URL below:
en.allexperts.com/q/Deafness-Hearing-Impairment-3221/2009/4/ABR-test-hear.htm
On the other hand, perhaps you can purchase the ear plug (ear protection NRR 25 dB or higher, silicon plug should be better than foam plug), and put one in her right ear then to “train her left ear”, and always do it when she is staying in a safe place (i.e. at home). I have no any idea whether this treatment can cure her problem (if there is something wrong in her brain), however if she is faking, I think you can know that very soon.
Hope these have some help.
All of your comments have been helpful. The thing is, she hadn’t mentioned not being able to hear at all and the loss was found at a routine health exam for sports for school. That is why I want to believe she isn’t faking it. I watched her responses as they were recorded on the computer and it was all pretty consistent with the pure tone, speech and bone test. I am not an audiologist, but am a speech therapist and have a little background in hearing testing (although it was 30 years ago). I guess the audiologist must have suspected something since she did the last test on the hairs. I just wanted to know if anyone knew of any cases of this which were legit. She has had some neurological events lately and we are checking out if they are seizures by having an eeg and brain scan so I guess I was wondering if maybe it could possibly be connected to the hearing loss, if there is in fact one at all. Again, thank you all for your comments.
Hi cprovance,
regarding your question about “Is there an instance when the hairs are working correctly but there is still a loss?” I have showed you an instance in my last post.
I do not think your daughter was faking, and I doubt the problem could be with the earphone jack of the test equipment.
Thank you CL. Something like this would probably not show up at all in a brain scan or eeg, right?
If someone has a mixed hearing loss like you mention, an ABR, depending on how they present the click/tone stimuli (bone conduction or air conduction) should be consistent with their air or bone thresholds. But if you have a moderate SNHL and do an ABR which indicates normal thresholds then yes, something doesn’t match up. Any time you do an ABR and the results aren’t consistent with the thresholds you have to start asking why.
I don’t think those things indicate a “screwed up teenage girl”. Most of the girls I see that “pad” hearing loss or outright try to indicate a hearing loss where there is none are completely “normal” looking and come from good, steady families. Boils down to a lot of the time they just want attention. Case in point, I wanted glasses when I was about 11 so I tried to fake a vision loss. Well obviously, the dude figured it out and I didn’t get glasses, but I came from a very stable home with incredibly loving and supportive parents. Kids are just weird and do weird things a lot of the time for apparently no reason whatsoever and a lot of the time I don’t think they even realize they are doing it.
I would love a VA job…I loved the 6 months I spent as a grad student there but unfortunately, it’s an incredibly difficult system to get into.
I would not use the “therapy” method mentioned at the bottom. If you feel that someone is “having trouble hearing” but has normal hearing on testing it could be a Central Auditory Processing Disorder. If that’s the case, finding a pro that specializes in diagnosing and treating CAPD is ideal. There are computer programs and other things that you can do to improve processing issues if that is, in fact, what is going on.
Correct. Hearing loss, unless it’s due to physical or electrical changes in the brain won’t show up with those tests.
The results that the first audiologist aren’t consistent with each other. It’s possible that she could be “faking” or something else could be going on. Could have been equipment malfunction somewhere…could be something else. Repeating testing is the normal follow-up to test results that are inconsistent. Like I said before, if the results remain the same then further testing needs to be done to figure out why the results aren’t making sense.
Originally Posted by Doc Jake
sorry didn’t realize teenage girls were that screwed up these days but now thinking about what I see at the mall, movies, etc… I guess anything goes… tattoo’s (which would make my wwii and korean guys blush) to all the metal in their lips, eyebrows and other places I’ve heard. Another perk of the VA no teenage girls to deal with.
I don’t think those things indicate a “screwed up teenage girl”. Most of the girls I see that “pad” hearing loss or outright try to indicate a hearing loss where there is none are completely “normal” looking and come from good, steady families. Boils down to a lot of the time they just want attention. Case in point, I wanted glasses when I was about 11 so I tried to fake a vision loss. Well obviously, the dude figured it out and I didn’t get glasses, but I came from a very stable home with incredibly loving and supportive parents. Kids are just weird and do weird things a lot of the time for apparently no reason whatsoever and a lot of the time I don’t think they even realize they are doing it.
Well, maybe I’m kind of old school but when I see teenage girls with tattoo’s across their backs and across the top of the waist so you can see them above their jeans. Arms with full sleeve tattoos. Red and purple hair and lips, nose, eyebrow, belly button piercings I just assume something ain’t right particularly with the parents. If she has no prior ‘issues’ then why she would decide to fake on a sports physical out of the blue just seems odd. But, since I have no kids and don’t deal with teenagers I’ll defer to you one your expert opinion. I think there may be more to this that we don’t know.
I would not use the “therapy” method mentioned at the bottom. If you feel that someone is “having trouble hearing” but has normal hearing on testing it could be a Central Auditory Processing Disorder.
How is that different from putting a patch on the better eye for amblyopia, or a sling on the better arm of a stroke patient? If it is CAPD, it might be beneficial, forcing the patient to process what is heard in the “lazy ear.”
ex-School Psychologist.
The auditory system doesn’t work that way. A “lazy eye” is that way because of muscles not because the visual cortex can’t process the incoming signal. When you do therapy for CAPD you have to teach the brain how to integrate the signal binaurally…by limiting the input to one side you can’t do that.