Hearing tests etc.

[AdelaofBlois]

I've posted before, but am anxious again to get Mumsnetters advice on the 'unknown knowns' I'm about to run into, especially since time is of the essence.

DS1 (3.2) has a speech delay with symptoms consistent with dyspraxia. We are lucky in that otherwise he is normal, and indeed has a comparatively large amount of intelligible speech. He has been under SaLTs for about four months.

On Monday he was referred by our GP for an ENT outpatients' appointment, and on Wednesday underwent mild suction to clear his outer ear. We have been given drops/olive oil and told to return in two months for more suction and a consultant appointment. One of the shocking things to come out of all of this was that all doctors concerned believe that, even if just due to packed wax, DS must have very impaired hearing, yet his behaviour is normal. In other words, I'm pretty sure his hearing range must be well below normal on a consistent basis.

What should I be looking for/demanding at the next hearing test? The first noted 'normal range and glue ear', but also that he was 'shy' (which I think may have been used to explain some non-responses). Is it worth getting both SaLTs to write to the consultant ahead of that appointment?

Second, sounds awful, but I know the SaLTs are in minor disagreement over the diagnosis-definitely disordered, but one says 'dyspraxia' the other only that that is a 'possibility'. Much in my son's speech-attention to very precise vocab, difficulties in hearing and correcting soundsbut not in the forced production of them-seems to me very consistent with simple deafness (although probably given it's been like that for half his life at least now some processing hassles as well). Is it worth raising and revisiting the original diagnosis with them on the basis of the new 'ear information'?

I think informing the salts about the ent appointment will definitely be a good idea, the same with informing ent about the salts.

Was the first hearing test with glue ear and normal range this week or was that an old test? Assuming it's an old test and that you mange to clear all the gunk before he goes back, you will be wanting his tymps checked to see if there is still glue.

When they retest your ds you will be wanting to know what his levels are over what frequencies or a copy of the audiogram. When you know at what level he can hear over different frequencies you will have a good idea of how his hearing is affecting his speech. Some very good info here scroll down to audiogram and look at where the speech sounds are placed, this is known as the speech banana incase you want to google further. The ndcs is a great source of info and their helpline is pretty good too, they have an experienced audiologist who will call you back if you feel you need it.

A standard hearing test won't identify processing problems though so you'll have to discuss that with the ent people and the salts.

Thank you, that's brilliant. The original test was in July. It showed glue ear, but they were unwilling to speculate on this further as it might have been due to a cold. I have been assured a further full test will be done, providing the gunk is clear.

I think my main worry is that DS is rather good at faking things and compensating (have become aware how much he remembers being told specifically and repeats it so he seems to be hearing / understanding). Is there an alternative to the both ear (and look at the animal boxes) test? Should I ask for this even though it isn't usual in younger children?

Whatever happens, SaLT will be a necessity for a while and I'm not at all convinced (however much my parents would like it to be the case) that this is purely about his hearing. But I am concerned that the physical aspects of this are and haven't been investigated properly, especially due to perceptions about DS's capabilities and age.

Thanks again, have read the info and am very definitely going to push for a 'proper' test of both ears with button or pegs this time-especially if the age is supposed to be 3.

Will ask SaLTs to write explaining the areas of difficulty for DS, perhaps then the test might concentrate a little there?

I have cared for a child whose mother was told that the reason he was not responding to a hearing test was because he was stubborn. It was apparent to those who cared for him that he had severely reduced hearing but the consultant would not listen. They realised too late that he had needed grommets all along and although he has now had surgery he has significant permanent hearing loss.

Don't be fobbed off by an audiologist saying he's shy. Push for really comprehensive testing and conclusive results.

Thank you, will push hard. One of the problems with DS is he lies-I've asked him if he can hear the television when it's muted and he says 'yes, they are saying....'. Wonder whether he won't just press the button all the damn time to please, but have time to try and get him to be honest.

The audiologist I'm sure will have come across a child that just presses the button many a time and should be able to recognise if that happens. Thing is, he has to time his 'lie' press or put the man in the boat with a noise he can't hear, it's not overly easy to get that consistently right.

Often if they are not sure of results, are saying shy/stubborn, they'll say come back in 6 months, do ask for a quicker appointment if you would rather.

bigcar wasn't worried he fake hearing, just that he'd lie so often the test would be inconclusive.

Whether processing or hearing, something very wrong with a child who responds to muted TV as with sound on full, behaves indistinguishably from normal when so congested he can't hear and manages to play with French adults so well they assumed he was bilingual. Needs explaining.

ahhh sorry, misunderstood your other option then if you don't want to wait for a retest would be an abr done either while asleep at nap time or under sedation but I'm not sure how willing ent would be to do that. Hope you get some answers.