Hearing loss and ABR test, how accurate are they?

[Imnotwonderwoman]

DS was 3 in May. His speech and language development was slow so we were referred to a SALT. She recommended a hearing test and this indicated conductive hearing loss possibly caused by glue ear. We attended ENT for an appt, where it was recommended he have grommets and an ABR test while under general.

The results have been a real shocker. Apparently he has no hearing at all in his left ear and moderate to severe in his right. He has an aid for the right but now his left ear is effectively useless, we have been advised not to use an aid in that one.

He certainly doesn't have speech anywhere like most his peers but he does speak and he does copy our words. The SALT said she thought it was more conductive rather than sensorineural which is what we thought before the ABR.

Has anyone experience in questioning the ABR results or are they 100% conclusive?

Hi Imnot - I've got deaf DCs. If the ABR test was done properly - ie, they removed all the glue ear first, then the results are highly likely to be reliable.

DS's situation is unusual, but not super-rare. My youngest was hearing at birth - he passed his neo-natal ABR, got glue ear at around 15 months, was retested with ABR during a grommet operation at 20 months, and there we found out he had a profound hearing loss.

There are forms of deafness that happen 'progressively' - where hearing loss happens over time, sometimes slowly, sometimes quickly. That's the type of hearing loss my DCs have.

It's very hard for parents to pick up this type of loss, because one day isn't much different to the next - it's only over months and years that the difference becomes apparent, and when you chuck glue ear into the mix, things become even harder to pin down. So please don't beat yourself up about anything you think you've missed

Are the audiologists going to investigate what's going on with the left ear? Would cochlear implantation be an option for you, if you were interested in checking it out?

There are two types of tests for hearing loss, OAE and ABR. The OAE is generally used at newborn screening and is an echo test for middle ear function. The ABR measures whether or not the signal is getting to the brain. ABRs are generally not done at newborn screening, unless you have a premmie. Anyway, the ABR measures how the brain reacts to different levels of sound and different frequencies. It is not more accurate than an OAE, it just measures a different part of the hearing process. From 6 months old, children can do VRA (visual reinforcement audiometry) which is where they will respond to sounds that they hear in a sound proof booth. This is best way of understanding exactly what your child can hear (with and without hearing aids) and a decent specialist will be able to get a response from a very young child. They test both ears and different frequencies of sound.

I have two deaf children, both of whom had absent or very poor ABRs (they have something called ANSD - where the signal from the ear to the brain mis-fires). Bizarrely, as part of the condition, they have perfect OAEs - so it's rarely picked up at birth, despite being present.

You need to get yourself to a decent audiology department, ENTs are surgeons, you need a hearing specialist too. The big hospitals are much better at helping you get to the root cause and therefore can help you get the right technology to give your child good access to sound. The glue ear may have just covered up an underlying issue and depending on the level of the hearing loss, whether hearing aids or cochlear implants would be the best solution.

My two both have bilateral cochlear implants. They are both at mainstream school and found the help from www.avuk.org life changing. Deafness isn't the diagnosis it once was, but you do need to focus on getting good quality support and technology. The charity was amazing at really helping me to understand what I could do to help them listen and speak.

The NDCS can be a good source of information, but my personal feeling is that they focus a lot on total communication (ie including signing) which we've never done.

Good luck and keep on pushing for support.