Yesterday our youngest, who has the dwarfism condition achondroplasia, had his 6th hearing test since birth. His first two was the standard newborn hearing screening that is done soon after birth. He had failed his first one the day after his birth so we had to come back to the hospital a week later to do the test again. It's not uncommon for newborns to fail the first time as often there's just liquid that needs to clear from after the actual birth.
Because of his achondroplasia he is more prone to ear infections and hearing loss as their condition leaves them with smaller ear canals and they often suffer from a build up of fluid in the middle ear canals. Due to this we always knew his hearing would be monitored regardless of how he did at the newborn screening. If he were average height he'd not be offered a hearing test before the age of 4 or 5 unless we had concerns about his ability hear prior to that. If you have any concerns remember to reach out to your GP or health visitor.
His first proper test (test #3) was what's called a visual reinforcement audiometry (VRA) which is how they test the hearing of children aged about 6 months to 2.5 years old. During this kind of test your child sit on a chair or on your lap while sounds are played. The child is taught to link the sound with a visual "reward" (in Elis' case it's been creepy old Disney characters that dance about in a box that lights up every time he turns his head towards the sound). Once the child has picked up that they need to respond to the sound the audiologist tests varying pitches and volumes to gauge their hearing. He was 6 months old when he had his first one and he reacted just as he should at the time. During these appointments they also do a tympanometry test to see how flexible the ear drum is. A small rubber tube is placed at the entrance to the child's ear and air is gently blown out of it while sound is played out of a small speaker inside it. The tube measures how well the sound is bounced back. Elis got no reading off one of his ears at this appointment but as he had responded well to the actual hearing test they weren't concerned. The next day Elis had a fever and ear infection that ended with a delightful, funky explosion from the ear they hadn't got a read off of.
Over the coming months Elis had several ear infections (it was the winter season and endless bugs in our house). When he went back for his next audiology appointment at 1 year's age he once again passed the VRA test without any issues although slightly less hearing than the previous test. This time he passed the tympanometry test on the ear that had failed the previous time, however he failed on the other one instead. Considering his recurring ear infections and the two tests the audiologist felt glue ear was likely but he didn't want to confirm just yet. For the time being Elis' hearing was more than good enough to keep developing as he should.
His next test was done in September of 2019 when Elis was 18 months old. This time they could confirm glue ear as both ears failed the tympanometry test and they could see that they ears were filled. Glue ear is when the normally empty middle ear canal fills with liquid and can't drain. It is more common in children and those with certain conditions (for example achondroplasia and down's syndrome) but can happen to anyone, along with hearing loss it can cause discomfort and tinnitus (hearing a buzzing to ringing). Often it clears by itself in a few weeks or months. For kids it can greatly affect their development, in particular their speech and attention span. If persistent patients are generally offered grommets (small tubes that are surgically placed in the ear canal to help drain the fluid) or temporary hearing aids. In particular if it's part of a great underlying condition. In rare cases an adenoidectomy, where the adenoid glands at the back of the nose are removed, may be offered.
Back to September: he passed his VRA at his appointment but levels had dropped again. The audiologist felt his hearing was still good enough that it shouldn't hinder his speech and ability to take instructions so decided no further action would be taken immediately. She did say they'd call him back 3 months later instead of 6 to check if things had improved or if his hearing had diminished further.
Yesterday we had the follow up appointment and again he failed his tympanometry tests and his ears were filled with fluid. He apparently performed his VRA test really well, however she had to turn up the volume quite high before he'd respond. The audiologist's readings showed that his hearing hadn't just diminished a little in the last 4 months but had done so quite severely. I had been expecting him to have lost a bit more hearing as I've been concerned that his speech isn't coming along at all. He literally just says "mamma" & "pappa" the rest is just a series of "bababa" sounds - even our eldest who was a late speaker had more sounds even if she couldn't say words to begin. I hadn't been prepared for it to have gone down as much as it had though. While I'm glad that it seems we know why his speech is delayed and I know that we have several options ahead of us to help him it was a bit disappointing that he'd lost so much hearing in just a few months. He's not had any ear infections this season and generally been in better health than last year so I hadn't been prepared for it. Although the audiologist said that the lack of infections and ear explosions was probably why he was hearing less. At least last year his ears were managing to drain the fluid.
As he is at such an important stage in the development of his speech at his age she was hoping to get him fast tracked onto the team we need to meet to discuss what they think is best for him. We will spend the next wee while looking into these options and speaking to others who have gone through the same with their kids to see what they recommend. Then we will take it from there, I have an inkling as to what we'll decide but it's not an easy decision and we won't make it properly until we've seen the specialists and informed ourselves.
If you have any experiences of your own regarding these choices we'd love to hear from you and what your pros and cons are.
Part 2: How our follow up audiology appointment went two months later can found here
Part 2: How our follow up audiology appointment went two months later can found here
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