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Online EHDI Case 2 (Case Questions Without Answers)

              Online EHDI Case 2: Child with Profound Hearing Loss

Part 1

History: Ismael Zawdi is a 2-month old infant who comes to your practice for the first time for well child care. He was a full term infant with an uncomplicated pregnancy, labor, and delivery. Birth weight was 3.2 kg. In the newborn period he did not pass his otoacoustic emissions testing (OAE). As instructed, his family took him for repeat testing at the hospital and again he did not pass. He then went to a local audiologist for Auditory Brainstem Responses (ABR). He had no responses up to 90 decibels in the right ear. Responses were not obtained for the left ear. Ismael is healthy, well grown, and in all other ways doing well. The family history includes a maternal cousin with hearing loss.
Ismael’s parents are from Saudi Arabia and have lived in the United States for almost 2 years. His father is a graduate student in mechanical engineering. His mother is college educated but does not work outside the home at this time. They both speak excellent English. They seem to have a good grasp on information they have received about hearing loss.
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1. What is your interpretation of his hearing status?

2. What should Ismael’s family do next?

3. How does the family’s ethnic and cultural background affect your approach?

Click <HERE> for answers to Part 1

Part 2

Ismael returns for evaluation at 4 months of age. He has been fitted with hearing aids, and has worn them for one month. He shows minimal response to sound even when the aids are in place. His father, who has read extensively since the last visit, wants to proceed immediately to cochlear implantation. He is unconvinced that Early Intervention with hearing aids in place will benefit Ismael given the severity of the hearing loss. He declines the recommendation for genetic testing.
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1. How do you respond to Ismael’s father’s interest in cochlear implantation for his son?

2. What is your current advice?

Click <HERE> for answers to Part 2

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