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Online EHDI Case 4 (Part 2 With Answers)

 Online EHDI Case 4 - A Child with Unilateral Hearing Loss

Part 2

Sarah is now 3.5 months. Sarah’s ABR revealed normal hearing sensitivity in the right ear but a moderate to severe hearing loss in the left ear. The audiologist suggested a hearing aid for the left ear. Susan’s mother worries that a hearing aid will stigmatize her daughter. She also worries she cannot afford the aid and the trips for fitting.


1. What is your impression?

• The hearing screening proved to be accurate in Sarah’s case. A permanent, unilateral sensori-neural severe hearing loss was detected early in Sarah’s life.
• There are reasons that a hearing aid is strongly recommended for Sarah’s left ear even though hearing sensitivity is normal on the right:
     o Input from two ears helps us localize sounds from side to side, front to back and up and down.
    o Input from two ears helps us discriminate in certain situations such as noisy environments.
    o As Sarah grows, this hearing aid may help her develop language more efficiently than if she had input from only one ear. Given that we cannot be sure if unaided she will develop normally, it is prudent to provide her amplification at this young age.
    o At older ages, the hearing aid will likely prove useful to her in the classroom as well as in the playground; it may help her as an adolescent when she is learning to drive a car.
• Ms. Ramey’s concern about the stigmatization is reasonable. However, poor speech and language skills are also stigmatizing. When Sarah is older she can decide if she wants to wear the hearing aid.
• Funding for hearing aids and for visits with the audiologists is available for Sarah in the State of Pennsylvania through the Medical Assistance program.
• Sarah can be referred to Early Intervention. The child may not be able to get services, but she will be enrolled for the purposes of screening and tracking. She will receive services if in the future she has a developmental delay.

2. What strategies might be effective in your interactions with Ms. Ramey?

• Ms. Ramey has done an excellent job at getting Sarah all of the recommended preventive care required for her age. Provide honest compliments, such as that she has consistently done the right thing for her daughter
• Acknowledge the emotional aspects of learning that your child has a problem, even a problem of relatively low severity. Check with Ms. Ramey about where she finds support when she has stresses with the other children.
• Emphasize the value of parent-to-parent support. In addition to family support specific to the issues of hearing loss, family support through early intervention may also help her.
• Continue to monitor the situation and provide professional support to this family. Careful monitoring of speech and language development may be of particular importance to this family at this point.
• Ask Ms. Ramsey about her other children. She might want to bring them in for audiology evaluation.
• Also genetic counseling is available (even for unilateral losses):

Additional Info

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