Patient's Query
Hi doctor,
My daughter is three years old and failed the OAE (otoacoustic emissions) testing at that age. She has issues with articulation and has been in speech therapy for over a year, with scores at 1 percent for understandability. Our audiologist did not provide much information.
Could you give me your insight into my daughter's audiogram?
Kindly help.
Thank you.
Hi,
Welcome to icliniq.com.
Your daughter's audiogram (attachment removed to protect patient identity) shows a conductive hearing loss, but the ear is not mentioned. The cause seems to be some middle ear disease only. Please tell me about her subjective hearing.
I hope this helps.
Kindly revert so I can assist you further.
Thank you.
Patient's Query
Hi doctor,
Thank you for the reply.
She has never commented on hearing loss. In loud areas, she does not respond or look at us, regardless of what we say. For example, when we ask if she wants chocolate, she does not answer. She also does not respond appropriately if we are not facing her. We can speak to her in a normal voice when we are alone, but not in a whisper.
She has excellent comprehension of specific items; for instance, if you directly ask her to point to a comb in a book, she can do it. However, if you give her general directions, it is uncertain whether she will be able to follow them. She has been in speech therapy since she was 25 months old and is now 39 months old.
She barely qualified for therapy at 25 months, and the latest evaluation showed a decline in her speech. They are still working on beginning sounds. While she gets every syllable and intonation correct, the actual sounds of the words are incorrect.
She talks constantly, but very little is understandable to family members and even less to unfamiliar listeners. She does not get frustrated with us; instead, she looks at us as if we are silly and walks away. She often forces us to face her when we talk to her so she can see our faces.
There is no ear discharge, ear infections, colds, or flu. Her pediatrician has never observed fluid in her ear. She had strep throat a year ago, which was the last time she was sick. She was born with sepsis and received IV (intravenous) antibiotics (ototoxic) at birth, spending seven days in the NICU (neonatal intensive care unit).
Please help.
Thank you.
Hi,
Welcome back to icliniq.com.
As you mentioned, she does not respond well in loud places, which suggests she may have a hearing problem. The audiogram also indicates conductive hearing loss. If the loss were due to the ototoxic drugs she received at birth, it would likely be sensorineural in nature.
However, the audiogram report suggests that the loss is not related to the medication she was given at birth. The most common cause of conductive hearing loss in children is fluid behind the eardrum, which is treatable and usually recoverable. The impedance audiometry report you provided also suggests a middle ear issue that could be causing the conductive hearing loss.
Since your child is at an age when she is learning to speak, it is understandable if she is not yet able to say a few words clearly. However, it is important that her hearing loss does not negatively impact her speech development, as indicated by the speech audiometry results.
My advice is to visit an ENT specialist for a thorough examination. Conditions such as adenoids or tonsils may be contributing to the middle ear problem, and these can only be diagnosed through examination. Based on my experience, your child may need grommet insertion to address the issue.
I hope you are satisfied with my answer.
For further queries, you can consult me at icliniq.
Thank you.
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Answered byDr. Priyanka Aggarwal
Medically reviewed byiCliniq medical review team
Same symptoms don't mean you have the same problem. Consult a doctor now!
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