Sorry for the long post, but I thought this would be a good board to ask this on. I know this sounds strange, and I have yet to find anything on the web to corroborate that it's even possible, that a permanent loss can get markedly better, but here's some background on my son:
Andrew was born very early, at 23 weeks gestation exactly (1 lb. 6.5 oz/11 inches). He was on a vent for 11 weeks and in the NICU for 18 weeks. He came home on oxygen and was on it here for 4 months. Before his NICU discharge, he failed two hearing screenings in his right ear only. Follow-up testing with a pediatric audiologist, including the ABR, revealed a pretty much straight line loss in both ears, 50 to 55 dB in the left ear, that had somehow passed the screenings, and 55 to 65 in the right. Nothing better than 50 dB at any of the frequencies tested (500 to 4000) although he apparently had a clicker reading we weren't given in our paperwork, on the lest testing, of 35 dB. His ears were checked for fluid by both the audiologist, via a test, and the ENT a couple of weeks later. He had none during the times of either ABR, and essentially, has only ever had a little in the time since...once in May 2010 and then again this past winter/spring, always in the same ear (right).
Andrew was aided at 4 months corrected age and began Early Intervention services. Prior to that time, he didn't really coo. In fact, he never actually went through that phase. Four weeks after being aided, he tested at an 85 for expressive language on the Bayley test for infants, and a 109 in receptive language. The therapists were amazed at that receptive score since he hadn't had his aids long. He went on to have a good repeated babbling stage, beginning at 10 months corrected, going swiftly on to words. By 12 months corrected, he was testing at a 15-month level in expressive language and a 14-month level in receptive. The receptive language has continued to climb, now moving into the 120s/90th percentile range. However, the expressive language has fallen and now would probably be around a 90 for his corrected age, by my estimates. We will know more in a month when he is tested again on the Bayley. He has many word approximations, around 280, and a nice amount of signs, about 110, but they overlap a lot. He doesn't say second syllables, except for a few exceptions. And while he occasionally will say a phrase, it's rare still, no more than once a day. He also doesn't have many endings on his words. His ST says his speech is consistent with his hearing loss level, but what isn't consistent, according to her, is just how well he hears without his aids. She thinks some of the problem was his lack of sound play as an infant and the early move to words...something at the time we thought was good. He has almost every sound back from the babbling stage now, except initial l, but he just doesn't use a lot of them in words. Many of his word approximations sound the same. For instance, muh means anything from music to monkey to Mickey Mouse.
Here's the quandary our one ST notices...When his back is turned, Andrew can easily follow directions, respond to a simple question, imitiate, and laugh at something funny. He has heard me give a direction at about 20 ft., outside, and heard our soft-spoken speech therapist do the same inside, 15 feet away, when he couldn't see her face. He looks almost all the time when I make sounds like "ssss" or "fffff" behind him, things that he isn't supposed to hear. His hearing seems to have gotten progressively better. For instance, he used to be able to sleep through my husband and I talking in the room where he slept, but now often will awake if we talk downstairs, near the foot of the stairs. (His room is on the second floor). He has woken up to our cat meowing on the first floor (Granted she is loud). He has also stopped in mid tracks while playing upstairs, when she meowed on the first floor, and said "Meow"--his only 2-syllable, different syllable word. He awakes with the phone ringing all the time. It just seems to be getting progressively better with noises outside too. This past spring, I can remember the first time he heard the train outside without his aids, one night when I was rocking him after a bad dream--it's about a mile away. Then a month or so ago, it was the faint chimes from the church behind our house he finally heard. They begin at a very soft decibel--25/30 at best, yet he heard it, stopping what he was doing and going "Ding-ding."
This past month, the wax has gotten the best of him and he appears to hear a little less without his aids. The pediatrician checked his ears last week and said it looked awful in the right, and pretty bad in the left. The ENT doesn't favor drops and likes to have someone there clean them out. This time, though, since my son will be getting a tonsillectomy in a month, he just wants to do it then. The good news is that with his hearing aids in, he appears to still be hearing very well. Without them, I notice a difference at the fainter/softer sounds he was hearing. He may have fluid underneath the wax in his right (worse) ear, as he did last winter. If he does, they will be putting a tube in. The audiologist told me on the phone that the wax couldn't be bad if he could still hear some with his aids. I said he appears to hear as well as normal with them. I asked her if it would be normal to hold a conversation with him, at his level of loss, with a lot of wax on top of it, without his aids. She said not unless his hearing is good at the lower frequencies, as she sometimes sees. I reminded her his was 55 in the better ear at the 500. She appears to believe me now that he's hearing better than those ABR results. In the past I could tell she didn't because she kept saying they can perform a little better than those results but not a lot (something like 10 dB better). But we're seeing more with him and it isn't just his parents seeing it, it's all his therapists too.
They attempted booth tests with him last January and March. Before that time, they tested him as an infant with his aids on. On both of those occasions as a toddler, he didn't cooperate. The first one, only one eardrum turned, so she only tested the ear that was fluid free, the better ear, his left (We had the ears cleaned out a couple of hours after the test). She didn't get double hits at any frequency, but decided to go with what she got rather than call it inconclusive. She labelled him moderately severe only in that ear (down from moderate before) but didn't give us a printout of every frequency. I knew from his behavior, even back then, that he wasn't moderately severe, when she wanted to talk about turning up his aids. In March, they could do very little in the booth, as he cried most of the time. But in between the cries, they got a clicker test reading of 25 dB. However, that's about all they got, and couldn't do any individual frequencies.
I guess my question is, can sensorineural hearing loss improve? Are there cases like this? And if it can, will that show up on an ABR? Even if the improvement is what his brain has done since being aided (growing more neurons or whatever)? The audiologist made it sound like it would, but our speech therapists think the ABR will be the same, but the booth test, if we got one where he cooperated, would show the big improvements we have seen with him at home. I am hoping the audiologist is right, and if there's improvement, we'll find out with the upcoming ABR. I have a feeling it will be a while before he stops crying in the booth...he cries everywhere we go that is medical related.
Andrew was born very early, at 23 weeks gestation exactly (1 lb. 6.5 oz/11 inches). He was on a vent for 11 weeks and in the NICU for 18 weeks. He came home on oxygen and was on it here for 4 months. Before his NICU discharge, he failed two hearing screenings in his right ear only. Follow-up testing with a pediatric audiologist, including the ABR, revealed a pretty much straight line loss in both ears, 50 to 55 dB in the left ear, that had somehow passed the screenings, and 55 to 65 in the right. Nothing better than 50 dB at any of the frequencies tested (500 to 4000) although he apparently had a clicker reading we weren't given in our paperwork, on the lest testing, of 35 dB. His ears were checked for fluid by both the audiologist, via a test, and the ENT a couple of weeks later. He had none during the times of either ABR, and essentially, has only ever had a little in the time since...once in May 2010 and then again this past winter/spring, always in the same ear (right).
Andrew was aided at 4 months corrected age and began Early Intervention services. Prior to that time, he didn't really coo. In fact, he never actually went through that phase. Four weeks after being aided, he tested at an 85 for expressive language on the Bayley test for infants, and a 109 in receptive language. The therapists were amazed at that receptive score since he hadn't had his aids long. He went on to have a good repeated babbling stage, beginning at 10 months corrected, going swiftly on to words. By 12 months corrected, he was testing at a 15-month level in expressive language and a 14-month level in receptive. The receptive language has continued to climb, now moving into the 120s/90th percentile range. However, the expressive language has fallen and now would probably be around a 90 for his corrected age, by my estimates. We will know more in a month when he is tested again on the Bayley. He has many word approximations, around 280, and a nice amount of signs, about 110, but they overlap a lot. He doesn't say second syllables, except for a few exceptions. And while he occasionally will say a phrase, it's rare still, no more than once a day. He also doesn't have many endings on his words. His ST says his speech is consistent with his hearing loss level, but what isn't consistent, according to her, is just how well he hears without his aids. She thinks some of the problem was his lack of sound play as an infant and the early move to words...something at the time we thought was good. He has almost every sound back from the babbling stage now, except initial l, but he just doesn't use a lot of them in words. Many of his word approximations sound the same. For instance, muh means anything from music to monkey to Mickey Mouse.
Here's the quandary our one ST notices...When his back is turned, Andrew can easily follow directions, respond to a simple question, imitiate, and laugh at something funny. He has heard me give a direction at about 20 ft., outside, and heard our soft-spoken speech therapist do the same inside, 15 feet away, when he couldn't see her face. He looks almost all the time when I make sounds like "ssss" or "fffff" behind him, things that he isn't supposed to hear. His hearing seems to have gotten progressively better. For instance, he used to be able to sleep through my husband and I talking in the room where he slept, but now often will awake if we talk downstairs, near the foot of the stairs. (His room is on the second floor). He has woken up to our cat meowing on the first floor (Granted she is loud). He has also stopped in mid tracks while playing upstairs, when she meowed on the first floor, and said "Meow"--his only 2-syllable, different syllable word. He awakes with the phone ringing all the time. It just seems to be getting progressively better with noises outside too. This past spring, I can remember the first time he heard the train outside without his aids, one night when I was rocking him after a bad dream--it's about a mile away. Then a month or so ago, it was the faint chimes from the church behind our house he finally heard. They begin at a very soft decibel--25/30 at best, yet he heard it, stopping what he was doing and going "Ding-ding."
This past month, the wax has gotten the best of him and he appears to hear a little less without his aids. The pediatrician checked his ears last week and said it looked awful in the right, and pretty bad in the left. The ENT doesn't favor drops and likes to have someone there clean them out. This time, though, since my son will be getting a tonsillectomy in a month, he just wants to do it then. The good news is that with his hearing aids in, he appears to still be hearing very well. Without them, I notice a difference at the fainter/softer sounds he was hearing. He may have fluid underneath the wax in his right (worse) ear, as he did last winter. If he does, they will be putting a tube in. The audiologist told me on the phone that the wax couldn't be bad if he could still hear some with his aids. I said he appears to hear as well as normal with them. I asked her if it would be normal to hold a conversation with him, at his level of loss, with a lot of wax on top of it, without his aids. She said not unless his hearing is good at the lower frequencies, as she sometimes sees. I reminded her his was 55 in the better ear at the 500. She appears to believe me now that he's hearing better than those ABR results. In the past I could tell she didn't because she kept saying they can perform a little better than those results but not a lot (something like 10 dB better). But we're seeing more with him and it isn't just his parents seeing it, it's all his therapists too.
They attempted booth tests with him last January and March. Before that time, they tested him as an infant with his aids on. On both of those occasions as a toddler, he didn't cooperate. The first one, only one eardrum turned, so she only tested the ear that was fluid free, the better ear, his left (We had the ears cleaned out a couple of hours after the test). She didn't get double hits at any frequency, but decided to go with what she got rather than call it inconclusive. She labelled him moderately severe only in that ear (down from moderate before) but didn't give us a printout of every frequency. I knew from his behavior, even back then, that he wasn't moderately severe, when she wanted to talk about turning up his aids. In March, they could do very little in the booth, as he cried most of the time. But in between the cries, they got a clicker test reading of 25 dB. However, that's about all they got, and couldn't do any individual frequencies.
I guess my question is, can sensorineural hearing loss improve? Are there cases like this? And if it can, will that show up on an ABR? Even if the improvement is what his brain has done since being aided (growing more neurons or whatever)? The audiologist made it sound like it would, but our speech therapists think the ABR will be the same, but the booth test, if we got one where he cooperated, would show the big improvements we have seen with him at home. I am hoping the audiologist is right, and if there's improvement, we'll find out with the upcoming ABR. I have a feeling it will be a while before he stops crying in the booth...he cries everywhere we go that is medical related.
