Auditory Neuropathy
Posted on February 13 2012, 2:44:41 PM | Posted by jtcweb
What Tests Can be Done?
Your child has been diagnosed with auditory neuropathy. If the audiologist told you that your child was deaf or hard of hearing, you would understand the problem and solution. Family and friends all know something about hearing loss. But this diagnosis is not common, and even the words “Auditory Neuropathy” do not convey the problem or solution to most people. After hearing their youngster’s diagnosis, some parents feel confused, overwhelmed and often very much alone.
It is important now to focus on the job you have as you gather information, determine the best way to communicate with your child and move forward to provide him with the best options to meet his potential in life. It sounds overwhelming, but it doesn’t need to be. You will take one step at a time. Your first step is to gather information. Then you will be in a position to act.
The word, “auditory” refers to hearing. “Neuropathy” means that there is a pathology in the nerve. So Auditory Neuropathy is a problem in the nerve that carries sound to the brain. You might also hear this described as Auditory Dys-synchrony, which also refers to the manner in which sound is carried to the brain. This problem can vary in degree from quite mild to very severe. You will know that degree as the audiologist tests your child and as you watch his responses to sound.
The diagnosis of auditory neuropathy was based on at least two tests. The first test is Otoacoustic Emissions (OAE). This test assesses the function of the cochlea, the sense organ for sound. People with auditory neuropathy generally have a normally functioning cochlea. This is because the hearing loss is not in the sense organ for sound, but rather in the nerve. So otoacoustic emissions testing will probably provide a “pass” result. The cochlea is functioning well.
Acoustic Brainstem Response (ABR) testing will be done in conjunction with otoacoustic emissions. This test provides information about the hearing nerve and how it is functioning. Since auditory neuropathy is a problem in the nerve, this test will show an absent or abnormal response. The combination of these two tests showing that the cochlea is functioning well and that the nerve is not transmitting sound perfectly to the brain, provides the diagnosis of auditory neuropathy. (Request our booklet, “Hearing Tests and Your Baby” for more information about these tests.)
When your child is old enough to be tested in a sound-proof booth, the results may vary in degree from slight to profound. Often the test results will show a flat hearing loss across frequencies (tones), or there will be better hearing in the high frequencies. Although testing in a sound-proof booth can provide an indication about whether your child is aware of sound, and possibly how loud a sound must be for him to hear it, neither this test or any of the others will tell you exactly how clearly your child hears.
Why Did This Happen?
Naturally the first question you will ask is why your child has auditory neuropathy. There are associated medical conditions, such as hyperbillirubinemia or prematurity which can be the cause. Genetic history can determine a family predisposition for this diagnosis. There are also some identified syndromes, such as Charcot-Marie-Tooth syndrome which have been identified with auditory neuropathy. You might want to talk to your physician and a geneticist as you search for answers. However, ultimately you will find that what you know now is what you need to know. Your child has been diagnosed with auditory neuropathy and there is much you can do for him.
What Can I do?
First you want to know what your child can hear. Since there are different degrees of auditory neuropathy, you will use a combination of your own observations and your audiologist’s test results. Remember that you know your child better than anyone else and because you are with him the most, you know his responses to sound. Since there are varying degrees of auditory neuropathy, children can respond differently. In general, if speech is heard, the signal is not clear. Speech sounds become less clear in noisy environments. Many parents report that their child sometimes appears to hear and sometimes does not. Many children seem to hear the same with or without hearing aids. In fact, some seem to hear better without amplification. This is what you can do, and you can begin today: Watch your little one closely and take notes. Date your entries and jot comments about the situation at the moment. In fact, begin a notebook with your observations and comments. You will share this information with the audiologist and other professionals who will work with your child. You are and always will be a critical member of your youngster’s educational team.
Hearing Aids, Cochlear Implants or an FM System
Your audiologist might suggest that your child try hearing aids. During this trial period, watch closely for reactions to sound, especially your voice. Also watch for any discomfort in noise. Your child will be tested in a sound-proof booth to determine benefit from hearing aids, but your observations will be equally important. You and your audiologist will be a team as you evaluate your child’s response to sound.
If your child responds well with hearing aids, you might find that an FM system will be helpful when there is background noise. Loud environments can be very difficult for children with auditory neuropathy because the hearing nerve cannot ignore those sounds. An FM system will amplify the speaker’s voice so that it is more easily heard when there is other noise.
If your child does not benefit from hearing aids, a cochlear implant may be recommended. This device is often helpful because it provides electrical stimulation of the nerve. This stimulation can synchronize sound as it travels through the nerve fibers. Request our paper, “Inquiring about implants” for more information about this device.
How Will We Communicate?
Although your child does not clearly hear your voice, you still want to talk to him as much as possible. Often a form of manual communication is also used, such as Signing Exact English. Cued Speech, a system of hand signals used with spoken language, may be suggested. The combination of your voice and either signs or cues can be very helpful. The John Tracy Clinic Distance Education Courses for Parents have many ideas for you to help your child develop language, whether you use spoken language alone or Total Communication.
If you have not contacted us for information about our Distance Education Courses for Parents, do so today. You may contact us here.
Other Sources of Information
Auditory Neuropathy: A New Perspective on Hearing Disorders by Yvonne Sinninger and Arnold Starr. Singular Publishing Group, Inc. 2001
Websites:
auditoryneuropathy.tripod.com/ANindex.html
groups.yahoo.com/group/AuditoryNeuropathy/
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