Today, I had the opportunity to work with a mother and her one-year old son. She returned to the Speech-Language-Hearing Center at Utah State University for another opinion about the status of her son's hearing loss. Previously, "Allan" was diagnosed with a bilateral severe-to-profound sensorineural hearing loss. In fact, he was diagnosed shortly after birth, fitted with powerful digital hearing aids, and has received intensive early intervention designed to maximize his amplified residual hearing and to develop his spoken language.  Allan's case is what we hope to see happen for all children with hearing loss!

His parents also have been through the cochlear implant candidacy process with Allan, which found that he indeed was a great candidate for bilateral cochlear implants. Sequential surgeries have been scheduled for him later this month for his right ear and his left ear will be implanted in November.

The primary reason that his parents wanted another opinion about his hearing status is because Allan is actually doing very well with his listening and spoken language development! He is imitating almost all of the beginning vowels and consonants, can turn his head when his name is called from across the room, dances when he hears music, and he is using approximately five words consistently.

And now, to borrow a phrase from Paul Harvey, here is the rest of the story. Earlier this week, Allan's mom took him to see a "pediatric" audiologist who was located closer to her home. Allan's cochlear implant surgeries are already scheduled, and the goal of the audiological appointment was to confirm his hearing status -- just one last time. Since he is doing so well in his communication development, his parents wanted to make doubly sure that his hearing had not improved.

Unfortunately, the appointment went awry. The audiologist did confirm Allan's severe-to-profound hearing loss. However, instead of honoring the parents' decision to seek bilateral cochlear implants, the audiologist proceeded to explain that cochlear implants weren't successful in prelingually deafened children and that they should seek out the resources at the state school for the deaf. He then expressed his affection for Deaf Culture.

Of course, this was inaccurate information that led to inappropriate recommendations.The audiologist seemingly wasn't informed about current evidence-based practices with pediatric hearing loss. The parents' decisions were appropriate for Allan -- given his early diagnosis, the degree of hearing loss, the functional benefit he has received from hearing aids, and the progress he's made in his communication development. His parents also realize that his speech and language most likely will reach a developmental plateau, and cochlear implants are the logical next step. The path Allan's parents have chosen for him is based on their desired outcomes for him; namely, that he will use spoken language and be mainstreamed with his same-age peers in their neighborhood school.

If the audiologist had listened to Allan's parents and fully evaluated his functional hearing, I would like to believe that he would have made different recommendations or actually supported the decisions they already have made. We'll never know for sure. Based on his general attitudes, it seems that he had very low expectations for what a child with a bilateral severe-to-profound hearing loss could achieve.  When will professionals -- and in this case professionals who should know better -- stop predicting a child's future success using just one piece of information -- the audiogram?  We all can agree that the audiogram is critical in rendering a diagnosis of hearing loss; however, its usefulness is limited. The audiogram doesn't measure how a child with hearing loss will respond to and use auditory information.  In other words, hearing loss doesn't equal hearing function.  

Allan's parents are now reassured about their decisions for him, and they look forward to what he will achieve as a bilateral cochlear implant user.  While they know he always will have a severe-to-profound hearing loss, they foresee a life full of possibilities -- rather than limitations. Thank goodness some parents disregard the advice they receive from the so-called experts!