Assume that you have tested a child with electrophysiologic measures. Otoacoustic emissions are absent, tympanograms are normal, acoustic reflexes are present though elevated. The electrophysiologic thresholds are consistent with moderate to severe bilateral hearing loss.
Information giving
-What steps will you take as you explain the findings to the parents of the 3 month old infant?
-Where will you discuss it? Think specifically of your clinic. What is the best setting to discuss the results and why did you select that room?
-What information will you provide, and when? Will you have “one big long session” or are you going to cover material in several meetings?
-Are you giving the information orally, in writing, or both?
-What referral recommendations are you making?
Encountering patient reactions
-Assume that the mother breaks down in tears and sobs “this is the worst imaginable news!” How would you react/respond?
-Assume instead that the father responds angrily “I don’t know why I trusted a student clinic with my baby’s hearing! I know she can hear me, everyone tells me I have to be quiet or I’ll wake the baby and dammit, they’re right! The least bit of noise and she wakes up!” How would you react/respond?
Answering questions
Diplomatically but truthfully answer each of these questions about the same hypothetical child diagnosed by electrophysiologic testing as having moderate to severe sensorineural hearing loss bilaterally.
- Are you sure the hearing loss is permanent?
- Are you sure of your findings – is there a chance these test results are wrong?
- Are sure it’s not even a worse loss of a hearing loss?
- Can she hear me at all?
- Are you sure it’s that bad a loss? I’m thinking back and she cried when I dropped a pan into the kitchen sink while holding her…
- Will the hearing loss get worse over time?
- Could my having had a drink at New Year’s have caused this?
- What will happen if we don’t get her hearing aids right away?
- Do I need to learn sign language?