H.T. is age 7 months, and had failed screening subsequent to meningitis at age 2 weeks, having passed his birth hearing screening. He received IV antibiotics during a two week hospitalization, then received oral antibiotics.  The type of antibiotics used are not noted.  There is no history of hearing loss.  The family is Spanish speaking.

• Are audiologists legally required to arrange for Spanish interpreters for their Spanish-speaking clients?  They must do so for sign-language using patients.

Tympanometry revealed type A (1000 Hz probe tone) for the left ear, with present ipsilateral reflexes 500 – 4k Hz.  The right ear had a flat tympanogram and absent reflexes.

ABR testing was performed in natural sleep.

• When is natural sleep testing used, when must sedation be used?

• Would you have conducted ABR testing or would you have first tried VRA testing?

A response was observed using 20 dB nHL click stimuli, in each ear.  Neural synchrony was reported as normal in each ear.

• Summarize and interpret the findings.

The patient was referred to the pediatrician for medical management.  He will return in one month’s time for repeated tympaometry, and if those results are abnormal, he will be referred to an ENT.  The family was given information on normal speech and language development milestones, and a 6 month re-evaluation was recommended.

• Is this plan of action appropriate?

Case donated by Gail Lim, AuD, Pediatrix Neonatal Group, presenting follow-up data on a child identified by Pediatrix through their neonatal screening program.