Much Ado About Nothing

Six years ago, we took FMO for his first audiology exam, at Oakland Children's Hospital. That was the first time we were told his hearing is adequate for understanding speech. It was the first time we were advised against a sedated ABR (Auditory Brainstem Response) test. Four years ago, we took him to the audiology clinic specifically to get the ABR. She reached the same conclusion as the previous audiologist, his hearing was adequate for understanding speech, and we were advised against doing the sedated ABR. FMO recently went for a third audiogram, this time at a new audiologist who specializes in APD. She had to perform an audiogram as a matter of course prior to administering the CAPD test we requested. For the third time, the results were the same. FMO does not have a hearing loss (or at least not one significant enough to explain his difficulty understanding verbal language.)

The new audiologist is really great. I appreciate how thorough she is. Unlike the one we took him to before, her primary tools are not an inflated ego and a firm belief that she has all the answers.
The objective was for FMO to take the APD test, which is required for CAPDOTS, an online therapy service specifically designed for people with APD. In order to get the therapy, a person has to have taken that test, because it identifies the sub-categories of auditory processing deficit. I drove to the Bay Area and stayed with my mom the night before so FMO wouldn't have to sit in a car bored for the three hours it would take to get to the audiologist's office, take tests, and have people try to stick stuff in his ears. That worked well; we had a nice visit, a short drive, and he did great. Unfortunately, the end result was another unnecessary audiogram, and he didn't take the APD test.

The audiologist was concerned that if he performed poorly on the test she wouldn't know if the reason is that he didn't hear, he didn't understand the directions, he doesn't have enough language to perform the tasks, he didn't want to cooperate, or some combination of those factors. Also, she wants to build trust and not push him too hard. Somewhat reluctantly and disappointedly, I had to agree. She said she is becoming a CAPDOTS provider, and, even if he did the test at a later time and got unreliable results, she might be able to talk to them and get them to attempt to serve FMO anyway.
She recommended starting auditory discrimination training and offered to connect with his speech therapists to implement a program. He now has two SLPs, one online, provided by school and one in town, covered by insurance.

The audiologist brought up AN (Auditory Neuropathy) several times in the context of ruling it out with a sedated ABR. We were already in the process of finding a facility to perform it. I told her if there was a elephant on the room we should talk about it. She responded that she had no reason to doubt my observations and reports of what he seems to be experiencing in terms of how he hears. She said she needs more information like the ABR, but if he has APD, as Dr. C had told us, that it's the most severe case she's seen. That was a little difficult to hear since APD is her specialty. She said if the ABR shows AN, since it is a physiological versus a neurological disorder like APD, that treatment is completely different. So when he got the ABR today, it was a relief to finally know for certain he has no physiological issues, but a definite letdown that he is not a candidate for hearing aides.

There's no point in doing anything other than accepting what is and what isn't. Nothing has really changed. We're doing everything we can.