Q: My 16 months old son is a premature baby delivered at 33 weeks gestation. The doctor advised to test his hearing ability. It was observed that - tone blast ABR (500hz) - NR-90db-NR, late latency response - NR-90db-NR. Electrocochleography: cochlear microphonics present in both ears (till 3 msec in left ear and till 1.5 msec in right ear). They concluded auditory maturation delay in both ears. Will my son be able to hear as with normal ears by 2 years of age? How will be his hearing ability?

A:I share your concern about the hearing. I also appreciate yourself acting on your suspicion by taking him to an audiology-testing unit. But, in your query, you have just mentioned the result of the test. You have not told me the following: when did you start suspecting hearing impairment – whether your son is turning towards you when called by name - Whether he responds to loud sounds - what speech sounds he has acquired - any other physical problems. I am sure that that the doctor who has ordered the BERA test would have asked all these questions. These are all important information, which will help us to come to any worthwhile conclusion.

I feel that you have already delayed quite a bit. There is a window period during which the brain soaks up new knowledge like a blotting paper and this window of opportunity closes by the age of three or four years. Afterwards, it is a lot difficult for the child to learn. The priority now is to treat the present hearing impairment right away without wasting further time, instead of waiting the delay to catch up etc.

Prediction whether your son will get over the so termed "auditory maturational delay" would certainly help you, at the least, to reduce your anxiety level. But, it requires astute clinical ability to say that. The priority at the present stage is to maximise his hearing ability and to start his learning process. Certain simple tests are available to predict the level of the present hearing ability. Right from age 6 - 8 months, behavioural hearing tests can be done by operant conditioning or by visual reinforcement. These tests are simple, inexpensive and can be done by any qualified audiologist. From the rehabilitation angle, these tests give more relevant information. An appropriate hearing aid must be fitted. You, as parents, must start talking to the child. As far as possible, do not fall into the trap of hand gestures. Initially, do a psychologist's assessment. Use every available moment of your life, to talk with the child. Start from simple words and sentences to more difficult diction. A variety of personnel are available to help you in this task - audiologist, speech therapist and special teachers. The singular difficulty is that these personnel are scarce and you will have to find a person, easily accessible to you. If both the parents are working, consider whether one of you can interrupt your career for a few years.

Please get the help of an audiologist or an ENT surgeon (who is familiar with such issues viz. a paediatric otolaryngologist if one is available), while you make your decisions. Whenever necessary and if necessary, please do not hesitate to get second opinions. However, do not procrastinate under the ruse of second opinion etc. And, do not be misled by any unfounded advice that you should wait.