Elena is a 14-year-old girl. She was born full-term with no…
Questions
Elenа is а 14-yeаr-оld girl. She was bоrn full-term with nо complications during pregnancy or delivery. She passed her newborn hearing screening and demonstrated age-appropriate speech and language milestones throughout early childhood, although consistently at the lower end of the typical range. She has no history of recurrent ear infections, ototoxic medication use, or significant illnesses. However, Elena has a history of behavioral and attentional issues in the classroom, including in her current grade. She frequently appears distracted, uncooperative, or “defiant,” often claiming she “did not hear” instructions. She sometimes misunderstands verbal directions and tends to perform better in one-on-one settings. Elena was referred for a full audiological evaluation after ongoing concerns from her school’s SLP. At the initial appointment, she was found to have normal air- and bone- conduction thresholds. However, at a subsequent appointment, the same audiologist reported a bilateral severe sensorineural hearing loss, with normal tympanometry, present OAEs, and absent ABR. After a few months, subsequent follow-up audiometries revealed fluctuating hearing thresholds and inconsistent ABR results (present–absent). Tympanometry and OAEs remained normal throughout. What possible disorder could explain Elena’s fluctuating hearing thresholds, and what evidence supports your conclusion? (0.5p) Which part of the auditory system might be affected, and how could this account for the variability observed over time? (1 p) Given the current information, would you recommend any type of hearing technology? If so, which one and for what purpose? (0.5p) What can teachers and the broader educational team do to support Elena’s learning and classroom engagement? (1.5p) How would you approach counseling and supporting Elena’s family throughout this process? (1.5p)