Persons with auditory neuropathy spectrum disorder: A case study for disability certification

Four clients had visited Tertiary clinic seeking a hearing disability certificate. All the clients reported reduced hearing sensitivity in both ears. Audiological evaluation and hearing aid trial were performed. In addition, the standardized hearing handicap checklist was administered on them. The audiological evaluation showed that two of them had bilateral symmetrical sensorineural hearing loss (SNHL) with moderate (pure-tone average [PTA]: R-42.5 and L-46.25) and moderately severe (PTA: R-61.5 and L-61.5) degree, respectively. The other two clients are diagnosed as bilateral symmetrical mild (PTA: R-38.25 and L-31.25) and moderately severe (PTA: R-61.25 and L-61.25) degree, respectively, with overlaid auditory neuropathy spectrum disorder (ANSD). The severity of hearing handicap was mild to moderate for SNHL clients and severe for ANSD clients. Further, hearing aid was found to be beneficial to the two clients with SNHL, but the two ANSD clients did not get benefit from hearing aid. Irrespective of the site of the lesion, the two clients who had moderately severe sensory neural hearing loss (HL) (≥60-dB HL) in both ears availed of concessions/benefits with the disability certificate issued to them under the guidelines of the RPD Act, 2016. Though the individual with ANSD had a mild degree of HL and experienced severe handicap due to severely impaired speech perception. The hearing aid was not beneficial for the purposes of speech perception. In spite of his severe speech perception problem, the client with ANSD with mild degree of HL was not eligible to avail of benefits from the hearing disability certificate as his HL did not reach the benchmark disability of 60-dB HL or 40% under the RPwD Act, 2016. The probable conflicts of thoughts on benchmark hearing disability are discussed in the present study.