When I went with Tyler at 18 months, they told me that they usually implant severe/profound. But maybe after a few years with no speech they will look at implanting with a lower loss???
**(As far as I know in many locations)** The requirements are still severe -profound, so regardless of his speech or lack there of unless he meets the auditory requirements no he isn't a CI candidate.
It is possible that he may have something like CAPD (central auditory processing disorder) or APD )auditory processing disorder) ... this can be VERY hard to test for. They are NOT "hearing loss" ... It's difficult to explain, but it's like the auditory information that the person hears just doesn't make sense and is often ignored by the brain. It can vary from mild (making HL seem greater than it is, and making listening in noisy environments & with background noise etc very difficult) to very severe where the person effectively can't process auditory information at all. This is a "brain issue" NOT a hearing issue - which means that a CI isn't going to make a difference at all.
Personally I have profound hearing loss on my right side +120db across all frequencies & I have mild/moderate fluctuating loss on my left side... but I also (almost certainly) have a mild APD.
The result is that instead of responding like an individual with Rt profound & Lt mild/mod loss ... I respond & interact with the world a lot more like I have Rt Profound & Lt mod/severe or severe loss. When I am over-whelmed by auditory information (ie sound/noise) my brain sometimes will temporarily "shut off" the audio ... just as if someone hit "mute" on the TV. As a result I am a VERY visual person. ASL makes more sense to me than speech, seeing makes more sense than hearing ... visually is almost entirely how I process and retain information.
As the others have said - it's critical that your son is surrounded by "accessible language" this means being around fluent signers as much as possible (look into "signing play-dates" , Signing Parent&child groups etc in your area).
From a "learning a primary language" point of view ASL makes more sense visually than SEE does - all the word endings/tenses as well as "the","a" etc often get in the way more than they help (in this situation, it's different if your teaching reading & English ... but right now, you need to focus on communication not English grammar lessons). It will also be much easier to surround yourself with other ASL users than SEE users.
Read, read, read with him as much as possible (signing words, espeically nouns and reading at the same time so that he can see the book & your hands at the same time). Even if he's not getting the auditory input he's learning how language works - which is very important.
If you have TV you watch - ALWAYS have the captions/subtitles on. It's an important habit to get into now.
I'm not sure when the last time he had an audiogram done? but if it's been more than 6months and you are concerned that he may have more hearing loss than his previous audiogram indicates I'd recommend taking him to a Audiologist who is a specialist in paediatric Audiology and is familiar with various auditory processing etc issues (CAPD, APD, AN etc). If you have a copy of his Audiogram and have questions about it feel free to post it here and we'll help you make sense of it.
Always request a copy of your child's audiograms (you have a right to one) so you can keep them in a file at home for your own records .. this is VERY helpful!
Regarding the possibility that your child may not speak verbally (although it's very early to "go there")...
"speaking" isn't about making sounds with your voicebox ... it's about being able to communicate with someone. It's being able to tell someone you care about "I LOVE YOU" and for them to be able to understand and return the affection.
One of the most profoundly important things in my life was the very first time my mom signed a sentence to me - not a "practice sentence for ASL class", but actaully elected to enter MY world and use the language that I was more comfortable in (after 25years of making me do all the accommodating via speech-reading, hearing aids, guessing games etc). The content of the sentence wasn't important (I think she asked if I wanted coffee or tea lol!) it was that she made a CHOICE.... and honestly it felt like I was "hearing my mom's voice for the first time" ... I had that same "glee" that a parent has when their child says "mama" or "dada" correctly.
Speech comes in different forms - sometimes they are vibrations in one's voicebox... other times it's the subtle movement of ones hands ... it's the knowledge that it's the start of "meaningful communication" that makes it a beautiful and special moment.
