A 4-month-old infant is brought in by her parents for not making eye contact and not responding to loud noises. Upon examination, the child does not startle to loud sounds and does not follow objects visually. What are the potential diagnoses, and what are the next steps?
The infant's symptoms of not responding to loud noises and not making eye contact or visually tracking objects raise concerns for sensory deficits, specifically potential hearing and vision impairment. Initial steps would include a further audiological assessment to evaluate for hearing loss, such as an otoacoustic emission test (OAE) or auditory brainstem response (ABR) testing. An ophthalmologic evaluation should also be performed to assess for visual impairment. Depending on these results, interventions such as hearing aids, cochlear implants, or vision therapies may be considered, and early intervention services should be initiated.