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He could make out some conversation, but my whispered “I love yous,” at thirty decibels or less, would have been inaudible.
    Hearing loss doesn’t just make the world quieter, it garbles it. When the ear can’t tune sounds as sharply, they blur into one another. To someone with some low-frequency hearing, speech sounds dull and muffled, so that even what is audible is hard to understand.
    This explained why it had taken so long to detect Alex’s loss. He had been hearing some things but not others, responding to some things but not others. What he did hear, he didn’t hear clearly. The fluid had intensified the problem but also made it obvious, allowing us to act. A profoundly deaf child is far easier to identify than one who is hard of hearing. Alex’s hearing loss also suggested an explanation for the delays in his gross motor skills as a baby; hearing and balance are both centered in the inner ear. Damage sometimes, though not always, encompasses both systems.
    Uncovering Alex’s hearing loss had been like falling downstairs in slow motion. It dragged on, with information coming in fits and starts. Now, perhaps, we had come to rest, could catch our breath, take stock, and start climbing back up the steps.
    With some usable hearing, and hearing aids, there was every reason to think that Alex could achieve spoken language. When it comes to learning to speak, the difference between those who are profoundly deaf from birth or before learning language and those who are hard of hearing has historically been stark.In one state’s survey, only 25 percent of children who started out profoundly deaf were able to speak intelligibly by the age of five or six. The statistic was reversed for those with mild to severe hearing loss: 75 percent could be understood when they talked.
    Karen had been right about the audiogram. Our decision hinged on it. Since Alex appeared to be able to hear most speech using hearing aids, and he would be right in the speech banana for everything but the highest frequencies, we decided to make speaking and listening our immediate goal and to learn ASL later as a second language.
    Sound became essential, the all-important sensation on which everything depended. Like a musician who trains to play by ear, to identify if a note is flat, to pick out oboes over the clarinets, Alex was going to need to practice, practice, practice, and practice his listening some more. He had a lot of catching up to do. He was nearly two and he could say only “mama,” “dada,” “hello,” and “up.”
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    â€œWe figured out why Alex isn’t talking,” I explained to Jake and Matty, who were then six and three. “He can’t hear very well.” Although they’d been caught up in their school lives—in first grade and preschool respectively—they had certainly noticed that Alex and I had been spending an awful lot of time going to the doctor and the audiologist. And they had periodically complained.
    Even before that, they hadn’t been overly thrilled at the prospect of another baby competing for attention. Matthew had been offended at having his role as youngest in the family usurped. Only nineteen months old when Alex was born, he’d thrown a spectacular tantrum while visiting us in the hospital and then mostly ignored Alex in his first year of life, as if that might just make him go away. Jake had already been toughened up by one new brother’s arrival. “Can you be my mommy and daddy be Matty’s mommy?” he’d asked me plaintively the night Matthew came home from the hospital. He was more accepting of Alex but still capable of an occasional fit of pique over the time I had to devote to the baby.
    So I was relieved and gratified when the big boys reacted to my announcement by dropping to the floor, leaning in close on either side of Alex, and hollering: “We love you,