An Auckland toddler's language development has been blighted by the failure of testing at birth under a government screening programme to pick up his hearing loss.
Ray Ruilin Yang, aged 2 years and 10 months, is a bright and engaging youngster, but he cannot utter a single word.
His mother, Mei Yang, said "My husband said he felt really sad because the best present is for Ray to say happy Father's Day."
Mrs Yang says she holds the Counties Manukau District Health Board responsible. She can now only hope that following the implantation of cochlear implants last month that Ray's language development will catch up in time.
Hearing House chief executive Scott Johnston said that up until the age of 3 was the prime time for language development. "It's going to be a hard road to get Ray to school with age-appropriate language."
Mrs Yang said a DHB screener declared Ray to have cleared the hearing test done soon after his birth at Middlemore Hospital in December 2010. He was speaking well at 1 year old, saying "Ma" and other words and joking with his aunty.
But within six months, Ray's family noticed he didn't respond when people spoke to him unless he was looking at them - and he stopped saying words.
This has created some uncertainty about what happened, but Dr David Grayson, the DHB's clinical head of ear, nose and throat services, said the view of the cochlear implant surgeon who treated Ray was that he had had significant hearing loss from birth.
The screening programme's failure to detect this has prompted the DHB to offer to re-screen 963 babies and infants who, it says, "may not have been screened correctly for hearing loss".
Dr Grayson said the screening failure was similar to the problems detected in a Health Ministry review of the newborn hearing screening programme last year.
The screener in Ray's case was no longer doing the work and had maintained she had done her job properly.
The ministry review found that in some cases screeners had tested their own hearing, rather than the babies'.
Eight screeners at six DHBs were not screening according to required methods, potentially leading to missed detection of hearing loss, said the reviewers, who made 21 recommendations for improvements.
Counties Manukau's problems were not picked up in that review, which looked only at screeners working from February to August last year. Ray's screener had ceased the work by then.
When Ray's family realised he had stopped speaking, they took him to a GP who referred him to a Counties Manukau outpatients clinic. His hearing loss was detected and he was referred to the cochlear implant service, but only after a delay of several vital months.
The Government pays for one cochlear implant. Ray's parents, who run a cafe in South Auckland, had a second implanted and have paid part of the $39,000 bill, although the DHB has agreed to refund them and pay the rest.
A treatment injury claim has been made to ACC and it is hoped this will cover the ongoing costs of about $10,000 every seven years for upgrades to the second implant's external controller - but Mrs Yang is worried about the financial impact.
"The fault lies with Middlemore and they should support Ray for life."
* A South Auckland toddler is diagnosed with profound hearing loss, despite having been cleared in a hearing screening test at birth in 2010.
* This prompts a review by the Counties Manukau District Health Board.
* Result: 963 babies and infants may not have been screened correctly.
* DHB offers to rescreen them.
* This follows a national review last year finding problems in the screening programme at six other DHBs.
* Concerned parents can call Counties Manukau DHB on 0800 992290.