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Li, aged 10 years of age, presents to your clinic with her parents for a hearing assessment. Li is finding she is experiencing difficulties with hearing her teachers in the classroom over the last 6 months and her parents are concerned. Li passed her newborn hearing screening when she was born.
Her mother reports:
• an uneventful pregnancy and birth,
• no known family history of hearing loss,
• no previous difficulties with Li’s hearing in early childhood.
She was doing well in school until recently.
Subsequent diagnostic testing finds results below. You recommend genetic testing to give Li’s family more information.
Hypothesize in 1,000 words a potential theory for how Li could have passed her newborn hearing screening at birth but is then diagnosed with a permanent hearing loss later in life.

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