Sorry for the delayed response…swim meet all day LOL
Yes a full hearing evaluation from an audiologist is often more encompassing than what you'll get in a pediatrician's office and will include things like immittance/acoustic reflex testing and otoacoustic emission testing in addition to the typical pure tone and speech testing. That will let you know that the entire peripheral auditory system is working correctly and is necessary before you can even attempt to evaluate the central auditory processing system. Especially with your concerns regarding his congestion, it is important to make sure there aren't underlying middle ear issues.
Many people have issues understanding in noise (middle ear issues can definitely contribute to this). But at age 3 it is very difficult to tease out what is normal or an issue…in fact I would say almost impossible. I strongly support parent intuition in many cases. But a lot of 3 year olds (gifted or not) would likely have these issues. Heck, I have these issues. It might be that you are just more in tune to the problem b/c your child is able to describe the problem/issue while others are not capable of doing so.
I agree with everything amp221 said above. In my experience in the midwest, audiologists diagnose but SLPs treat. Every once in a while you'll find an audiologist that can treat too. Developing these auditory skills takes time for kids and it is difficult to interpret auditory stimulus in noise (for adults and children)…
Also, the recommendations really are symptom based, so even if someone ends up testing normal auditory processing, you'd still recommend treating the symptoms. Sometimes people need the dx for an IEP or some other reason, but otherwise, usually the recommendations will be the same. Again, age 3 is really too young to dx.
If I was you, I'd definitely keep my eye on it, reduce noise and improve the signal to noise ratio whenever possible. Since your child is bothered by it, I'd talk with him about how it is very normal to have difficulty in noisy environments and it isn't anything that is wrong or bad about him. And I'd try to wait a few years to see how this issue plays out.
Again, this all is just related to purely auditory processing. Other sensory issues/sensitivities are out of my professional realm so cannot comment on them with any authority LOL. Some may be co-existing too.
good luck with this process and be wary of specific expensive programs without fully understanding the research behind them as it applies to a 3 year old.
