An alternative may be auditory neuropathy spectrum disorder, in which the dysfunction occurs either at the auditory nerve that transmits sound from the ear to the brainstem or the inner hair cells of the ear (which are responsible for encoding sound to neural signals). It's a bit of a weird disorder because people can have almost normal hearing outcomes from standard hearing tests yet have very poor hearing ability in background noise. It's a very recent disorder and the dominant view is that it is a hereditary condition due to hyperbilirubinemia or mild lack of oxygen during fetal development, however, not all cases are detected at birth.