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Assessment of hearing in infants with moderate to profound impairment: the Melbourne experience with auditory
Gary Rance1, Robert J S Briggs
1Department of Otolaryngology, University of Melbourne, and the Bionic Ear Institute, Australia.
Insights
Auditory steady-state evoked potential (ASSEP) testing accurately identifies sensorineural hearing loss in infants, guiding early intervention. However, ASSEP is less reliable for diagnosing auditory neuropathy.
Area of Science:
- Audiology
- Neuroscience
- Pediatrics
Background:
- Auditory steady-state evoked potential (ASSEP) testing is a key audiological tool.
- Accurate hearing assessment in infants is crucial for timely intervention.
- Previous studies highlight the utility of ASSEP in pediatric audiology.
Purpose of the Study:
- To evaluate the diagnostic accuracy of ASSEP in infants with permanent hearing loss.
- To compare ASSEP findings with behavioral audiometry in a pediatric cohort.
- To determine the correlation between ASSEP and behavioral thresholds across different hearing loss etiologies.
Main Methods:
- Retrospective analysis of 200 children diagnosed with hearing loss using ASSEP.
- ASSEP audiograms generated using amplitude and frequency modulated tones (500-4000 Hz).
- Comparison of ASSEP thresholds with behavioral hearing test results.
Main Results:
- Strong correlation (r=0.81-0.93) between ASSEP and behavioral thresholds in 184 infants with sensorineural hearing loss.
- ASSEP findings in early infancy accurately informed amplification fitting and early intervention.
- Limited correlation between ASSEP and behavioral audiograms in 16 children with auditory neuropathy.
Conclusions:
- ASSEP is a reliable method for assessing sensorineural hearing loss in infants.
- Early ASSEP results provide a valid basis for audiological management.
- ASSEP's efficacy is limited in cases of auditory neuropathy, necessitating alternative diagnostic approaches.
Abstract:
Auditory steady-state evoked potential (ASSEP) testing has been used in the assessment of hearing in infants at the University of Melbourne School of Audiology Clinic during the past 10 years. This study examines the evoked potential and behavioral hearing test findings for 200 children in whom permanent, moderate to profound hearing loss was diagnosed with the ASSEP procedure. The ASSEP audiograms were obtained with amplitude and frequency modulated tones at octave frequencies (500 to 4,000 Hz). In 184 infants, the hearing loss appeared to be of sensorineural origin. For these children, there was a strong correlation between ASSEP findings and behavioral thresholds, with Pearson r coefficients ranging from 0.81 to 0.93 with test frequency. As such, the ASSEP findings obtained in the first months of life were accurate enough to form a basis for fitting amplification and early intervention. For the 16 children whose hearing loss appeared to be the result of auditory neuropathy, however, ASSEP thresholds showed little or no relationship to the behavioral audiogram.
