Related Experiment Video
Updated: Aug 20, 2026
Infant Auditory Processing and Event-related Brain Oscillations
Published on: July 1, 2015
[Delay in the development of the auditory pathways. A differential diagnosis in hearing impairment in young infants]
C Massinger1, K L Lippert, A Keilmann
1Klinik für Kommunikationsstörungen am Klinikum der Johannes-Gutenberg-Universität Mainz. c.massinger@lrz.uni-muenchen.de
Insights
Delayed auditory pathway maturation can mimic hearing loss in infants. Repeated objective hearing tests are crucial for accurate diagnosis in young children, especially those with risk factors.
Area of Science:
- Pediatric Audiology
- Neuroscience
- Otolaryngology
Context:
- Increased frequency of newborn hearing screening necessitates more pediatric audiology evaluations.
- Brainstem Evoked Response Audiometry (BERA) and otoacoustic emissions are standard for infant hearing loss screening.
- Pathologic results in initial BERA tests have been observed in infants with later normal hearing.
Purpose:
- To investigate the occurrence of delayed auditory pathway maturation in infants initially diagnosed with hearing loss.
- To emphasize the need for serial audiological assessments in very young children.
Summary:
- Fourteen infants (1-7 months) with high hearing loss risk underwent BERA and subjective hearing tests.
- All infants showed abnormal BERA thresholds, and subjective tests indicated hearing loss.
- However, objective and subjective hearing improved to normal levels within months, suggesting delayed maturation.
Impact:
- Highlights the importance of considering delayed auditory maturation in infants with abnormal BERA results.
- Recommends multiple objective hearing examinations within the first year for accurate diagnosis of sensorineural hearing loss in young children.
Background:
Due to the increased frequency of screening tests in new-born infants, the number of subsequent examinations of very young children has increased in the Departments of Phoniatrics and Pediatric Audiology. To exclude hearing loss in young children, click stimulated brainstem evoked response audiometry (BERA) and otoacoustic emission tests are, in general, considered to be reliable methods. However, pathologic BERA thresholds and pathologic hearing reactions have been observed occasionally in young infants who show improved and even normal hearing reactions in subjective and objective hearing tests after some months.
Patients And Results:
Our group of 14 children (ten female, four male) was initially examined by BERA at the ages of 1-7 months. Twelve children had an elevated risk of hearing loss due to complications in the pre-, peri- and postnatal period. In the BERA, no deafness was diagnosed, but in all children at least monaural pathologic BERA thresholds were observed. Subjective hearing tests confirmed hearing loss. Objective and even subjective hearing reactions improved and normalised within a few months at least monaurally.
Conclusion:
In very young infants, the possibility of a delayed maturation of the auditory pathways must be considered when a hearing loss is diagnosed. Our examples prove that young children with sensorineural hearing loss need more than one objective hearing examination during the first year of life.
Related Concept Videos
01:15Auditory Pathway
When viewed cross-sectionally, the cochlea reveals the scala vestibuli and scala tympani flanking the...
01:22Language Development
The critical period for language acquisition suggests that the ability to acquire language is at its peak early in life. As people age, this proficiency decreases. Language development begins very...