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Updated: Jul 13, 2026

Behavioral Assessment of Hearing in 2 to 4 Year-old Children: A Two-interval, Observer-based Procedure Using Conditioned Play-based Responses
Published on: January 23, 2017
BERA in children with hearing loss and delayed speech
J M Al-Kandari1, W B Alshuaib, M Joe
1Audiology & Speech Clinic, Ahmadi Hospital, Kuwait.
Insights
Brainstem evoked response audiometry (BERA) identified hearing loss in 42% of children with suspected hearing loss and 63% of those with delayed speech. Early hearing tests are crucial for timely intervention in children.
Area of Science:
- Neuroscience
- Audiology
- Pediatrics
Background:
- Hearing loss is a significant factor affecting speech development in children.
- Objective neurophysiological methods like BERA are essential for accurate hearing threshold evaluation.
- Diagnosing retrocochlear lesions requires specialized audiological assessments.
Purpose of the Study:
- To investigate the hearing levels in children with suspected hearing loss or pathological speech development.
- To assess the utility of Brainstem Evoked Response Audiometry (BERA) in pediatric audiology.
- To determine the prevalence of different degrees of hearing loss in a pediatric population.
Main Methods:
- Brainstem Evoked Response Audiometry (BERA) diagnostic procedure was employed.
- The study included 184 children aged 1 to 12 years.
- Data was collected at Ahmadi Hospital in Kuwait.
Main Results:
- Profound hearing loss was observed in 13 children, severe in 8, moderate in 34, and mild in 34.
- Normal hearing was found in 95 children.
- 42% of children with suspected hearing loss had some degree of impairment; 63% of children with delayed speech had hearing loss contributing to the delay.
Conclusions:
- Early hearing screening for children is essential, even with slight parental or physician suspicion.
- The findings support the establishment of newborn hearing screening programs in Kuwait.
- Timely audiological evaluation and intervention, including hearing aids, are critical for children with hearing loss.
Objectives:
The brainstem evoked response audiometry (BERA) is an objective neurophysiological method for the evaluation of the hearing threshold and diagnosing retrocochlear lesions. The aim of the study was to investigate the hearing level in children with suspected hearing loss or pathological speech development.
Patients And Methods:
The BERA diagnostic procedure was applied in 184 children ranging from 1 to 12 years of age at Ahmadi Hospital in Kuwait.
Results:
We found profound hearing loss (deafness) in 13 children, severe hearing loss in 8 children, moderate hearing loss in 34 children, mild hearing loss in 34 children, and normal hearing level in 95 children. Out of the children suspected for hearing loss, 42% actually had some level (mild-moderate) of hearing loss. Out of the children with delayed speech, 63% had some level (mild-profound) of hearing loss which actually caused the delay in speech development; 37% had normal hearing, but inadequate verbal communication affected their language acquisition and speech development.
Conclusions:
These results illustrate the necessity to test children hearing even with the slightest suspicion by the parent or doctor of hearing loss. The results warrant the establishment of a hearing screening test of newborns in Kuwait to provide hearing aid to children with hearing loss.
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