Related Experiment Video
Updated: Jul 10, 2026
Systematic Hearing Performance Evaluation Process for Adolescents with Cochlear Implantation at Early Ages
Published on: March 24, 2023
Comprehensive evaluation of a child with an auditory brainstem implant
Laurie S Eisenberg1, Karen C Johnson, Amy S Martinez
1House Ear Institute, Los Angeles, California 90057, USA. leisenberg@hei.org
Insights
This case study evaluated an American child receiving an auditory brainstem implant (ABI) in Italy. The child showed sound detection and speech pattern perception, indicating potential benefits for pediatric ABI use.
Area of Science:
- Neuroscience
- Audiology
- Pediatric Medicine
Background:
- Auditory Brainstem Implants (ABI) offer a potential solution for hearing restoration in cases of auditory nerve agenesis.
- Pediatric clinical trials for ABI require robust assessment protocols to evaluate efficacy.
Observation:
- A single pediatric case study involving an American child with auditory nerve agenesis who received an ABI in Italy.
- Initial assessments at age 3 years 11 months showed sound detection and speech pattern perception with visual cues.
- Follow-up at 12 months demonstrated consistent speech pattern identification and emerging closed-set word identification.
Findings:
- The patient demonstrated progressive auditory and speech perception skills post-ABI implantation.
- Performance was comparable to pediatric cochlear implant users in certain domains.
- Challenges included attention deficits impacting structured task completion.
Implications:
- This case highlights the need for structured pediatric ABI assessment protocols.
- Further research with well-selected pediatric populations is crucial to determine the risk-benefit profile of ABIs.
- Investigating the potential for open-set speech recognition in pediatric ABI recipients is warranted.
Objective:
We had an opportunity to evaluate an American child whose family traveled to Italy to receive an auditory brainstem implant (ABI). The goal of this evaluation was to obtain insight into possible benefits derived from the ABI and to begin developing assessment protocols for pediatric clinical trials.
Study Design:
Case study.
Setting:
Tertiary referral center.
Patient:
Pediatric ABI Patient 1 was born with auditory nerve agenesis. Auditory brainstem implant surgery was performed in December, 2005, in Verona, Italy. The child was assessed at the House Ear Institute, Los Angeles, in July 2006 at the age of 3 years 11 months. Follow-up assessment has continued at the HEAR Center in Birmingham, Alabama.
Intervention:
Auditory brainstem implant.
Main Outcome Measures:
Performance was assessed for the domains of audition, speech and language, intelligence and behavior, quality of life, and parental factors.
Results:
Patient 1 demonstrated detection of sound, speech pattern perception with visual cues, and inconsistent auditory-only vowel discrimination. Language age with signs was approximately 2 years, and vocalizations were increasing. Of normal intelligence, he exhibited attention deficits with difficulty completing structured tasks. Twelve months later, this child was able to identify speech patterns consistently; closed-set word identification was emerging. These results were within the range of performance for a small sample of similarly aged pediatric cochlear implant users.
Conclusion:
Pediatric ABI assessment with a group of well-selected children is needed to examine risk versus benefit in this population and to analyze whether open-set speech recognition is achievable.
