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Behavioral Assessment of Hearing in 2 to 4 Year-old Children: A Two-interval, Observer-based Procedure Using Conditioned Play-based Responses
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Auditory steady-state response and auditory brainstem response thresholds in children.

DeWet Swanepoel1, Shamim Ebrahim

  • 1Department of Communication Pathology, University of Pretoria, Pretoria 0002, South Africa. dewet.swanepoel@up.ac.za

European Archives of Oto-Rhino-Laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : Affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery
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Summary

Objective audiometry using auditory steady-state response (ASSR) reliably verifies auditory brainstem response (ABR) thresholds in infants. This comparison is crucial for diagnosing hearing loss when behavioral tests are not feasible.

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Area of Science:

  • Audiology
  • Neuroscience
  • Pediatric Medicine

Background:

  • Auditory steady-state response (ASSR) is increasingly used in objective audiometry.
  • Clinical comparisons between ASSR and auditory brainstem response (ABR) are essential for validating hearing assessment methods.
  • Accurate hearing threshold determination in infants and young children is critical for early intervention.

Purpose of the Study:

  • To compare auditory steady-state response (ASSR) and auditory brainstem response (ABR) thresholds in infants and young children.
  • To evaluate the reliability of ASSR in assessing various types and degrees of hearing loss.
  • To establish the correlation between ASSR and ABR thresholds for different frequency ranges.

Main Methods:

  • A cohort of 48 infants and young children with diagnosed hearing loss was studied.
  • Audiometric assessment included broadband click-evoked ABR and single-frequency ASSR (0.25-4 kHz).
  • Subjects were classified by hearing loss type and degree; thresholds were statistically analyzed.

Main Results:

  • High correlation (r=0.92) was observed between ABR and mean ASSR thresholds (2-4 kHz and 1-4 kHz).
  • Mean difference scores between ABR and high-frequency ASSR thresholds were within acceptable clinical ranges.
  • The 2-4 kHz ASSR average correlated best with ABR across most hearing loss categories.

Conclusions:

  • Auditory steady-state response (ASSR) thresholds are reliable and can effectively cross-check auditory brainstem response (ABR) findings.
  • This verification is particularly valuable for high-frequency hearing assessment in young children.
  • ASSR provides a dependable objective measure for hearing loss evaluation when behavioral audiometry is not feasible.