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Updated: Jun 5, 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
[Newborn hearing screening test with multiple auditory steady-state responses]
Eleina Mijares Nodarse1, Didiesle Herrera Alonso, José Gaya Vázquez
1Departamento de Audición y Lenguaje, Centro de Neurociencias de Cuba, Havana, Cuba.
Introduction:
The techniques most frequently used within a screening context (otoacoustic emissions and click auditory brainstem response) have well-known limitations in hearing loss detection.
Objective:
This study examines the feasibility of a semi-automated multiple auditory steady-state responses (MSSR) system designed for neonatal hearing screening.
Methods:
A sample of 50 newborns without risk factors (well-babies) was tested within two weeks of birth. All had detectable auditory brainstem responses to clicks down to 40dB nHL in both ears. Two amplitude modulated carrier tones of 500 and 2,000Hz were mixed together and presented simultaneously. Each infant (and ear) was screened with the MSSR system; to simulate a hearing loss, a recording without stimulation was also obtained.
Results:
Mean auditory thresholds were 42.5±7dB HL at 500Hz and 35.5±6dB HL at 2,000Hz. The average duration of the MSSR recording was 2.6±1.6 minutes for each tested ear and the overall duration of the screening procedure (including electrode fitting and infant preparation) was 17.8±3.7 minutes. The diagnostic sensibility and the positive predictive values of the MSSR semi-automatic screening system was 100% and 96% respectively, with specificity of 96% and negative predictive values of 100%.
Conclusions:
Although the diagnostic efficiency of the semi-automated MSSR system was found adequate, further technological improvements are still necessary to facilitate its use in the context of universal newborn hearing screening program.
