Related Experiment Video
Updated: May 17, 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
Chirp-evoked otoacoustic emissions in children
W Wiktor Jedrzejczak1, Krzysztof Kochanek, Lech Sliwa
1Institute of Physiology and Pathology of Hearing, ul. Zgrupowania AK Kampinos 1, 01-943 Warszawa, Poland. w.jedrzejczak@ifps.org.pl
Insights
Chirp-evoked otoacoustic emissions (OAEs) perform similarly to click-evoked OAEs in hearing screening. Lower stimulus levels improve sensitivity to middle ear issues, and spontaneous OAEs impact screening results.
Area of Science:
- Audiology
- Otoacoustic Emissions
- Pediatric Hearing Screening
Background:
- Otoacoustic emissions (OAEs) are objective measures of cochlear outer hair cell function.
- Chirp stimuli offer potential advantages over traditional click stimuli for OAE assessment.
- Understanding OAE properties is crucial for effective hearing screening in children.
Purpose of the Study:
- To compare chirp-evoked OAEs with click-evoked OAEs.
- To evaluate the influence of spontaneous OAEs (SOAEs) on evoked OAE results.
- To assess the efficacy of different stimulus levels for OAE screening.
Main Methods:
- OAEs were recorded from 54 children (4-10 years) using chirp and click stimuli.
- Tympanometry was performed concurrently.
- Pass/refer criteria based on signal-to-noise ratios (SNRs) were applied and compared across methods.
Main Results:
- Chirp- and click-evoked OAEs showed similar pass rates at equivalent stimulus levels.
- Lower stimulus levels (70 dB pSPL) increased sensitivity to middle ear pathology.
- Presence of SOAEs correlated with higher OAE response levels and SNRs, significantly impacting pass rates.
Conclusions:
- Chirp-evoked OAEs are comparable to click-evoked OAEs for hearing screening.
- Reduced stimulus levels enhance OAEs' ability to detect middle ear problems.
- SOAEs play a significant role in determining OAE screening outcomes.
Objective:
The purpose of the study was to investigate the properties of otoacoustic emissions (OAEs) evoked by chirp stimuli and compare them with standard click-evoked OAEs. Differences between evoked OAEs in children with and without spontaneous otoacoustic emissions (SOAEs) were also assessed.
Methods:
OAEs were first recorded from 54 children (age 4-10 years) in a screening setup. In each ear five OAE measurements were made using two types of chirps (7.5 ms and 10.5 ms) at around 70 dB pSPL; clicks at 70 and 80 dB pSPL; and a standard synchronized SOAE stimulation protocol. Tympanometry was also conducted. Pass/refer criteria based on signal to noise ratios (SNRs) were applied to all OAEs. Pass/refer rates from all methods (OAEs evoked by chirps and clicks, and tympanometry) were compared. Additionally, half-octave-band values of OAE SNRs and response levels were used to assess statistical differences.
Results:
Chirp-evoked OAEs generated a similar number of passes to click-evoked OAEs when the same level of stimulus was used. When using lower stimulus levels, both chirp- and click-evoked OAEs diagnosed nearly all ears that failed tympanometry. The response levels and SNRs of OAEs evoked by clicks and chirps were very similar. The highest response levels were in the 1.4 kHz half-octave band. The SNRs for ears with SOAEs were highest at 1.4 kHz, whereas they were at 4 kHz for ears without SOAEs. Both response levels and SNRs were higher by about 5 dB for ears with SOAEs than ears without SOAEs. Also all ears with SOAEs generated a pass result in screening, while ears without SOAEs gave a pass less frequently (at least 30% fewer cases).
Conclusions:
The results suggest that performance of chirp-evoked OAEs for screening purposes is similar to click-evoked OAEs when the same stimulus level is applied. OAEs evoked with lower stimulus levels (70 vs. 80 dB pSPL) are more sensitive to middle ear pathology. The presence of SOAEs significantly influences the pass rates of OAEs evoked by chirps and clicks.
