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Updated: May 14, 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
[Follow-up examination for high risk infants with auditory neuropathy spectrum disorder]
Youhua Wei1, Zhinan Wang, Zhongqiang Xu
1Department of Otorhinolaryngology, Wuhan Children's Hospital, Wuhan, 430012, China. w82828114@163.com
Insights
Auditory neuropathy spectrum disorder (ANSD) in high-risk infants can be temporary. Prognosis is difficult to predict, requiring follow-up until age 3 for accurate diagnosis and management of hearing loss.
Area of Science:
- Pediatric Audiology
- Neonatal Screening
- Auditory Neuropathy Spectrum Disorder (ANSD)
Context:
- Newborn hearing screening is crucial for early detection of hearing impairments in high-risk infants.
- Auditory Neuropathy Spectrum Disorder (ANSD) presents unique diagnostic challenges in neonates.
- Auditory Brainstem Response (ABR) and Otoacoustic Emissions (OAEs) are key audiological assessments.
Purpose:
- To characterize Auditory Neuropathy Spectrum Disorder (ANSD) in high-risk infants.
- To evaluate the diagnostic utility of ABR, TEOAE, DPOAE, and CMs in neonates.
- To understand the transient nature and prognostic indicators of ANSD in this population.
Summary:
- Eighteen high-risk infants diagnosed with ANSD at 3 months showed absent or elevated ABR thresholds.
- Follow-up revealed ABR improvement in 9 infants, with hearing loss resolution in 11.
- Behavioral audiometry indicated a range of hearing loss from mild to profound.
Impact:
- ANSD in high-risk neonates may exhibit a temporary course, complicating early prognosis.
- Long-term follow-up (up to 3 years) is essential for accurate diagnosis and management of ANSD.
- Early identification and monitoring are vital for optimizing developmental outcomes in infants with ANSD.
Objective:
The goal was to know more about the characteristic of auditory neuropathy spectrum disorder (ANSD) for high risk infants.
Method:
The newborn hearing screening was performed with automatic auditory brainstem response (AABR) and transient evoked otoacoustic emission(TEOAE) for the infants in the NICUs from August 2007 to January 2011. After subsequent rescreening, children with AABR test referred were perform hearing test set including high frequency (1000 Hz) tympanometry, ABR, DPOAE and/or Cochlear Microphonics (CMs) in 3 months old. Only infants demonstrated severely abnormal ABRs along with preserved DPOAEs and/or CMs were scheduled for re-examination in 6-8 months old and Behavior audiometry in 8-12 months old.
Result:
Eighteen infants (14 cases were bilateral and 4 cases were unilateral) considered as suffering from AN in 3 months old. All of them showed ABR thresholds > or = 80 dB nHL or absent at maximum test intensity. Follow-up examination revealed 9 cases (18 ears) with restoration of ABR to normal or a lower ABR thresholds and a resolution of ANSI) in 11 out of 18 infants retested in 6-8 months old. CMs were present in all ears but DPOAE were not present in 4 ears with middle ear pathology in 3 months test. Behavioral hearing of 10 cases ranged from mild (n = 2), moderate(n = 4) to severe and profound loss (n = 4).
Conclusion:
ANSD in high risk neonates could show the temporary character. It was too difficult to forecast the prognosis, they would be to follow up to at least 3 years old for newborn ANSD.
