Auditory middle latency responses in children: effects of age and diagnostic category

The nature of auditory middle latency responses (MLRs) in children has been the subject of considerable debate. In order to study MLRs as a function of age, MLRs were obtained in 217 subjects ranging in age from 6 days to 20 years, all with normal auditory brain-stem responses (ABRs). Subjects were classified into several diagnostic categories: normal; communicative disorders (language delay, learning disability); mentally retarded, multiply handicapped; and post-meningitic. Age effects, the effects of diagnostic category, and possible differences in MLRs of males vs. females and right vs. left ears were examined. The detectability of both Na and Pa was found to increase significantly as a function of age. Detection of these MLR components became similar to adult values (approaching 100% detectability) at approximately 10 years of age. No significant differences were found among diagnostic categories. There were also no significant differences in the detectability of MLRs in males as compared to females, and there were no right vs. left ear differences. The strong age effect which appears to exist in the MLR influences their clinical use. When responses are present, they may be useful indicators of hearing sensitivity, but the absence of MLRs in children cannot be taken as an indication of hearing loss. Similarly, absent or abnormal MLRs cannot be interpreted as a manifestation of auditory pathway dysfunction, since there appears to be little difference in MLRs in normal subjects and MLRs in patients with a wide range of neurologic, cognitive, and speech and language disorders.