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Updated: Jan 5, 2026
Infant Auditory Processing and Event-related Brain Oscillations
Published on: July 1, 2015
Recording Obligatory Cortical Auditory Evoked Potentials in Infants: Quantitative Information on Feasibility and
Kevin J Munro1,2, Suzanne C Purdy3, Kai Uus1
1Manchester Centre for Audiology and Deafness, School of Health Sciences, University of Manchester, Manchester, United Kingdom.
Insights
Supra-threshold obligatory cortical auditory evoked potentials (CAEPs) are feasible and well-accepted for infant hearing assessments. This method can supplement current pediatric audiology practices for young children.
Area of Science:
- Pediatric audiology
- Neuroscience
- Speech-language pathology
Background:
- Newborn hearing screening and early intervention necessitate advanced pediatric audiology tools.
- Cortical auditory evoked potentials (CAEPs) offer a promising avenue for assessing auditory function in infants.
- Evaluating the feasibility and parental acceptance of infant CAEPs is crucial for clinical integration.
Purpose of the Study:
- To assess the feasibility of recording supra-threshold obligatory cortical auditory evoked potentials (CAEPs) in infants.
- To determine the acceptability of infant CAEP testing among parents.
- To explore the potential of CAEPs as a complementary tool in pediatric audiology.
Main Methods:
- Recruited 104 typically developing infants (5-39 weeks old) who passed newborn hearing screening.
- Presented three speech-like stimuli (/m/, /g/, /t/) at 65 dB SPL.
- Assessed clinical feasibility using test duration, completion rates, and response detection; parental acceptability via questionnaire and interviews.
Main Results:
- Median test duration was 27 minutes, with a 94% appropriate behavioral state for testing.
- CAEPs were detected in 91 infants (86-100% detection rates for stimuli).
- Parental acceptability scores were high (1.1-2.6), with positive feedback on the testing experience.
Conclusions:
- Infant CAEP testing meets feasibility targets for duration, completion, and detection rates.
- Parental acceptance of CAEP testing is high, indicating its suitability for clinical use.
- CAEPs show potential to supplement existing pediatric audiology practices for infants aged 3-9 months.
Objectives:
With the advent of newborn hearing screening and early intervention, there is a growing interest in using supra-threshold obligatory cortical auditory evoked potentials (CAEPs) to complement established pediatric clinical test procedures. The aim of this study was to assess the feasibility, and parent acceptability, of recording infant CAEPs.
Design:
Typically developing infants (n = 104) who had passed newborn hearing screening and whose parents expressed no hearing concerns were recruited. Testing was not possible in 6 infants, leaving 98, age range 5 to 39 weeks (mean age = 21.9, SD = 9.4). Three short duration speech-like stimuli (/m/, /g/, /t/) were presented at 65 dB SPL via a loudspeaker at 0° azimuth. Three criteria were used to assess clinical feasibility: (i) median test duration <30 min, (ii) >90% completion rate in a single test session, and (iii) >90% response detection for each stimulus. We also recorded response amplitude, latency, and CAEP signal to noise ratio. Response amplitudes and residual noise levels were compared for Fpz (n = 56) and Cz (n = 42) noninverting electrode locations. Parental acceptability was based on an 8-item questionnaire (7-point scale, 1 being best). In addition, we explored the patient experience in semistructured telephone interviews with seven families.
Results:
The median time taken to complete 2 runs for 3 stimuli, including preparation, was 27 min (range 17 to 59 min). Of the 104 infants, 98 (94%) were in an appropriate behavioral state for testing. A further 7 became restless during testing and their results were classified as "inconclusive." In the remaining 91 infants, CAEPs were detected in every case with normal bilateral tympanograms. Detection of CAEPs in response to /m/, /g/, and /t/ in these individuals was 86%, 100%, and 92%, respectively. Residual noise levels and CAEP amplitudes were higher for Cz electrode recordings. Mean scores on the acceptability questionnaire ranged from 1.1 to 2.6. Analysis of interviews indicated that parents found CAEP testing to be a positive experience and recognized the benefit of having an assessment procedure that uses conversational level speech stimuli.
Conclusions:
Test duration, completion rates, and response detection rates met (or were close to) our feasibility targets, and parent acceptability was high. CAEPs have the potential to supplement existing practice in 3- to 9-month olds.
