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Updated: Oct 25, 2026
Quantitative Assessment of Cortical Auditory-tactile Processing in Children with Disabilities
Published on: January 29, 2014
Comparison of ABR and ASSR using NB-chirp-stimuli in children with severe and profound hearing loss
Katharina Eder1, Maria Elke Schuster1, Daniel Polterauer1
1Department of Oto-Rhino-Laryngology, Head & Neck Surgery, Ludwig-Maximilians-University Munich, Germany.
Insights
Comparing auditory brainstem responses and auditory steady-state responses for hearing threshold estimation in children with severe to profound hearing loss is crucial. Both methods correlate well, but auditory steady-state responses often provide a clearer threshold, impacting therapeutic strategies.
Area of Science:
- Pediatric Audiology
- Neuroscience
- Hearing Science
Background:
- Accurate hearing threshold estimation is vital for children with severe to profound hearing loss to guide therapy and prevent speech disorders.
- Auditory brainstem responses (ABR) and auditory steady-state responses (ASSR) are established methods for frequency-dependent threshold estimation.
- Variability in systems and stimuli complicates direct comparison, and no single gold standard exists for this population.
Purpose of the Study:
- To compare hearing threshold estimations between narrow-band CE-chirps evoked auditory brainstem responses and auditory steady-state responses in children.
- To evaluate the clinical impact of using one technique versus the other for therapeutic decisions.
Main Methods:
- Seventy-one children (3 months to 15 years) with severe to profound hearing loss were included.
- Measurements were conducted using the Interacoustics Eclipse EP25 ABR system with narrow-band CE-chirps at 500, 1000, 2000, and 4000 Hz.
- Standardized conditions were maintained for all measurements.
Main Results:
- A high correlation (r=0.694, p<0.001) was observed between ABR and ASSR thresholds.
- Correlation varied based on center frequency and patient age.
- ASSR generally yielded better hearing thresholds than ABR, especially when ABR thresholds were unobtainable, potentially altering therapeutic strategies in ~15% of cases.
Conclusions:
- Joint utilization of ABR and ASSR is recommended for comprehensive diagnostic assessment in children with suspected severe to profound hearing loss.
- This combined approach ensures more accurate threshold determination and optimizes therapeutic planning.
- Further research may refine the understanding of specific frequency and age-related differences.
Introduction:
Objective techniques for hearing threshold estimation in infants and children with profound or severe hearing loss play a key role in pediatric audiology to prevent speech acquisition disorders by choosing the adequate therapy. Auditory brainstem responses and auditory steady-state responses are available for frequency-dependent hearing threshold estimations and both techniques show strong correlations. However, various systems and stimuli are available, which is one reason why comparison is challenging, and, so far, no single "gold standard" could be established for hearing threshold estimation in children suffering from profound or severe hearing loss. The aim of the study was to compare hearing threshold estimations in children with profound or severe hearing loss derived with narrow-band CE-chirps evoked auditory brainstem responses and auditory steady-state response.
Subjects:
and Methods: 71 children (121 ears) with an age from 3 month to 15 years were measured with the Interacoustics Eclipse EP25 ABR system® (Denmark) with narrow-band CE-chirps® at 500, 1000, 2000 and 4000 Hz under identical conditions.
Results:
Auditory brainstem responses and auditory steady-state responses highly correlate (r = 0.694, p < 0.001). Correlation coefficients differ depending on the center frequency and patient age. Generally, auditory steady-state responses show a better hearing threshold than auditory brainstem responses or a remaining hearing threshold when auditory brainstem responses could not be obtained. In approximately 15% of cases this would have affected the therapeutic strategy when only taking one technique into account.
Conclusion:
Auditory brainstem responses and auditory steady-state responses should be jointly used in the diagnostic approach in children with suspected profound or severe hearing loss.
