Auditory Evoked Response Testing in Infants and Children
Key Points
- For auditory brainstem response (ABR) and auditory steady-state response (ASSR) testing, infants need to be well settled in a deep sleep for good quality recordings
- Electrode contacts need to be good (low and balanced impedances) and the environment should be free of electrical noise to obtain quality evoked response recordings
- Frequency-specific testing is easy to do and is essential for fitting of hearing instruments for children whose hearing loss has been detected via universal newborn screening
- Clinicians do not need to wait for confirmation of evoked response testing with behavioral data hearing thresholds can be reliably estimated using evoked responses, although not for children with auditory neuropathy spectrum disorder
- Bone conduction ABR should be performed when a hearing loss is identified using ABR or ASSR to determine whether there is a conductive component to the hearing loss
- Cortical evoked responses can be used for showing that amplified speech stimuli are audible for young infants who are not able to provide reliable behavioral responses to sound
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Evoked Response
ABR ASSR ECoG MLR CAEP |
Latency Range
0-15ms 0-15ms 0-3ms 15-50ms 50-400ms |
Clinical Applications
Newborn Hearing Screening Diagnosis of ANSD Retrocochlear Pathology Estimation of Pure Tones Estimation of Pure Tones Diagnosis of ANSD Estimation of Pure Tones Assessment of Central Aud. Fx Evaluation of Hearing Aids Evaluation of hearing w/o ABR |
Stimuli Typically Used
Single-Polarity Clicks Single-Polarity Clicks Single-Polarity Clicks Brief Tonebursts Freq or Amp mod tones Single-polarity clicks Tonebursts Clicks Speech Sounds Long duration toneburst |