Multiple-ASSR thresholds in infants and young children with hearing loss. 2010

Anna Van Maanen, and David R Stapells
School of Audiology and Speech Sciences, University of British Columbia, Vancouver, Canada.

BACKGROUND The multiple auditory steady-state response (multiple ASSR) is a promising technique for determining thresholds for infants and children. However, there are few data for infants and young children with hearing loss where multiple-ASSR thresholds have been compared to frequency-specific gold standard (i.e., behavioral or tone-evoked auditory brainstem response [tone ABR]) measures. OBJECTIVE The study compared multiple-ASSR and tone-ABR thresholds and assessed how well "normal" ASSR levels differentiate normal from elevated thresholds. METHODS Multiple-ASSR and tone-ABR results (to air-conduction stimuli) were obtained in infants and young children with hearing loss or normal hearing. METHODS 98 infants with hearing loss (53 infants provided thresholds) and 34 infants with normal hearing. METHODS Multiple-ASSR and tone-ABR results were typically completed on the same day. Correlations between ASSR and ABR thresholds, linear regressions, and ASSR-minus-ABR threshold difference scores were calculated for each group (normal or hearing loss), and for both groups combined. RESULTS Multiple-ASSR thresholds (dB HL) were strongly correlated (r = .97) with tone-ABR thresholds (dB nHL) for 500, 1000, 2000, and 4000 Hz. Mean (±1 SD) difference scores (ASSR-minus-ABR) were 10.7 ± 9.0, 9.5 ± 9.4, 9.2 ± 9.0, and 6.3 ± 9.5 dB for 500, 1000, 2000, and 4000 Hz, respectively. The previously published "normal" ASSR levels accurately differentiated normal from elevated thresholds. Out of 523 tests with elevated tone-ABR thresholds, the multiple ASSR was "normal" in only 22 tests. In these 13 infants, other ASSR frequencies were elevated, and thus the infants would not have "passed" the ASSR. CONCLUSIONS There are few studies of infants and young children comparing ASSR thresholds to frequency-specific gold standard measures, especially using the multiple-ASSR technique. The present study, comparing multiple-ASSR to tone-ABR thresholds, nearly doubles the multiple-ASSR sample size in the literature. The results indicate that the multiple-ASSR and tone-ABR thresholds are strongly correlated, and the "normal" multiple-ASSR levels of 50, 45, 40, and 40 dB HL correctly classified children as having "normal" or "elevated" thresholds. However, due to the lack of air- and bone-conduction data in infants with different types and degrees of hearing loss, further ASSR research is needed.

UI MeSH Term Description Entries
D007223 Infant A child between 1 and 23 months of age. Infants
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D010898 Pitch Perception A dimension of auditory sensation varying with cycles per second of the sound stimulus. Perception, Pitch,Perceptions, Pitch,Pitch Perceptions
D012016 Reference Values The range or frequency distribution of a measurement in a population (of organisms, organs or things) that has not been selected for the presence of disease or abnormality. Normal Range,Normal Values,Reference Ranges,Normal Ranges,Normal Value,Range, Normal,Range, Reference,Ranges, Normal,Ranges, Reference,Reference Range,Reference Value,Value, Normal,Value, Reference,Values, Normal,Values, Reference
D001933 Brain Stem The part of the brain that connects the CEREBRAL HEMISPHERES with the SPINAL CORD. It consists of the MESENCEPHALON; PONS; and MEDULLA OBLONGATA. Brainstem,Truncus Cerebri,Brain Stems,Brainstems,Cerebri, Truncus,Cerebrus, Truncus,Truncus Cerebrus
D002675 Child, Preschool A child between the ages of 2 and 5. Children, Preschool,Preschool Child,Preschool Children
D005260 Female Females
D006319 Hearing Loss, Sensorineural Hearing loss resulting from damage to the COCHLEA and the sensorineural elements which lie internally beyond the oval and round windows. These elements include the AUDITORY NERVE and its connections in the BRAINSTEM. Deafness Neurosensory,Deafness, Neurosensory,Deafness, Sensoryneural,Neurosensory Deafness,Sensorineural Hearing Loss,Sensoryneural Deafness,Cochlear Hearing Loss,Hearing Loss, Cochlear,Deafnesses, Neurosensory,Deafnesses, Sensoryneural,Neurosensory Deafnesses,Sensoryneural Deafness,Sensoryneural Deafnesses
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man

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