Clinical Status of the Auditory Steady-State Response in Infants

ABSTRACT

Pediatric audiology has seen the inclusion of the auditory steady-state response (ASSR) in clinical test batteries as a valuable diagnostic tool. Its unique stimuli, recording and analysis characteristics allow for applications not previously possible with other auditory evoked responses in infants and young children. Although the long-standing research and clinical validation history of the frequency-specific auditory brain stem response (ABR) make it the current gold standard for estimating hearing thresholds, accumulating evidence is establishing the ASSR as a reliable and accurate tool for the diagnosis of hearing loss in infants. Current test-protocol efficiency and accuracy may be improved by including the ASSR to supplement ABR data and to cross-check test results. This article reviews the ASSR and its current clinical applications and limitations for determining hearing thresholds in infants and young children.

KEYWORDS

Auditory steady-state response - objective audiometry - auditory brain stem response - infant hearing loss - pediatric audiology - auditory evoked potentials

REFERENCES

• 1 Jewett DL, Williston JS. Auditory-evoked far fields averaged from the scalp of humans.  Brain. 1971;  94 (4) 681-696
• 2 Busa J, Harrison J, Chappell J American Academy of Pediatrics, Joint Committee on Infant Hearing et al. Year 2007 position statement: principles and guidelines for early hearing detection and intervention programs.  Pediatrics. 2007;  120 (4) 898-921
• 3 Hall III JW, Swanepoel D. Objective Assessment of Hearing. San Diego, CA: Plural Publishing; 2010
• 4 Picton TW, John MS, Dimitrijevic A, Purcell D. Human auditory steady-state responses.  Int J Audiol. 2003;  42 (4) 177-219
• 5 D'haenens W, Vinck BM, Maes L et al. Determination and evaluation of clinically efficient stopping criteria for the multiple auditory steady-state response technique.  Clin Neurophysiol. 2010;  121 (8) 1267-1278
• 6 Van Maanen A, Stapells DR. Normal multiple auditory steady-state response thresholds to air-conducted stimuli in infants.  J Am Acad Audiol. 2009;  20 (3) 196-207
• 7 Ribeiro FM, Carvallo RM, Marcoux AM. Auditory steady-state evoked responses for preterm and term neonates.  Audiol Neurootol. 2010;  15 (2) 97-110
• 8 Luts H, Desloovere C, Wouters J. Clinical application of dichotic multiple-stimulus auditory steady-state responses in high-risk newborns and young children.  Audiol Neurootol. 2006;  11 (1) 24-37
• 9 Rance G, Rickards F. Prediction of hearing threshold in infants using auditory steady-state evoked potentials.  J Am Acad Audiol. 2002;  13 (5) 236-245
• 10 Cone-Wesson B, Parker J, Swiderski N, Rickards F. The auditory steady-state response: full-term and premature neonates.  J Am Acad Audiol. 2002;  13 (5) 260-269
• 11 Swanepoel De W, Steyn K. Short report: establishing normal hearing for infants with the auditory steady-state response.  S Afr J Commun Disord. 2005;  52 36-39
• 12 John MS, Brown DK, Muir PJ, Picton TW. Recording auditory steady-state responses in young infants.  Ear Hear. 2004;  25 (6) 539-553
• 13 Lins OG, Picton TW, Boucher BL et al. Frequency-specific audiometry using steady-state responses.  Ear Hear. 1996;  17 (2) 81-96
• 14 Alaerts J, Luts H, Van Dun B, Desloovere C, Wouters J. Latencies of auditory steady-state responses recorded in early infancy.  Audiol Neurootol. 2010;  15 (2) 116-127
• 15 Rance G, Tomlin D. Maturation of auditory steady-state responses in normal babies.  Ear Hear. 2006;  27 (1) 20-29
• 16 Rance G, Roper R, Symons L et al. Hearing threshold estimation in infants using auditory steady-state responses.  J Am Acad Audiol. 2005;  16 (5) 291-300
• 17 Rance G, Tomlin D, Rickards FW. Comparison of auditory steady-state responses and tone-burst auditory brainstem responses in normal babies.  Ear Hear. 2006;  27 (6) 751-762
• 18 Rodrigues GRI, Lewis DR. Threshold prediction in children with sensorioneural hearing loss using the auditory steady-state responses and tone-evoked auditory brain stem response.  Int J Pediatr Otorhinolaryngol. 2010;  74 (5) 540-546
• 19 Swanepoel D, Hugo R, Roode R. Auditory steady-state responses for children with severe to profound hearing loss.  Arch Otolaryngol Head Neck Surg. 2004;  130 (5) 531-535
• 20 Gorga MP, Neely ST, Hoover BM, Dierking DM, Beauchaine KL, Manning C. Determining the upper limits of stimulation for auditory steady-state response measurements.  Ear Hear. 2004;  25 (3) 302-307
• 21 Small SA, Stapells DR. Artifactual responses when recording auditory steady-state responses.  Ear Hear. 2004;  25 (6) 611-623
• 22 Picton TW, John MS. Avoiding electromagnetic artifacts when recording auditory steady-state responses.  J Am Acad Audiol. 2004;  15 (8) 541-554
• 23 Small SA, Stapells DR. Multiple auditory steady-state response thresholds to bone-conduction stimuli in young infants with normal hearing.  Ear Hear. 2006;  27 (3) 219-228
• 24 Small SA, Hatton JL, Stapells DR. Effects of bone oscillator coupling method, placement location, and occlusion on bone-conduction auditory steady-state responses in infants.  Ear Hear. 2007;  28 (1) 83-98
• 25 Small SA, Stapells DR. Normal ipsilateral/contralateral asymmetries in infant multiple auditory steady-state responses to air- and bone-conduction stimuli.  Ear Hear. 2008;  29 (2) 185-198
• 26 Swanepoel W, Ebrahim S, Friedland P, Swanepoel A, Pottas L. Auditory steady-state responses to bone conduction stimuli in children with hearing loss.  Int J Pediatr Otorhinolaryngol. 2008;  72 (12) 1861-1871
• 27 Jeng FC, Brownt CJ, Johnson TA, Vander Werff KR. Estimating air-bone gaps using auditory steady-state responses.  J Am Acad Audiol. 2004;  15 (1) 67-78
• 28 Brooke RE, Brennan SK, Stevens JC. Bone conduction auditory steady state response: investigations into reducing artifact.  Ear Hear. 2009;  30 (1) 23-30
• 29 Cone-Wesson B, Rickards F, Poulis C, Parker J, Tan L, Pollard J. The auditory steady-state response: clinical observations and applications in infants and children.  J Am Acad Audiol. 2002;  13 (5) 270-282
• 30 Stroebel D, Swanepoel W, Groenewald E. Aided auditory steady-state responses in infants.  Int J Audiol. 2007;  46 (6) 287-292
• 31 Picton TW, Durieux-Smith A, Champagne SC et al. Objective evaluation of aided thresholds using auditory steady-state responses.  J Am Acad Audiol. 1998;  9 (5) 315-331
• 32 Rance G. Auditory neuropathy/dys-synchrony and its perceptual consequences.  Trends Amplif. 2005;  9 (1) 1-43
• 33 Sininger YS. Identification of auditory neuropathy in infants and children.  Semin Hear. 2002;  23 (3) 193-200
• 34 Rance G, Briggs RJS. Assessment of hearing in infants with moderate to profound impairment: the Melbourne experience with auditory steady-state evoked potential testing.  Ann Otol Rhinol Laryngol Suppl. 2002;  189 22-28
• 35 Rance G, Beer DE, Cone-Wesson B et al. Clinical findings for a group of infants and young children with auditory neuropathy.  Ear Hear. 1999;  20 (3) 238-252
• 36 Emara AA, Gabr TA. Auditory steady state response in auditory neuropathy.  J Laryngol Otol. 2010;  124 (9) 950-956
• 37 Jafari Z, Malayeri S, Ashayeri H, Farahani MA. Adults with auditory neuropathy: comparison of auditory steady-state response and pure-tone audiometry.  J Am Acad Audiol. 2009;  20 (10) 621-628