Predicting the Degree of Hearing Loss Using Click Auditory Brainstem Response in Babies Referred From Newborn Hearing Screening

Baldwin, Margaret; Watkin, Peter

doi:10.1097/aud.0b013e3182728b88

Cited by 30 publications

(27 citation statements)

References 2 publications

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“…However, data from Gorga et al (2006) at 2000 and 4000 Hz were limited by the clinical practice at that time of using click-evoked ABRs to estimate hearing at high frequencies. Despite the strong relationship between clicks and high-frequency behavioral thresholds in that study and others (Baldwin & Watkin, 2013), tone-burst data at 2000 Hz and 4000 Hz would allow for a more direct comparison of the relationship between ABR threshold and behavioral threshold across a range of frequencies that are important for the diagnosis of hearing loss and for the prescription of amplification for infants. Additionally, the data from Gorga et al were reported as a function of degree of behavioral threshold, which typically is not available at the time that the ABR is conducted; thus, the data could not be used to generate a correction that could be applied directly to ABR thresholds.…”

Section: Introductionmentioning

confidence: 80%

The Impact of Degree of Hearing Loss on Auditory Brainstem Response Predictions of Behavioral Thresholds

et al. 2015

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Objectives: Diagnosis of hearing loss and prescription of amplification for infants and young children require accurate estimates of ear- and frequency-specific behavioral thresholds based on auditory brainstem response measurements. Although the overall relationship between ABR and behavioral thresholds has been demonstrated, the agreement is imperfect, and the accuracy of predictions of behavioral threshold based on ABR may depend on degree of hearing loss. Behavioral thresholds are lower than ABR thresholds, at least in part due to differences in calibration interacting with the effects of temporal integration, which are manifest in behavioral measurements but not ABR measurements and depend on behavioral threshold. Listeners with sensory hearing loss exhibit reduced or absent temporal integration, which could impact the relationship between ABR and behavioral thresholds as degree of hearing loss increases. The current study evaluated the relationship between ABR and behavioral thresholds in infants and children over a range of hearing thresholds, and tested an approach for adjusting the correction factor based on degree of hearing loss as estimated by ABR measurements. Design: A retrospective review of clinical records was completed for 309 ears of 177 children with hearing thresholds ranging from normal to profound hearing loss and for whom both ABR and behavioral thresholds were available. Children were required to have the same middle-ear status at both evaluations. The relationship between ABR and behavioral thresholds was examined. Factors that potentially could affect the relationship between ABR and behavioral thresholds were analyzed, including degree of hearing loss observed on the ABR, behavioral test method (visual reinforcement, conditioned play or conventional audiometry), the length of time between ABR and behavioral assessments, and clinician-reported reliability of the behavioral assessment. Predictive accuracy of a correction factor based on the difference between ABR and behavioral thresholds as a function of ABR threshold was compared to the predictive accuracy achieved by two other correction approaches in current clinical use. Results: As expected, ABR threshold was a significant predictor of behavioral threshold. The relationship between ABR and behavioral thresholds varied as a function of degree of hearing loss. The test method, length of time between assessments and reported reliability of the behavioral test results were not related to the difference between ABR and behavioral thresholds. A correction factor based on the linear relationship between the differences in ABR and behavioral thresholds as a function of ABR threshold resulted in more accurately predicted behavioral thresholds than other correction factors in clinical use. Conclusions: ABR is a valid predictor of behavioral threshold in infants and children. A correction factor that accounts for the effect of degree of hearing loss on the difference between ABR and behavioral thresholds resulted in more accurate pred...

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Section: Introductionmentioning

confidence: 80%

The Impact of Degree of Hearing Loss on Auditory Brainstem Response Predictions of Behavioral Thresholds

et al. 2015

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“…To prevent this disparity, the Joint Committee on Infant Hearing recommended a method of two-step automated otoacoustic emission (OAE) program, completed by an ABR for the positive diagnosis of hearing impairment in all newborns at risk of hearing impairment [40]. Though, using the two electrophysiologic tests of hearing tools for routine hearing screening is unaffordable in Nigeria, however it has been reported that click ABR in babies referred for newborn hearing screening can predict the degree of hearing loss in them [41] which was therefore used in the present study.…”

Section: Discussionmentioning

confidence: 99%

Comparison of auditory brainstem response in HIV-1 exposed and unexposed newborns and correlation with the maternal viral load and CD4+ cell counts

Fasunla¹,

Ogunbosi

Odaibo

et al. 2014

Aids

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Objective The effects of maternal HIV infection and antiretroviral therapy on hearing of HIV-exposed newborns in sub-Saharan Africa have not been investigated. We determined the prevalence of sensorineural hearing loss among HIV-exposed newborns and the association between the hearing threshold and maternal & newborn parameters. Design A cohort audiometric study of newborns between October 2012 and April 2013. Settings Secondary and tertiary hospital based study. Participants Consecutive 126 HIV-exposed and 121 HIV-unexposed newborns. Intervention Hearing screening of the newborns were done with Auditory Brainstem Response and compared with maternal HAART, CD4 cell counts, RNA viral loads and newborn CD4 percent. Main outcome measure Hearing threshold levels of both groups were measured and analyzed. Results 11.1% of HIV-exposed and 6.6% of unexposed newborns had hearing impairment (p=0.2214). 6.4% of HIV-exposed and 2.5% HIV-unexposed newborns had hearing threshold >20dBHL (p = 0.1578). There was no significant association between the hearing thresholds of HIV-exposed newborns and maternal CD4 cell counts (p = 0.059) but there was with maternal viral load (p=0.034). There was significant difference between the hearing thresholds of HIV-exposed newborns with CD4 % of ≤25 and >25. This study showed significant difference in the hearing of the 119 HAART-exposed newborns and 7 unexposed newborns (p=0.002; RR=0.13 [0.05–0.32]). Conclusion There was a trend towards more hearing loss in HIV-exposed newborns. However, hearing thresholds increase with increasing mothers’ viral load. This background information supports the need for further studies on the role of in-utero exposure to HIV and HAART in newborn hearing loss.

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“…Some audiologists believe it is not feasible to obtain accurate frequency-specific ABR due to a lack of frequency specificity or neural synchrony (Baldwin & Watkin, 2013; Stapells, 2011). Concerns about obtaining adequate recordings in naturally sleeping or quiet, awake infants, and time required to obtain TB recordings have caused many audiologists to persist with using only click stimuli.…”

Section: Introductionmentioning

confidence: 99%

Air and Bone Conduction Click and Tone-Burst Auditory Brainstem Thresholds Using Kalman Adaptive Processing in Nonsedated Normal-Hearing Infants

et al. 2015

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Objective To study normative thresholds and latencies for click and tone-burst auditory brainstem response (TB-ABR) for air and bone conduction in normal infants and those discharged from neonatal intensive care units (NICU), who passed newborn hearing screening and follow-up DPOAE. An evoked potential system (Vivosonic Integrity™) that incorporates Bluetooth electrical isolation and Kalman-weighted adaptive processing to improve signal to noise ratios was employed for this study. Results were compared with other published data. Research Design One hundred forty-five infants who passed two-stage hearing screening with transient-evoked otoacoustic emission (OAE) or automated ABR were assessed with clicks at 70 dB nHL and threshold TB-ABR. Tone-bursts at frequencies between 500 to 4000 Hz were employed for air and bone conduction ABR testing using a specified staircase threshold search to establish threshold levels and Wave V peak latencies. Results Median air conduction hearing thresholds using TB-ABR ranged from 0-20 dB nHL, depending on stimulus frequency. Median bone conduction thresholds were 10 dB nHL across all frequencies, and median air-bone gaps were 0 dB across all frequencies. There was no significant threshold difference between left and right ears and no significant relationship between thresholds and hearing loss risk factors, ethnicity or gender. Older age was related to decreased latency for air conduction. Compared to previous studies, mean air conduction thresholds were found at slightly lower (better) levels, while bone conduction levels were better at 2000 Hz and higher at 500 Hz. Latency values were longer at 500 Hz than previous studies using other instrumentation. Sleep state did not affect air or bone conduction thresholds. Conclusions This study demonstrated slightly better Wave V thresholds for air conduction than previous infant studies. The differences found in the current study, while statistically significant, were within the test step size of 10 dB. This suggests that threshold responses obtained using the Kalman weighting software were within the range of other published studies using traditional signal averaging, given step-size limitations. Thresholds were not adversely affected by variable sleep states.

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Predicting the Degree of Hearing Loss Using Click Auditory Brainstem Response in Babies Referred From Newborn Hearing Screening

Cited by 30 publications

References 2 publications

The Impact of Degree of Hearing Loss on Auditory Brainstem Response Predictions of Behavioral Thresholds

The Impact of Degree of Hearing Loss on Auditory Brainstem Response Predictions of Behavioral Thresholds

Comparison of auditory brainstem response in HIV-1 exposed and unexposed newborns and correlation with the maternal viral load and CD4+ cell counts

Air and Bone Conduction Click and Tone-Burst Auditory Brainstem Thresholds Using Kalman Adaptive Processing in Nonsedated Normal-Hearing Infants

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