Use of auditory steady-state responses in children and comparison with other electrophysiological and behavioral tests

Eur Ann Otorhinolaryngol Head Neck Dis. 2016 Nov;133(5):331-335. doi: 10.1016/j.anorl.2016.07.008. Epub 2016 Aug 5.


Objective: In patients who cannot or will not cooperate in behavioral hearing assessment, electrophysiological examinations are used, but are time-consuming because the subject has to remain immobile. The aim of this study was to assess whether auditory steady-state responses (ASSR) are sufficiently reliable, compared to auditory brainstem responses (ABR) and free-field audiometry, for assessment to begin with ASSR instead of ABR.

Material and methods: A retrospective study was performed between January 2012 and April 2013, including children less than 6 years of age who could not be tested via headphones. ASSR and ABR were measured during natural sleep or under phenobarbital-alimemazine sedation. Subjective pure-tone audiometry was performed, using the visual reinforcement audiometry method, in 69 children who were able and willing to cooperate.

Results: A total of 175 children were included. ASSR and ABR thresholds showed good positive correlation (338 ears; Pearson's correlation coefficient, 0.87). Behavioral thresholds correlated significantly with ASSR thresholds (Student t-test for matched series; P<0.05). ASSR thresholds were usually better than behavioral thresholds, with a difference of 8-15dB HL.

Conclusion: ASSR is reliable in children under 6 years of age, and should be performed before ABR when hearing threshold rather than latency is to be determined.

Keywords: Audiometry; Auditory brainstem response; Auditory steady-state response; Child; Hearing loss.

Publication types

  • Comparative Study

MeSH terms

  • Audiometry, Evoked Response*
  • Audiometry, Pure-Tone*
  • Auditory Threshold
  • Behavior Rating Scale
  • Child
  • Child, Preschool
  • Evoked Potentials, Auditory*
  • Evoked Potentials, Auditory, Brain Stem*
  • Hearing Loss / diagnosis*
  • Humans
  • Infant
  • Infant, Newborn
  • Retrospective Studies