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Should Tone Burst ABR be Performed at 8000 Hz for Infant Hearing Assessment?

James W. Hall III, PhD

November 18, 2013

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Question

When performing ABR with tone burst stimuli for the purpose of hearing assessment in infants, should 8000 Hz be tested?  I would think this would be useful for children who have been treated with potentially ototoxic medications.

Answer

The ABR can be elicited with high frequency tone burst stimulation at 8000 Hz and even much higher, assuming the earphones used have an adequate frequency response. It would be possible, for example, to stimulate an ABR for frequencies of 10000 or 12000 Hz with the right earphones.

For years, I've been asking ABR equipment manufacturers to offer high frequency stimuli and earphones as an option on their ABR systems for the very application you mentioned ... identification or documentation of ototoxic induced hearing loss in infants and young children. Nowadays I use the ASSR for threshold estimation at 8000 Hz in such patients, assuming they are quiet enough.

Before using 8000 Hz tone bursts with a typical ABR system you would want to first verify behavioral threshold with the stimuli. Most supra-aural earphones roll off in the high frequencies and insert earphones were designed to mimic the TDH supra-aural earphones. The maximum intensity level for insert earphones might be reduced for the 8000 Hz tone burst. 

I think the 8000 Hz stimulus would be a good choice to use for newborn hearing screening because almost all infant hearing loss involves high frequencies, but at this point the click stimulus will probably not be abandoned for newborn hearing screening.

For an in-depth discussion of this topic, please view Dr. Hall’s recorded course on AudiologyOnline, Application of ABR in Objective Assessment of Infant Hearing


james w hall iii

James W. Hall III, PhD

James W. Hall III, PhD is an internationally recognized audiologist with 40-years of clinical, teaching, research, and administrative experience. He received his Ph.D. in audiology from Baylor College of Medicine under the direction of James Jerger.  During his career, Dr. Hall has held clinical and academic audiology positions at major medical centers. Dr. Hall now holds appointments as Professor at Salus University and the University of Hawaii, and as Extraordinary Professor at the University of Pretoria South Africa. Dr. Hall is the author of over 160 peer-reviewed journal articles, monographs, or book chapters, and nine textbooks including the 2014 Introduction to Audiology Today and the 2015 eHandbook of Auditory Evoked Responses.

 


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