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What is the Sequence of Stimuli when Performing ABR for Infant Hearing Assessment?

James W. Hall III, PhD

June 17, 2013

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Question

When performing an ABR with an infant for the purpose of hearing assessment, I first use a click stimulus.  To get frequency-specific information, would you recommend next using chirp stimuli or tone bursts?

Answer

In my opinion, the sequence of stimuli to use for ABR measurement in infants and young children is: 1) click, 2) tone burst (TB), and 3) chirp stimuli to refine auditory threshold.

Maybe someday we will go directly to chirp stimuli at moderate to low intensity levels, bypassing conventional TB stimuli. The problem with that approach is that chirp stimuli lose their effectiveness for intensity levels above about 60 dB nHL. If the click ABR was entirely normal (threshold of 20 dB or better), then you could go to chirp stimulation at less than 60 dB. However, if there was a moderate or severe hearing loss at any frequency by ABR measures, it would still be necessary to use conventional tone bursts or the ASSR to estimate threshold.

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.

 


Related Courses

Update on Auditory Evoked Responses: Evidence-Based ABR Protocol for Infant Hearing Assessment
Presented by James W. Hall III, PhD
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Presenter

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Course: #27299Level: Intermediate1 Hour
  'Clinically applicableExcellent presentation style and very understandable'   Read Reviews
A clinically feasible and effective protocol for infant hearing assessment with ABR is described. Research findings support all recommended stimulus and acquisition parameters. This course is open captioned.

Please note: You may earn ABA Tier 1 credits for this course if you complete it as part of the course 27890.

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In this course chirp stimuli are described and their rationale for clinical application is discussed. Data are presented in support of the use of chirp versions of click and tone burst stimuli in ABR and ASSR assessment of infants and young children. This course is open captioned.

Please note: You may earn ABA Tier 1 credits for this course if you complete it as part of the course 27885, "Auditory Evoked Responses for Infant Hearing Assessment Series". Course 27885 contains recordings of all three events from our 2016 series on Auditory Evoked Responses for Infant Hearing Assessment. ABA Tier 1 CEUs can be earned only when all modules are completed as part of course 27885.

View this Course for FREE.
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This course reviews the evidence and rationale for creating individualized audiologic diagnostic and screening test batteries with an emphasis on maximizing diagnostic value and enhancing clinical efficiency. It provides practical information for audiologists to review their protocols and implement value-added changes.

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This course discusses preschool hearing screening in an engaging Q & A format. Topics covered include: universal newborn screening, and why some children are not screened or lost to follow up; types of assessments for preschool hearing screenings; evidence-based protocols for preschool hearing screening and follow up.

Please note: You may earn ABA Tier 1 credits for this course if you complete it as part of the course 29608, "Audiological Test Battery Series." Course 29608 contains recordings of all three events from our 2017 series on Audiological Test Batteries. ABA Tier 1 CEUs can be earned only when all modules are completed as part of course 29608.

View this Course for FREE.
Need CEUs? Become a AudiologyOnline member to get unlimited CEUs.

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