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.
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
1https://www.audiologyonline.com/audiology-ceus/course/update-on-auditory-evoked-responses-27299Update on Auditory Evoked Responses: Evidence-Based ABR Protocol for Infant Hearing AssessmentA 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 auditory, textual, visual129USDSubscriptionUnlimited COURSE Access for $129/yearOnlineOnlyAudiologyOnlinewww.audiologyonline.comUpdate on Auditory Evoked Responses: Evidence-Based ABR Protocol for Infant Hearing AssessmentA 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 27299OnlinePT60M
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.
2https://www.audiologyonline.com/audiology-ceus/course/update-on-auditory-evoked-responses-27300Update on Auditory Evoked Responses: Value of Chirp Stimuli in ABR/ASSR MeasurementIn 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.auditory, textual, visual129USDSubscriptionUnlimited COURSE Access for $129/yearOnlineOnlyAudiologyOnlinewww.audiologyonline.comUpdate on Auditory Evoked Responses: Value of Chirp Stimuli in ABR/ASSR MeasurementIn 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 27885.27300OnlinePT60M
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.
3https://www.audiologyonline.com/audiology-ceus/course/auditory-evoked-responses-for-infant-27890Auditory Evoked Responses for Infant Hearing AssessmentThis modular course reviews hearing assessment for infants and young children using ABR. An evidence-based protocol as well as chirp and brief-tone bone-conducted stimuli are discussed.auditory, textual, visual129USDSubscriptionUnlimited COURSE Access for $129/yearOnlineOnlyAudiologyOnlinewww.audiologyonline.comAuditory Evoked Responses for Infant Hearing AssessmentThis modular course reviews hearing assessment for infants and young children using ABR. An evidence-based protocol as well as chirp and brief-tone bone-conducted stimuli are discussed.27890OnlinePT180M
This modular course reviews hearing assessment for infants and young children using ABR. An evidence-based protocol as well as chirp and brief-tone bone-conducted stimuli are discussed.
4https://www.audiologyonline.com/audiology-ceus/course/rethinking-your-audiology-test-battery-29608Rethinking Your Audiology Test BatteryThis 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.auditory, textual, visual129USDSubscriptionUnlimited COURSE Access for $129/yearOnlineOnlyAudiologyOnlinewww.audiologyonline.comRethinking Your Audiology Test BatteryThis 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.29608OnlinePT180M
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.
5https://www.audiologyonline.com/audiology-ceus/course/new-research-based-protocol-39856A New Research-Based Protocol for Childhood Hearing ScreeningThis text-based course covers the research, rationale, and protocol for hearing screening of preschool and young school-age children using a combination of two objective measures of auditory function, DPOAEs + tympanometry.textual, visual129USDSubscriptionUnlimited COURSE Access for $129/yearOnlineOnlyAudiologyOnlinewww.audiologyonline.comA New Research-Based Protocol for Childhood Hearing ScreeningThis text-based course covers the research, rationale, and protocol for hearing screening of preschool and young school-age children using a combination of two objective measures of auditory function, DPOAEs + tympanometry.39856OnlinePT60M
This text-based course covers the research, rationale, and protocol for hearing screening of preschool and young school-age children using a combination of two objective measures of auditory function, DPOAEs + tympanometry.
