Clinicians’ guide to obtaining a valid auditory brainstem response to determine hearing status

Signal, noise, and cross-checks

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Purpose: The auditory brainstem response (ABR) is a powerful tool for making clinical decisions about the presence, degree, and type of hearing loss in individuals in whom behavioral hearing thresholds cannot be obtained or are not reliable. Although the test is objective, interpretation of the results is subjective. Method: This review provides information about evidence-based criteria, suggested by the 2013 Newborn Hearing Screening Program guidelines, and the use of cross-check methods for making valid interpretations about hearing status from ABR recordings. Results: The use of an appropriate display scale setting, templates of expected response properties, and objective criteria to estimate the residual noise, signal level, and signal-to-noise ratio will provide quality data for determining ABR thresholds. Cross-checks (e.g., immittance measures, otoacoustic emissions testing, functional indications of a child’s hearing) are also needed to accurately interpret the ABR. Conclusions: Using evidence-based ABR signal detection criteria and considering the results within the context of other physiologic tests and assessments of hearing function will improve the clinician’s accuracy for detecting hearing loss and, when present, the degree of hearing loss. Diagnostic accuracy will ensure that appropriate remediation is initiated and that children or infants with normal hearing are not subjected to unnecessary intervention.

Original languageEnglish (US)
Pages (from-to)25-36
Number of pages12
JournalAmerican Journal of Audiology
Volume27
Issue number1
DOIs
StatePublished - Mar 1 2018

Fingerprint

Brain Stem Auditory Evoked Potentials
Hearing
Noise
Hearing Loss
Hearing Tests
Signal-To-Noise Ratio
Newborn Infant
Guidelines

ASJC Scopus subject areas

  • Speech and Hearing

Cite this

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abstract = "Purpose: The auditory brainstem response (ABR) is a powerful tool for making clinical decisions about the presence, degree, and type of hearing loss in individuals in whom behavioral hearing thresholds cannot be obtained or are not reliable. Although the test is objective, interpretation of the results is subjective. Method: This review provides information about evidence-based criteria, suggested by the 2013 Newborn Hearing Screening Program guidelines, and the use of cross-check methods for making valid interpretations about hearing status from ABR recordings. Results: The use of an appropriate display scale setting, templates of expected response properties, and objective criteria to estimate the residual noise, signal level, and signal-to-noise ratio will provide quality data for determining ABR thresholds. Cross-checks (e.g., immittance measures, otoacoustic emissions testing, functional indications of a child’s hearing) are also needed to accurately interpret the ABR. Conclusions: Using evidence-based ABR signal detection criteria and considering the results within the context of other physiologic tests and assessments of hearing function will improve the clinician’s accuracy for detecting hearing loss and, when present, the degree of hearing loss. Diagnostic accuracy will ensure that appropriate remediation is initiated and that children or infants with normal hearing are not subjected to unnecessary intervention.",
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