Hostname: page-component-586b7cd67f-tf8b9 Total loading time: 0 Render date: 2024-11-22T16:09:23.629Z Has data issue: false hasContentIssue false

Dilemmas in auditory assessment of developmentally retarded children using behavioural observation audiometry and brain stem evoked response audiometry

Published online by Cambridge University Press:  29 June 2007

V. Rupa*
Affiliation:
Department of ENT, Speech and Hearing, Christian Medical College Hospital, Vellore, India.
*
Dr V. Rupa, M.S., D.L.O., Department of ENT, Speech and Hearing, Christian Medical College Hospital, Vellore 632004, India. Fax: 091 416 22103

Abstract

The records of 94 consecutive developmentally retarded children with speech retardation and suspected hearing loss who underwent auditory assessment by both conventional behavioural observation audiometry (BOA) and brain stem evoked response audiometry (BERA) were analysed. In 54 children (57.4 percent) there was good agreement between the results of both techniques leading to a clearcut diagnosis. In 22 children a diagnosis was possible only by the results of BERA as the results of BOA were inconclusive. Of the remaining 18 children, two groups could be identified whose results posed a dilemma. Group 1 (n = 7) consisted of children whose BOA test results differed considerably from their BERA results. Group 2 (n = 11) consisted of children in whom there was no discernible response by BERA while the response by BOA was either inconsistent (n = 5) or not elicitable (n = 6). The specific strategies to be adopted for hearing assessment in these situations are discussed.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 1995

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Coats, A. C, Martin, J. L. (1977) Human auditory nerve action potentials and brain stem evoked responses. Archives of Otolaryngology 103: 605622.CrossRefGoogle ScholarPubMed
Cope, Y., Lutman, M. E. (1994) Otoacoustic emissions. In Paediatric Audiology 0–5 Years. (McCormick, B., ed.), Whurr Publishers, London, pp 221245.Google Scholar
Finitzo-Heiber, T. (1982) Auditory brain stem response: its place in infant audiological evaluations. Seminars in Speech, Language and Hearing 3: 7686.CrossRefGoogle Scholar
Hecox, K., Galambos, R. (1974) Brain stem auditory evoked response in human infants and adults. Archives of Otolaryngology 99: 3033.CrossRefGoogle Scholar
Jerger, J., Hayes, D., Jordan, C. (1980) Clinical experience with auditory brain stem response audiometry in pediatric assessment. Ear and Hearing 1: 1925.CrossRefGoogle ScholarPubMed
Kaga, K., Tanaka, Y. (1980) Auditory brain stem response and behavioural audiometry. Archives of Otolaryngology 106: 564566.CrossRefGoogle Scholar
Kemp, D. T., Ryan, S., Bray, P. (1990) A guide to the effective use of otoacoustic emissions. Ear and Hearing 11: 93105.CrossRefGoogle Scholar
Kraus, N., Ozdamar, O., Stein, L., Reed, N. (1984) Absent auditory brain stem response: peripheral hearing loss or brain stem dysfunction? Laryngoscope 94: 400406.CrossRefGoogle ScholarPubMed
McCormick, B. (1994) Behavioural hearing tests, 6 months to 5 years. In Paediatric Audiology 0–5 years. (McCormick, B., ed.). Whurr Publishers, London, pp 97115.Google Scholar
Mokotoff, B., Schulman-Galambos, C., Galambos, R. (1977) Brain stem auditory evoked responses in children. Archives of Otolaryngology 103: 3843.CrossRefGoogle ScholarPubMed
Northern, J. L., Downs, M. P. (1994) Hearing in Children. 4th Edition, Ch. 5, Williams and Wilkins, Baltimore, p 145.Google Scholar
Picton, T. W., Taylor, M. J., Durieux-Smith, A. (1992) Electrodiagnosis in Clinical Neurology, (Aminoff, M. J., ed.), Churchill-Livingstone, New York, pp 537569.Google Scholar
Rupa, V., Musiek, F. E. (1991) Click evoked otoacoustic emissions in adult subjects: standardindices and test-retest reliability. American Journal of Otology 12: 435442.Google Scholar
Sohmer, H., Student, M. (1978) Auditory nerve and brain stem evoked responses in normal, autistic, minimal brain dysfunction and psychomotor retarded children. Electroencephalography and Clinical Neurophysiology 44: 380388.CrossRefGoogle ScholarPubMed
Taylor, I. G. (1964) Cerebral palsied children. In The Neurological Mechanisms of Hearing and Speech in Children. (Taylor, I. G., ed.), University Press, Manchester, pp 145160.Google Scholar
Worthington, D. W., Peters, G. L. (1980) Quantifiable hearing and no ABR: paradox or error? Ear and Hearing 1: 281285.CrossRefGoogle ScholarPubMed