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. 2022 Dec 5;31(4):1279-1292.
doi: 10.1044/2022_AJA-22-00100. Epub 2022 Nov 28.

Auditory Brainstem Responses at 6 and 8 kHz in Infants With Normal Hearing

Heather L Porter  1 , Christina Dubas  2 , Manuel Vicente  3 , Emily Buss  4 , Jan Kaminski  1
Affiliations

Auditory Brainstem Responses at 6 and 8 kHz in Infants With Normal Hearing

Heather L Porter et al. Am J Audiol. .

Abstract

Purpose: Normative auditory brainstem response (ABR) data for infants and young children are available for 0.25-4 kHz, limiting clinical assessment to this range. As such, the high-frequency hearing sensitivity of infants and young children remains unknown until behavioral testing can be completed, often not until late preschool or early school ages. The purpose of this study was to obtain normative ABR data at 6 and 8 kHz in young infants.

Method: Participants were 173 full-term infants seen clinically for ABR testing at 0.4-6.7 months chronological age (M = 1.4 months, SD = 1.0), 97% of whom were ≤ 12 weeks chronological age. Stimuli included 6 and 8 kHz tone bursts presented at a rate of 27.7/s or 30.7/s using Blackman window gating with six cycles (6 kHz) or eight cycles (8 kHz) rise/fall time and no plateau. Presentation levels included 20, 40, and 60 dB nHL. The ABR threshold was estimated in 5- to 10-dB steps.

Results: As previously observed with lower frequency stimuli, ABR waveforms obtained in response to 6 and 8 kHz tone bursts decreased in latency with increasing intensity and increasing age. Latency was shorter for 8-kHz tone bursts than 6-kHz tone bursts. Data tables are presented for clinical reference for infants ≤ 4 weeks, 4.1-8 weeks, and 8.1-12 weeks chronological age including median ABR latency for Waves I, III, and V and the upper and lower boundaries of the 90% prediction interval. Interpeak Latencies I-III, III-V, and I-V are also reported.

Conclusion: The results from this study demonstrate that ABR assessment at 6 and 8 kHz is feasible for young infants within a standard clinical appointment and provide reference data for clinical interpretation of ABR waveforms for frequencies above 4 kHz.

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Figures

Figure 1.
Figure 1.
Time waveforms for 6- (green) and 8-kHz (blue) tone bursts at 75 dB nHL (i.e., 78 dB peSPL for 6 kHz and 82 dB peSPL for 8 kHz) measured in a 2-cc coupler (Larson Davis). peSPL = peak equivalent sound pressure level.
Figure 2.
Figure 2.
Sample auditory brainstem response waveforms for 0.25-, 1-, 2-, 4-, 6-, and 8-kHz tone burst stimuli for the left ear of a 5-week-old infant with normal hearing sensitivity. These data demonstrate feasibility of data collection within a clinical appointment and distinct waveforms for all test frequencies, including Waves I, III, and V for 6- and 8-kHz stimuli presented at 20, 40, and 60 dB nHL.
Figure 3.
Figure 3.
Auditory brainstem response waveform latency (ms) for infants ≤ 12 weeks of age. Wave I (red symbols), III (green symbols), and V (blue symbols) are plotted as a function of chronological age (weeks) for 6-kHz tone bursts (top panels) and 8-kHz tone bursts (bottom panels) presented at 20 dB nHL (left panels), 40 dB nHL (center panels), and 60 dB nHL (right panels).
Figure 4.
Figure 4.
Auditory brainstem response (ABR) waveform latency difference (ms) between 6 and 8 kHz for infants ≤ 12 weeks of age. Waves I (red symbols), III (green symbols), and V (blue symbols) are plotted as a function of chronological age (weeks) for stimuli presented at 20 dB nHL (left panel), 40 dB nHL (center panel), and 60 dB nHL (right panel).
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