Auditory Processing Rehabilitation Follow-up through Speech-evoked Auditory Brainstem Response in Contralateral Noise; A Case Report

Abstract

Background: Auditory training (AT) is an effective intervention for auditory processing disorder (APD), and its outcomes are usually assessed through behavioral and electrophysiological tests. Among objective tools, speech-evoked auditory brainstem response (s-ABR) has been used to evaluate AT effects, and it has shown promise, but s-ABR recorded in contralateral noise—a method activating both afferent and efferent auditory pathways—has not been applied to monitor rehabilitation progress in APD.
The Case: Here we compare pre- and post-intervention different tests' results of a 7-year-old boy with APD (with documented deficits in dichotic processing and speech-in-noise perception) to investigate which is the most appropriate tool for assessing rehabilitation efficacy. The case underwent behavioral and electrophysiological evaluations, including s-ABR with and without contralateral noise, before and after 15 sessions of targeted AT tailored to the child’s specific processing weaknesses. Post-training results revealed significant improvement in behavioral tests and questionnaire scores. S-ABR assessments also demonstrated improvements, including increased V/A slope as well as improvements in wave latencies and amplitudes, with more pronounced changes observed in recordings with contralateral noise.
Conclusion: This case highlights the novel use of s-ABR in contralateral noise as a promising objective tool for monitoring auditory rehabilitation in APD. While behavioral assessments remain the gold standard, this electrophysiological test may provide valuable complementary information, particularly for patients with limited behavioral test cooperation or when behavioral results are unreliable. As this case report involves a single child with APD, further studies are needed to validate these findings in broader APD populations.