Research Article

Effects of restricting maximum possible intensity on auditory steady-state responses


Background and Aim: Auditory steady-state response (ASSR) has widespread usage in the clinical hearing assessment of infants and young children. The present study evaluated the effect of restricting maximum possible intensity to 100 dB HL on ASSR thresholds.
Methods: This retrospective study was conducted in multiple audiology centers. ASSR thre­sholds with restricted settings were evaluated in 58 infants (116 ears). They had absent otoacoustic emissions and click-evoked auditory brainstem response waveforms and bilateral severe to profound hearing loss in behavioral evaluations.
Results: ASSR thresholds were absent in 28 %, 25%, 60 %, and 70 % of ears in 500, 1000, 2000, and 4000 Hz, respectively. The mean value of remained thresholds was approximately 90−95 dB HL.
Conclusion: Restricted ASSR settings are prevalent; however, they fail to provide extensive additional information about hearing sensitivity. Thus, manufacturers are suggested to improve ASSR setting and transducers and resolve the intensity restrictions. ASSR settings should be able to test auditory thresholds to level of 120 dB HL.

1. Hosseinabadi R, Jafarzadeh S. Auditory steady-state response thresholds in adults with conductive and mild to moderate sensorineural hearing loss. Iran Red Crescent Med J. 2014;17(1):e18029. doi: 10.5812/ircmj.18029
2. Korczak P, Smart J, Delgado R, Strobel TM, Bradford C. Auditory steady-state responses. J Am Acad Audiol. 2012;23(3):146-70. doi: 10.3766/jaaa.23.3.3
3. Jafarzadeh S, Jalaie B, Kamali M. [A comparison of thresholds in auditory steady-state response with pure tone audiometry in subjects with normal hearing and those with mild and moderate sensorineural hearing loss]. Audiol. 2008;17(1):53-62. Persian.
4. Sardari S, Jafari Z, Haghani H, Talebi H. Hearing aid validation based on 40 Hz auditory steady-state response thresholds. Hear Res. 2015;330(Pt A):134-41. doi: 10.1016/j.heares.2015.09.004
5. Torres-Fortuny A, Arnaiz-Marquez I, Hernández-Pérez H, Eimil-Suárez E. Auditory steady-state response in cochlear implant pati¬ents. Acta Otorrinolaringol Esp. 2018;69(5):268-74. doi: 10.1016/j.otorri.2017.08.007
6. Lin YH, Ho HC, Wu HP. Comparison of auditory steady-state responses and auditory brainstem responses in audiometric assess-ment of adults with sensorineural hearing loss. Auris Nasus Larynx. 2009;36(2):140-5. doi: 10.1016/j.anl.2008.04.009
7. Rodrigues GR, Lewis DR. Threshold prediction in children with sensorioneural hearing loss using the auditory steady-state responses and tone-evoked auditory brain stem response. Int J Pediatr Otorhinolaryngol. 2010;74(5):540-6. doi: 10.1016/j.ijporl.2010.02.017
8. Small SA, Stapells DR. Artifactual responses when recording auditory steady-state res-ponses. Ear Hear. 2004;25(6):611-23.
9. Brooke RE1, Brennan SK, Stevens JC. Bone conduction auditory steady state response: investigations into reducing artifact. Ear Hear. 2009;30(1):23-30. doi: 10.1097/AUD.0b013e31819144bd
10. Swanepoel de W, Ebrahim S, Friedland P, Swanepoel A, Pottas L. Auditory steady-state responses to bone conduction stimuli in children with hearing loss. Int J Pediatr Otorhinolaryngol. 2008;72(12):1861-71. doi: 10.1016/j.ijporl.2008.09.017
11. Grasel SS, de Almeida ER, Beck RM, Goffi-Gomez MV, Ramos HF, Rossi AC, et al. Are auditory steady-state responses useful to evaluate severe-to-profound hearing loss in children? Biomed Res Int. 2015;2015:579206. doi: 10.1155/2015/579206
12. American speech-language-hearing ass-ociation: Guide¬lines for the audiologic assessment of children from birth to 5 years of age [Guidelines]. Available from 2004.
13. Joint committee on infant hearing of the american academy of pediatrics, Muse C, Harrison J, Yoshinaga-Itano C, Grimes A, Brookhouser PE, et al. Supplement to the JCIH 2007 position statement: principles and guidelines for early intervention after confirmation that a child is deaf or hard of hearing. Pediatrics. 2013;131(4):e1324-49. doi: 10.1542/peds.2013-0008
14. American academy of pediatrics, Joint committee on infant hearing. Year 2007 position statement: Principles and guidelines for early hearing detection and inter¬vention programs. Pediatrics. 2007;120(4):898-921. doi: 10.1542/peds.2007-2333
IssueVol 28 No 4 (2019) QRcode
SectionResearch Article(s)
Auditory steady-state response; infants; profound hearing loss; restricted intensity setting

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
Haddadi Aval M, Jafarzadeh S. Effects of restricting maximum possible intensity on auditory steady-state responses. Aud Vestib Res. 2019;28(4):217-220.