Resende Luciana Macedo de, Carvalho Sirley Alves da Silva, Dos Santos Thamara Suzi, Abdo Filipe Ibraim, Romão Matheus, Ferreira Marcela Cristina, Tierra-Criollo Carlos Julio
Speech Therapy and Audiology Department, Federal University of Minas Gerais, Belo Horizonte, Brazil.
Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte, Brazil.
J Neuroeng Rehabil. 2015 Feb 10;12(1):13. doi: 10.1186/s12984-015-0003-y.
The use of Auditory Steady-State Responses (ASSRs) for auditory screening in school-aged children, particularly in children who are difficult to test and children with disabilities, has not been explored yet. This pilot study investigated the use of ASSR for auditory screening in school-aged children.
A cross-sectional pilot study of 23 children aged 9 to 11 with normal-hearing thresholds and seven age-matched children with permanent moderate-to-profound bilateral hearing loss were examined. The tested carrier frequencies were 500, 1,000, 2,000, and 4,000 Hz, and the stimulus was modulated between 77 and 107 Hz. The ASSRs decreased according to the tested intensity levels of 50, 40, and 30 dB sound pressure level (SPL). Sensitivity and specificity were estimated from the responses of the children with normal hearing and those with hearing loss.
For the children with normal hearing, the 2,000-Hz frequency was detected more often in both ears and at all intensity levels compared to the other frequencies. The 500- and 2,000-Hz frequencies resulted in different response patterns in both ears. The time until response detection increased in parallel with amplitude reduction, as expected. The overall time required for the test was 15 minutes, including the time spent in volunteer preparation. The sensitivity was 97% for the three intensities, and the best specificity value was 100%, which was observed at 50 dB.
The response analysis indicated that a screening protocol for school-aged children could include 1,000, 2,000, and 4,000 Hz and that the recording of ASSRs was highly sensitive to internal and external factors. Fifty dB SPL should be considered a cut-off criterion for screening purposes because this was the intensity level with a sensitivity of 97% and a specificity of 100%.
The use of ASSRs might be particularly useful in school-aged children who have difficulty performing subjective hearing tests. The sensitivity and specificity data suggested that the use of ASSRs was feasible as an auditory screening tool. In order to determine a protocol for screening, future studies should include a larger sample and children with mild hearing loss.
尚未探讨将听觉稳态反应（ASSR）用于学龄儿童的听力筛查，尤其是难以测试的儿童和残疾儿童。这项初步研究调查了ASSR在学龄儿童听力筛查中的应用。
对23名听力阈值正常的9至11岁儿童和7名年龄匹配的永久性中度至重度双侧听力损失儿童进行了横断面初步研究。测试的载波频率为500、1000、2000和4000赫兹，刺激频率在77至107赫兹之间调制。ASSR根据50、40和30分贝声压级（SPL）的测试强度水平而降低。根据听力正常儿童和听力损失儿童的反应估计敏感性和特异性。
对于听力正常的儿童，与其他频率相比，在所有强度水平下，双耳检测到2000赫兹频率的情况更为常见。500赫兹和2000赫兹频率在双耳中产生了不同的反应模式。正如预期的那样，响应检测所需的时间随着幅度降低而增加。测试所需的总时间为15分钟，包括志愿者准备时间。三种强度下的敏感性为97%，最佳特异性值为100%，在50分贝时观察到。
反应分析表明，学龄儿童的筛查方案可包括1000、2000和4000赫兹，并且ASSR的记录对内部和外部因素高度敏感。50分贝声压级应被视为筛查目的的临界标准，因为这是敏感性为97%、特异性为100%的强度水平。
ASSR的应用可能对难以进行主观听力测试的学龄儿童特别有用。敏感性和特异性数据表明，ASSR作为一种听力筛查工具是可行的。为了确定筛查方案，未来的研究应纳入更大的样本以及轻度听力损失儿童。
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