Frequency-specific BERA in infants.

Click BERA has several limitations, both physical and physiological, for early audiological assessment. It cannot quantify the audiometric contour, detect high or low frequency hearing loss, or reveal residual low frequency hearing. Several methods of cochlear place-specific BERA are reviewed briefly. BERA using tonepip stimuli in band-reject masking noise is described in more detail for both nil-risk and at-risk infants. Technical and normative problems are outlined. Most babies give clear ABRs to 40 dBnHL tonepips, but threshold distributions are broader at 500 Hz than for higher frequency tonepips or clicks. Thresholds improve over the first four months, especially at 500 Hz. Cases of click/tonepip threshold differences are presented. Place-specific testing may be a useful component of early assessment. Further research is needed to determine its limitations and relevance to early management.