Title: 'Implications of Comparisons between ABR Thresholds and Behavioral Responses in a Group of Infants Diagnosed with Permanent Hearing Loss'
Track: 2 - Audiological Services
Keyword(s): ABR, behavioral testing, diagnostics
Learning Objectives:
  1. Describe differences between ABR threshold estimates and behavioral responses in this group of infants
  2. Discuss implications of ABR vs behavioral responses in accuracy of initial hearing aid recommendations/fittings


The Joint Committee on Infant Hearing (JCIH) recommends at least one auditory brainstem response (ABR) test as part of a complete diagnostic evaluation for children under three to confirm permanent hearing loss (2007). The accuracy of ABR threshold estimates is critical for diagnosis of hearing loss and for use in programming hearing technology. This poster reports initial finding from a Quality Improvement Initiative designed to ensure consistency in diagnostic practices, ABR interpretation and “first fitting” strategies for infants diagnosed with permanent childhood hearing loss in a large pediatric hospital. A chart review was conducted to collect all diagnostic threshold data for children evaluated from 2005 to 2012. If both ABR threshold estimates and follow-up behavioral minimum response levels or hearing thresholds were available for a child, the data were entered into a database. Correlations for threshold pairs were calculated for corrected and uncorrected threshold estimates. In addition, the percent of agreement using + 5 dB, + 10 dB and > 15 dB were graphed for a variety of threshold comparisons to determine which resulted in the highest accuracy. Results for comparisons are presented and implications for practice are reported. A simple format for ongoing quality improvement for ABR threshold estimation procedures is presented. The results of this study will inform best practices for the use of ABR thresholds in estimating behavioral thresholds and will assist audiologists in clinical decision making when determining best practice initial fitting strategies with infants, as well as increase awareness of physicians, hospital personnel, and caregivers regarding the necessary diagnostic testing with this population.
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Rose Dockery - Primary Presenter
     Credentials: B.A, Communication Disorders M.Ed, Deaf Education
      Rose Dockery is a 2nd year Au.D. student at the University of Arkansas for Medical Sciences/University of Arkansas at Little Rock. She received her Master's degree in deaf education from Georgioa State University. Prior to beginning the doctoral program, she worked as a Teacher of the Deaf for Fulton County Schools in Alpharetta, Georgia.Additionally, she is a graduate assistant at Arkansas Children's Hospital where she works as a newborn hearing screener in the NICU.

Financial - No relevant financial relationship exist.

Nonfinancial - No relevant nonfinancial relationship exist.
Patti Martin - Co-Presenter,POC
Arkansas Children's Hospital
     Credentials: Ph.D. CCC-A F-AAA
     Other Affiliations: NCHAM
      Patti Martin, Ph.D., is the Director of Audiology and Speech Language Pathology at Arkansas Children’s Hospital (ACH). Her areas of expertise include infant screening/assessment, family support and program development. Her efforts with infant hearing screening began with a collaboration project to investigate the efficacy of TEOAEs as a newborn screening tool in the early 1990s and continue through her work on the board of the American Speech-Language-Hearing Association Special Interest Division on Childhood Hearing Disorders and as the Family Support Consultant for NCHAM. She has chaired the Arkansas Board of Examiners in Speech Pathology and Audiology, the Arkansas Universal Newborn Hearing Screening, Tracking and Intervention Boardand the Natinoal Investing in Family Support Conference for the past four years. Dr. Martin’s ongoing passion centers around how professionals can help support families in improving the outcomes of children with hearing loss.

Financial - No relevant financial relationship exist.

Nonfinancial - No relevant nonfinancial relationship exist.
Nannette Nicholson - Co-Presenter
     Credentials: Ph.D.
     Other Affiliations: ACH
      Nannette Nicholson, PhD is a Professor and Interim Chair of the Department of Audiology and Speech Pathology at the University of Arkansas for Medical Sciences/University of Arkansas at Little Rock. She also has a clinical staff appointment at Arkansas Children's Hospital. Her primary research area is early intervention and pediatric audiology.

Financial -

Nonfinancial -