This instructional course focuses on physiologic techniques, specifically Auditory Brainstem Response (ABR) and Auditory Steady-State Response (ASSR) for accurate auditory threshold estimation in infants and young children. Special attention will be paid to tone burst and chirp-evoked ABRs, comparing their utility with standard click stimuli. The course will provide clinical decision-making strategies for choosing stimulus types, managing calibration issues, and integrating physiologic results with limited behavioral data. The session will conclude with a brief overview of behavioral estimation methods to highlight a multimodal approach.

Learning Objectives:

• Differentiate between click, tone burst, and chirp stimuli in ABR and understand their use in frequency-specific threshold estimation.

• Apply chirp ABR in clinical settings, especially in infants, considering calibration and latency differences.

• Use ASSR as a complementary or alternative tool for auditory threshold estimation.

• Integrate physiologic results with limited behavioral observations to guide diagnosis.

• Apply decision making protocols in medically complex or time constrained pediatric cases.

Course Outline:

1.     Introduction (2 min): Importance of accurate auditory threshold estimation in pediatric diagnostics.

2.     Stimulus Comparisons in ABR (8 min): Click vs. tone burst vs. chirp; frequency specificity, temporal synchrony, and recording efficiency.

3.     Chirp ABR in Practice (6 min): Clinical benefits, limitations, calibration issues, and interpretation strategies.

4.     ASSR Applications (5 min): Role in bilateral threshold estimation, especially for profound hearing loss and auditory neuropathy.

5.     Behavioral Correlation (5 min): How to integrate physiologic data with behavioral responses like VRA and BOA.

6.     Decision Making Algorithms (4 min): Practical case based strategies and flowcharts for clinical use.

This instructional course focuses on physiologic techniques, specifically Auditory Brainstem Response (ABR) and Auditory Steady-State Response (ASSR) for accurate auditory threshold estimation in infants and young children. Special attention will be paid to tone burst and chirp-evoked ABRs, comparing their utility with standard click stimuli. The course will provide clinical decision-making strategies for choosing stimulus types, managing calibration issues, and integrating physiologic results with limited behavioral data. The session will conclude with a brief overview of behavioral estimation methods to highlight a multimodal approach.

Course Outline

1.     Introduction (2 min): Importance of accurate auditory threshold estimation in pediatric diagnostics.

2.     Stimulus Comparisons in ABR (8 min): Click vs. tone burst vs. chirp; frequency specificity, temporal synchrony, and recording efficiency.

3.     Chirp ABR in Practice (6 min): Clinical benefits, limitations, calibration issues, and interpretation strategies.

4.     ASSR Applications (5 min): Role in bilateral threshold estimation, especially for profound hearing loss and auditory neuropathy.

5.     Behavioral Correlation (5 min): How to integrate physiologic data with behavioral responses like VRA and BOA.

6.     Decision Making Algorithms (4 min): Practical case based strategies and flowcharts for clinical use.