Psychoacoustic and electrophysiologic auditory neural encoding in school-aged children with mild to moderate sensorineural hearing loss

Background: Sensorineural hearing loss (SNHL) in children could impact speech processing along different levels of the auditory pathway; subcortical and cortical. The most frequently used psychoacoustic tests for temporal resolution and ordering evaluation are Gaps-In-Noise (GIN) and Pitch Pattern Sequence (PPS) tests. Moreover, speech-evoked auditory brainstem response (speech-ABR) represents an electrophysiologic test of brainstem speech processing. Aim: to study the impact of mild to moderate SNHL on speech neural encoding in school-aged children, using psychoacoustic (GIN and PPS) and electrophysiological (speech-ABR) tests and to estimate the accuracy of the psychoacoustic and electrophysiological tests in the diagnosis of temporal processing deficit. Methods: This observational, case-control study involved 30 school-aged children who were classified into; control group of normal-hearing children and study group of 20 children with mild to moderate SNHL. They were subjected to history-data reporting, basic audiological testing, and both psychoacoustic and electrophysiologic evaluation of the temporal auditory processing. Results: In comparison to the control group, there were significantly higher approximate threshold (APT) measure of GIN test in the moderate SNHL subgroups, lower total correct score measure of GIN test at a lower (mild) degree of SNHL, lower PPS scores as the hearing threshold increased above normal, and longer speech-ABR latency in the moderate SNHL subgroup. All the examined measures revealed a high accuracy with the APT measure of the GIN test showing the highest accuracy (92%). Conclusions: The psychoacoustic and electrophysiologic evaluation provided evidence of temporal auditory processing impairment in children with SNHL.