Case Study: Behavioral, Electroacoustic, and Electrophysiological Assessment in Children with Academic Difficulties
Introduction: Children with language and communication impairments have deficient auditory brainstem responses to speech and speech-like sounds relative to typically developing peers, suggesting that auditory processing disorder may also include auditory brainstem dysfunction.
Objectives: To report of two case studies of children with academic difficulties who went through a behavioral, electroacoustic, and electrophysiological auditory processing assessment.
Resume report: Two male individuals, 10 and 11 years old, with academic difficulties assessed by an interdisciplinary professional staff (Disapre) were referred to Colangiopancreatografia Retrograda Endoscopia (CEPRE) for auditory evaluation. The following procedures were carried out: pure-tone threshold audiometry, logoaudiometry, immittance, central auditory processing tests, transient/distortion otoacoustic emissions, click/speech auditory brainstem responses (ABR), and long latency auditory evoked potential (LLAEP). Both cases had difficulties with comprehension, writing, and reading. On the auditory evaluation, both children had pure-tone audiometry, logoaudiometry, tympanometry/acoustic reflexes, transient/distortion otoacoustic emissions, ABR to clicks and LLAEP within normal values for both right and left ears. Central auditory processing behavioral tests revealed poor performance for monotic and dichotic tests, with worst results on auditory temporal tests. Furthermore, both cases showed abnormal auditory brainstem responses to speech stimuli.
Conclusion: Analysis of the cases showed the importance of the conjugate use of verbal and nonverbal stimuli on the auditory assessment for an accurate and efficient evaluation of the central auditory nervous system. ABR speech stimulation uses acoustic parameters that are important in the communication process.
Keywords: hearing, auditory evoked potentials, learning disorders.