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We analyzed the first audiological assessment and latest pure tone audiometry (PTA) in 29 hearing-impaired children (58 ears) visiting Osaka University for their first audiological assessment at the ages of 0, 1, and 2. We evaluated their hearing thresholds with PTA during follow-up and compared them to their first assessments. We combined auditory brain-stem response (ABR), behavioral audiometry, and conditioned orientation reflex (COR) for audiological evaluation of infants. Hearing thresholds assessed by 2 or 3 of these methods were sufficiently precise for hearing aid fitting. Thresholds of recorded ABR waves in 14 ears at loud sound pressure correlated well with later pure tone thresholds at high frequencies. Pure tone thresholds of those in whom no ABR waves were observed at 100 dB, were often out of scale at high frequencies--14% at 4000 Hz and 73% at 8000 Hz. Because of residual hearing at low frequencies, 4-frequency-averaged hearing at 500 Hz, 2 x 1000 Hz, 2000 Hz was better than 100 dB in 7 of 44 ears (16%), and 4 of 22 children (18%) did not fit the severest rank, 2, of the Disabled Persons, Welfare Law in Japan.

Audiological Assessment of Hearing-Impaired Children under Age 3 and Their Later Pure Tone Audiometry.