Australian Hearing protocols for the audiological management of infants who have auditory neuropathy

Hearing loss due to auditory neuropathy poses a number of challenges for paediatric audiologists who work with infants under 6 months of age. Behavioural hearing thresholds cannot be predicted from electrophysiological assessment and may vary from normal limits to profound hearing loss. The impact of the auditory neuropathy on a child's ability to use their residual hearing cannot be predicted from the behavioural hearing thresholds and is variable among individuals. Infants do not demonstrate behavioural responses at threshold in the first few months of life, nor is it possible to determine speech perception ability at this age. These factors combine to present difficulties in counseling families about the degree of hearing loss and potential implications for their child, and in prescribing and evaluating amplification, if fitted. This paper outlines Australian Hearing's protocols for managing infants who have auditory neuropathy, from diagnosis through to evaluation.