Preliminary studies have stirred the hope that sound-field stimulation through auditory steady state evoked potentials can be used to assess aided thresholds in the difficult-to-test population. Before the introduction of ASSEP into the clinical field, as a technique for the prediction of aided thresholds in the difficult-to-test population, a question arises concerning its clinical validation. The application of ASSEP through sound field stimulation, in the determination of aided thresholds and for the evaluation of amplification fittings, is dependent on the determination of unaided responses. Subsequently the estimation of unaided thresholds in the hearing impaired population is dependent on the establishment of normative data from the normal hearing population. The aim of this study was to determine the influence of insert earphones and sound field speaker presentation on threshold estimations using monotic auditory steady state evoked potentials, in a group of normal hearing adults. To achieve the aim of the study, a comparative, within-group experimental design was selected. The results of the current study indicated that the monotic single ASSEP technique under both insert earphone- and sound field conditions provided a reasonable estimation (25-35 dB HL for inset earphones; 20-33 dB HL for sound field speaker presentation) of the behavioural pure tone thresholds. The minimum response levels obtained under insert earphone conditions differed significantly from those obtained under sound field conditions for all the frequencies tested except 2 kHz (p < 0.01). Subsequently, the current study indicates that minimum response levels obtained using a specific transducer should serve as the basis of comparison with behavioural thresholds obtained under the same transducer. Therefore, behavioural pure tone thresholds obtained under insert earphone conditions will not suffice as a basis of comparison for minimum response levels obtained for the ASSEP technique under sound field conditions, and vice versa. This research endeavour concluded that the monotic ASSEP technique under both insert earphone and sound field conditions provide useful information for the estimation of frequency specific thresholds, but that the results are transducer specific and that comparison across transducers should be avoided.
Dissertation (M (Communication Pathology))--University of Pretoria, 2006.