Brainstem audiological assessment in auditory processing, learning, and language disorders
Claudia Cassandro, Valeria Caragli, Luciana Occhi, Andrea Canale, Elisabetta Genovese, Patrizia TrevisiAbstract
Background/Objective:
Brainstem structures play a crucial role in auditory processing and are increasingly recognized as factors which contribute to the development of language and learning disorders, even in the absence of peripheral hearing loss. Nonetheless, little is known about the assessment tools and the normative values to consider for the analysis of brainstem functioning in such conditions. This paper aims to provide an updated overview of brainstem audiological assessment methods and their clinical relevance in patients with auditory processing disorders (APDs), primary language disorders, and developmental dyslexia.
Materials and Methods:
A scoping review of neurophysiological and behavioral evaluation techniques was conducted, including auditory brainstem response (ABR), complex ABR (cABR), middle latency responses, cortical auditory evoked potentials, mismatch negativity, and central auditory processing tests. Functional imaging and recent findings on neural plasticity were also considered.
Results:
Children with APD and language or learning disorders often show subclinical alterations in temporal coding and spectral processing at the brainstem level. ABR and cABR reveal consistent markers such as prolonged latencies, reduced wave amplitudes, and increased variability, even in the presence of normal audiometric thresholds. These markers correlate with behavioral deficits in phonological and linguistic domains.
Conclusions:
Brainstem audiological assessment represents a valuable neurophysiological tool in neurodevelopmental disorders. As the current evidence does not support its use as a stand-alone diagnostic marker, electrophysiological findings must be interpreted cautiously and within a multidisciplinary clinical framework, including cognitive and behavioral evaluations.