This study investigates how well the air- and bone-conduction auditory steady-state response detects mild conductive hearing loss compared to the auditory brainstem response in young infants. Air-bone gap sizes are compared between infants with normal hearing and conductive loss using a two-group cross-sectional design. Twenty-three (500 Hz) and 22 (2000 Hz) infants (0-6 months of age) with normal hearing and 15 (500 Hz) with conductive loss were recruited from newborn hearing screening. Thresholds were obtained to frequency-specific air- and bone-conducted stimuli. There were no instances of conductive loss at 2000 Hz. 500 Hz mean thresholds and air-bone gap sizes were compared. Sensitivity and specificity for identifying conductive loss were measured. Overall, mean bone-conduction thresholds were similar between groups, and mean 500-Hz air conduction thresholds were higher with larger air-bone gap size for infants with conductive loss. Sensitivity and specificity for identifying conductive loss was highest for air-conduction auditory brainstem response threshold measurement compared to screening and auditory steady-state response threshold measurements. The variability of auditory steady-state response thresholds and air-bone gap size was too great to reliably separate normal hearing from mild conductive loss compared to the auditory brainstem response. More research is needed using infants with varying degrees of hearing loss at multiple frequencies to fully assess the appropriateness of the auditory steady-state response as a clinical diagnostic tool for an infant population.

The authors have declared no competing interest.

This research was supported by a Discovery Grant from the Natural Sciences and Engineering Research Council of Canada to Dr. Susan Small.

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Yes

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

Ethics committee of the University of British Columbia and the University of Saskatchewan gave ethical approval for this work.

I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.

Yes

I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

Yes

I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.

Yes

Data is not available.