Clinical Case · Trainee

A toddler with a sloping high-frequency loss

Vignette

An 18-month-old with delayed speech is tested under natural sleep. Behavioural testing was unreliable. A multiple-frequency ASSR shows present responses at all carriers, but the lowest intensity with a present response rises steeply from 500 Hz to 4000 Hz.

Audiogram

-10020406080100120500 Hz1k Hz2k Hz4k HzHearing level (dB HL)
O Right earX Left ear
Estimated thresholds by ear. O = right, X = left.

ASSR finding

Estimated thresholds near-normal at 500 Hz, worsening progressively to a severe loss at 4000 Hz — a sloping configuration.

Diagnostic question

Which audiometric configuration does this ASSR result describe?