An 18-month-old referred for delayed speech has present OAEs in both ears, but the click ABR is absent/grossly abnormal with preserved cochlear microphonic — a picture of auditory neuropathy spectrum disorder. The family is anxious about whether the child will ever use spoken language. You record cortical responses to speech sounds.
Findings
Despite the absent ABR, a cortical response is present — reduced and slightly delayed, but repeatable.
Diagnostic question
How should the present cortical response be interpreted in this ANSD picture?