J Am Acad Audiol 2001; 12(03): 155-164
DOI: 10.1055/s-0042-1745592
Original Article

Maximum Length Sequences-Auditory Brainstem Responses from Children with Auditory Processing Disorders

Robert E. Jirsa
Department of Communication Disorders, Southern Connecticut State University, New Haven, Connecticut
› Author Affiliations


This study was designed to evaluate maximum length sequences-auditory brainstem responses (MLS-ABR) in children with auditory processing disorders and to compare these results with a normal control group matched for age, intelligence, and gender. Although each waveform was analyzed for the presence of waves 1,111, and V, the primary focus was wave V. Although absolute latency measures for wave V were obtained from all subjects, waves I and III were not always identified. Although the results showed latency increases for all waveforms in both groups, the only significant difference noted was an increase in wave V latency for both the left and right ears in the clinical group. These results suggest that the MLS-ABR may be useful in the assessment of auditory processing disorders. Implications for the potential use of the MLS-ABR in management programs are discussed.

Abbreviations: ABR = auditory brainstem response, ADHD = attention-deficit hyperactivity disorder, APD = auditory processing disorders, DD = Dichotic Digits Test, DP = Duration Pattern Test, DS = Dichotic Sentences Identification Test, ERP = event-related potential, FP = Frequency Pattern Test, LL = linguistic label, MLR = middle latency response, MLS = maximum length sequences, MLS-ABR = maximum length sequences-auditory brainstem response, MMN = mismatch negativity, SSI-ICM = Synthetic Sentence Identification-Ipsilateral Competing Message, TC = Time Compressed Speech Test, VA = Veterans Administration

Publication History

Article published online:
28 February 2022

© 2001. American Academy of Audiology. This article is published by Thieme.

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  • Baran JA, Musiek FE. (1999). Behavioral assessment of the central auditory nervous system. In: Musiek FE, Rintleman WF, eds. Contemporary Perspectives in Hearing Assessment. Boston: Allyn and Bacon, 375–414.
  • Bellis TJ. (1996). Assessment and Management of Central Auditory Processing Disorders in the Educational Setting: from Science to Practice. San Diego: Singular.
  • Bellis TJ, Ferre JM. (1999). Multidimensional approach to the differential diagnosis of central auditory processing disorders in children. J Am Acad Audiol 10:319–328. Buchwald J, Huang CM. (1975). Far field acoustic response: origins in the cat. Science 189:382–384.
  • Burkard R. (1994). Gerbil brain-stem auditory-evoked responses to maximum length sequences. J Acoust Soc Am 95:2126–2135.
  • Burkard R, Shi Y, Hecox KE. (1990). Brain-stem audi- tory-evoked responses elicited by maximum length sequences: effect of simultaneous masking noise. J Acoust Soc Am 87:1665–1672.
  • Chermak GD, Musiek FE. (1997). Central Auditory Processing Disorders: New Perspectives. San Diego: Singular.
  • Courchesne E. (1978). Neurophysiological correlates of cognitive development: changes in long-latency event- related potentials from childhood to adulthood. Electroencephalogr Clin Neurophysiol 45:468—482.
  • Dalebout SD, Fox LG. (2000). Identification of the mismatch negativity in the responses of individual listeners. J Am Acad Audiol 11:12—22.
  • Dalebout SD, Stack JW. (1999). Mismatch negativity to acoustic differences not differentiated behaviorally. J Am Acad Audiol 10:388–399.
  • Don M, Allen AR, Starr A. (1977). Effect of click rate on the latency of auditory brain stem responses in humans. Ann Otol Rhinol Laryngol 86:186–195.
  • Eggermont JJ, Odenthal DW. (1974). Action potentials and summating potentials in the normal human cochlea. Acta Otolaryngol Suppl (Stockh) 319:39–61.
  • Eysholdt U, Schreiner C. (1982). Maximum length sequences—a fast method for measuring brainstem evoked responses. Audiology 21:242–250.
  • Fifer R, Jerger J, Berlin C, Tobey E, Campbell J. (1983). Development of a dichotic sentence identification test for hearing impaired adults. Ear Hear 4:300–305.
  • Hall JW. (1992). Handbook of Auditory Evoked Responses. Boston: Allyn and Bacon.
  • Hood LJ. (1998). Clinical Applications of the Auditory Brainstem Response. San Diego: Singular.
  • Jerger JF. (1998). Controversial issues in central auditory processing disorders. Semin Hear 19:393–397.
  • Jerger JF, Jerger SW. (1974). Auditory findings in brainstem disorders. Arch Otolaryngol 99:342–349.
  • Jerger SW, Jerger JF. (1985). Audiological applications of early, middle, and late auditory evoked potentials. Hear J 38:31–36.
  • Jerger JF, Oliver T, Chmiel R. (1988). The auditory middle latency response. Semin Hear 9:75—85.
  • Jirsa RE. (1992). The clinical utility of the P3 AERP in children with auditory processing disorders. J Speech Hear Res 35:903—912.
  • Jirsa RE. (1996, November). Maximum Length Sequences in Children with Auditory Processing Disorders. Paper presented at the convention of the American Speech-Language-Hearing Association, Seattle, WA.
  • Jirsa RE, Clontz K. (1990). Long latency auditory event- related potentials from children with auditory processing disorders. Ear Hear 11:222—232.
  • Kraus N. (1996). The discriminating brain: MMN and acoustic change. Hear J 49:10–43.
  • Kraus N, McGee T. (1994). Auditory event-related potentials. In: Katz J, ed. Handbook of Clinical Audiology. 4th Ed. Baltimore: Williams and Wilkins, 403–423.
  • Kraus N, McGee T, Carrell T, King C, Tremblay K, Nicol TG. (1995). Central auditory system plasticity associated with speech discrimination training. J Cogn Neurosci 7:25–32.
  • Kraus N, McGee T, Carrell T, Zecker SG, Nicol TG, Koch DB. (1996). Auditory neurophysiologic responses and discrimination deficits in children with learning problems. Science 273:971–973.
  • Kraus N, McGee T, Ferre J, Hoeppner J, Carrell T, Sharma A, Nicol T. (1993). Mismatch negativity in the neurophysiologic/behavioral evaluation of auditory processing deficits: a case study. Ear Hear 14:223–234.
  • Lasky R, Perlman J, Hecox K. (1992). Maximum length sequence auditory evoked brainstem responses in human newborns and adults. J Am Acad Audiol 3:383–389.
  • Liegeois-Chauvel C, Musolino A, Badier J, Marquis P, Chauvel P. (1994). Evoked potentials recorded from the auditory cortex in human: evaluation and topography of the middle latency components. Electroencephalogr Clin Neurophysiol 92:204–214.
  • Lina-Granade G, Collet L, Morgon A. (1994). Auditory- evoked brainstem responses elicited by maximum-length sequences in normal and sensorineural ears. Audiology 33:218–236.
  • McDonald WI, Sears TA. (1970). The effects of experimental demyelination of conduction in the central nervous system. Brain 93:583–598.
  • McGee T, Kraus N. (1996). Auditory development reflected by middle latency response. Ear Hear 17:419–429.
  • Musiek FE. (1983). Results of three dichotic speech tests on subjects with intracranial lesions. Ear Hear 4:318–323.
  • Musiek FE. (1991). Auditory evoked responses in site of lesion testing. In: Rintelman W, ed. Hearing Assessment. 2nd Ed. Boston: Allyn and Bacon, 397–399.
  • Musiek FE. (2000, July). Diagnostic Issues and CAPD. Paper presented at Advances in Auditory Processing at Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire.
  • Musiek FE, Baran JA, Pinheiro ML. (1994). Neuroaudiology Case Studies. San Diego: Singular.
  • Musiek FE, Berge BE. (1998). How electrophysiologic tests of central auditory processing influence management. In: Bess F, ed. Children with Hearing Impairment. Nashville: Vanderbilt-Bill Wilkerson Center Press.
  • Musiek FE, Gollegly K, Lamb L, Lamb P. (1990). Selected issues in screening for central auditory processing of dysfunction. Semin Hear 11:372–384.
  • Musiek FE, Lamb L. (1992). Neuroanatomy and neurophysiology of central auditory processing. In: Katz J, Stecker N, Henderson D, eds. Central Auditory Processing: A Transdisciplinary View. St Louis: Mosby Year Book, 11–38.
  • Musiek FE, Lee WW. (1997). Conventional and maximum length sequences middle latency response in patients with central nervous system lesions. J Am Acad Audiol 8:173–180.
  • Musiek FE, Lee WW. (1999). Auditory middle and late potentials. In: Musiek FE, Rintleman WF, eds. Contemporary Perspectives in Hearing Assessment. Boston: Allyn and Bacon, 243–271.
  • Näätänen R. (1995). The mismatch negativity: a powerful tool for cognitive neuroscience. Ear Hear 16:6–18.
  • Nicolet Instrument Corporation. (1991). Nicolet Maximum Length Sequence (MLS) User’s Guide. Madison, WI: Nicolet.
  • Picton TW, Champagne SC, Kellett AJ. (1992). Human auditory evoked potentials recorded using maximum length sequences. Electroencephalogr Clin Neurophysiol 84:90–99.
  • Pinheiro ML, Ptacek PH. (1971). Reversals in the perception of noise and pure tones. J Acoust Soc Am 49:1778–1782.
  • Pratt H, Ben-David Y, Peled R, Podoshin L, Scharf B. (1981). Auditory brain stem evoked potentials: clinical promise of increasing stimulus rate. Electroencephalogr Clin Neurophysiol 51:80–90.
  • Pratt H, Shomer H. (1976). Intensity and rate functions of cochlear and brain stem evoked responses to click stimuli in humans. Arch Otorhinolaryngol 212:85–92.
  • Rasminsky M, Sears TA. (1972). Internodal conduction in undissected demyelinated nerve fibers. J Physiol 227:323–350.
  • Schwartz DM, Morris MD, Jacobson JT. (1994). The normal auditory brainstem response and its variants. In: Jacobson JT, ed. Principles and Applications in Auditory Evoked Potentials. Boston: Allyn and Bacon, 124.
  • Shanon E, Gold S, Himelfarb M. (1981). Assessment of functional integrity of brain stem auditory pathways by stimulus stress. Audiology 20:65–71.
  • Tallal P, Miller S, Bedi G, Byma G, Wang X, Nagarajan S, Schreiner C, Jenkins W, Merzenich M. (1996). Language comprehension in language learning impaired children improved with acoustically modified speech. Science 271:81–84.
  • Weber B, Roush J. (1995). Use of maximum length sequence in newborn screening. Am J Audiol 6:187–190.
  • Wilson RH. (1993). Development and use of auditory com- pact discs in auditory evaluation. J Rehabil Res 30:342–351.
  • Wilson RH, Preece JP, Salamon DL, Sperry JL, Bomstein SP. (1994). Effects of time compression and time compression plus reverberation on the intelligibility of the Northwestern University Auditory Test No. 6. J Am Acad Audiol 5:269–277.
  • Yagi T, Kaga K. (1979). The effect of the click repetition rate on the latency of the auditory evoked brainstem response and its clinical use for neurological diagnosis. Arch Otorhinolaryngol 222:91–97.