Relationships Between Newborn Frequency-Following Responses and Follow-up Measures of Language and Cognition in Neonates with Hyperbilirubinemia




Bilirubin-induced neurologic dysfunction (BIND) is a spectrum of central nervous system (CNS) disorders that frequently impacts auditory system development in infants. Bilirubin-related toxicity can have a profound effect on auditory system development, including hearing and language outcomes. Performance on traditional audiologic measures such as the click-evoked auditory brainstem response (ABR) have little relationship to the level of bilirubin in the bloodstream, suggesting that this tool may be suboptimal for identifying infants at risk for transient or sustained neurologic deficits. In contrast, we have demonstrated a negative relationship between transcutaneous bilirubin (TcB) levels and the speechevoked frequency following response (FFR), such that high TcB level is associated with a poorer frequency following response (FFR) to speech. This suggests that the FFR could be a tool to predict which children are at greatest risk for transient or sustained neurologic deficits. At present, however, it is unknown whether suboptimal encoding of speech signals (as determined by the FFR) in the first few weeks of life is related to future developmental delays in language and cognition. As a first step towards addressing this question, we collected follow-up sensory, language and cognition behavioral measures consisting of the Griffiths Scales of Child Development and the Gesell Developmental Observation test battery over a two-year post-test period in children diagnosed with hyperbilirubinemia and those without. Our hypothesis is that poor FFRs observed to speech signals in neonates will increase the likelihood of poor language and cognitive outcomes with increasing age. The results of this study will advance our understanding of neurologic deficits associated with preterm birth and exposure to high TB levels, and may help to identify which children are at higher risk for sustained deficits.

Document Type


Publication Date

Spring 1-27-2020

Publication Title

Association for Research in Otolaryngology 43rd MidWinter Meeting

Conference Dates

01/25/2020 - 01/29/2020

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