Auditory brainstem responses in autism: brainstem dysfunction or peripheral hearing loss?

The advent of electrophysiological techniques for audiologic and neurologic assessment in the late 60s has generated at least 11 auditory brainstem response (ABR) studies in autism designed to test the integrity of the auditory brainstem pathways. The results reported are contradictory, involving prolongation, shortening, and no abnormalities in central transmission latencies. When sample and methodological factors influencing the ABR are taken into consideration in the interpretation of results, the ABR data available at present can be seen as only suggestive, rather than supportive, of brainstem involvement in autism. Paradoxically, these studies revealed the presence of peripheral hearing impairment in a non-negligible number of autistic individuals. Additional evidence of auditory abnormalities as well as the implications for the clinician are considered.