Modified T(2) Statistics for Improved Detection of Aided Cortical Auditory Evoked Potentials in Hearing-Impaired Infants

The cortical auditory evoked potential (CAEP) is a change in neural activity in response to sound, and is of interest for audiological assessment of infants, especially those who use hearing aids. Within this population, CAEP waveforms are known to vary substantially across individuals, which makes detecting the CAEP through visual inspection a challenging task. It also means that some of the best automated CAEP detection methods used in adults are probably not suitable for this population. This study therefore evaluates and optimizes the performance of new and existing methods for aided (i.e., the stimuli are presented through subjects’ hearing aid(s)) CAEP detection in infants with hearing loss. Methods include the conventional Hotellings T(2) test, various modified q-sample statistics, and two novel variants of T(2) statistics, which were designed to exploit the correlation structure underlying the data. Various additional methods from the literature were also evaluated, including the previously best-performing methods for adult CAEP detection. Data for the assessment consisted of aided CAEPs recorded from 59 infant hearing aid users with mild to profound bilateral hearing loss, and simulated signals. The highest test sensitivities were observed for the modified T(2) statistics, followed by the modified q-sample statistics, and lastly by the conventional Hotelling's T(2) test, which showed low detection rates for ensemble sizes <80 epochs. The high test sensitivities at small ensemble sizes observed for the modified T(2) and q-sample statistics are especially relevant for infant testing, as the time available for data collection tends to be limited in this population.