SLPOtherEar and hearing2025

Let's See If You Can Hear: The Effect of Stimulus Type and Intensity to Pupil Diameter Response in Infants and Adults.

Amanda Saksida, Sašo Živanović, Saba Battelino and 1 others

PMID 40113591

WHAT IT FOUND

Pupil dilation increased to loud sounds in infants and adults, but classification models failed to reliably estimate individual hearing thresholds.

Background noise likely masked responses to quieter sounds, making pupillometry currently unsuitable for clinical threshold assessment.

Key findings

01Pupil dilation response increased to target sounds at the highest intensity level (70 dB) in both infants and adults, but models could not reliably estimate individual auditory thresholds.

02Classification accuracy did not correlate with stimulus intensity, preventing the creation of psychometric curves needed to determine hearing thresholds.

03High ambient noise levels in the testing environment likely compromised results at lower intensity levels, hindering the response to quieter sounds.

STILL TO COME

How it was doneWhat they foundWhat it means for SLPs

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What it does not show

Small sample sizes (36 infants, 36 adults) limit generalizability. High ambient noise levels in the testing room likely masked pupil responses to quieter sounds, preventing assessment of low-level hearing. Classification models appeared to detect non-auditory regularities in pupil data, as they performed well even when trial types were randomized. The study only included normally hearing participants, so it does not show how pupillometry performs in people with hearing loss.

Declared interests

Funded by the Italian Health Ministry and Associazione Italiana Liberi di Sentire. No commercial conflicts of interest reported.

The easy way to misread this

Do not interpret the high classification accuracy reported in the models as evidence that pupillometry can diagnose hearing loss. The authors showed that these models also performed well when the sound categories were randomized, indicating the accuracy was likely driven by non-auditory patterns in the data rather than true detection of sound thresholds.

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