We review evidence for a high degree of neuroplasticity of the central auditory pathways in early childhood, citing evidence of studies of the P1 and N1 cortical auditory evoked potentials in congenitally deaf children receiving
cochlear implants at different ages during childhood, children with
auditory neuropathy spectrum disorder and children with
hearing loss and comorbid multiple disabilities. We discuss neuroplasticity, including cortico-cortical de-coupling and cross-modal re-organization that occurs in
deafness. We provide evidence for the clinical utility of the P1 cortical auditory evoked potential (CAEP) as a non-invasive
biomarker that can be used to objectively assess maturation of auditory cortex in clinical cases of
cochlear implant patients and candidates. Finally, we present clinical case studies in which the P1 CAEP
biomarker proved useful in clinical decision-making regarding intervention in cases of single-sided
deafness,
auditory neuropathy spectrum disorder, mild
hearing loss and hypoplastic auditory nerve.