Through examples, this article describes how particular aspects of auditory brainstem responses can portray certain kinds of language or communication impairments – a characteristic pattern or ‘neural signature’. A reduction in processing of the fundamental frequency is seen commonly in dyslexia, impaired pitch tracking ability is seen in the context of autistic spectrum disorder and pervasive delays across all measures are observed in older subjects with an otherwise clinically normal audiogram. In addition, there are neural signatures that are characteristic for those subjects with hearing expertise, such as musicians and bilingual language speakers who have enhanced response consistency and earlier peak timing. An individual’s neural signature takes into account lifetime experiences therefore, such variation in auditory brainstem responses as mentioned above may be superimposed upon each other giving a unique picture for that individual, for example, a dyslexic bilingual subject. Whilst neural signatures may enhance the broad interpretation of auditory brainstem responses as recognisable patterns, ultimately, detailed analyses will still rely on interpretation of pure threshold values.