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Auditory Brainstem Response Hearing Tests

It is important to test hearing on even the littlest ears. At Brenner Children's Hospital, our audiologists use objective test measures to assess hearing for newborn babies, infants and young children who are not old enough or developmentally ready for behavioral testing. 

We use a method called Auditory Brainstem Response (ABR) testing, also known as auditory evoked potential testing, which allows us to estimate hearing levels based on neurological activity in the auditory system. Sounds are introduced through earphones while electrodes area placed on the child's head to measure brainstem electrical activity. ABR is a pain-free test but requires that the patient be very still or asleep. Sedated testing is available if necessary.

Newborn Hearing Screening

Our audiologists manage newborn hearing screening at Brenner Children's Hospital. Newborn hearing screening is required for all infants born in North Carolina. Full term babies can be tested in the first 24 to 48 hours of life, and premature infants should be at least 34 weeks post-conception before testing.

Newborns undergo hearing screening using an automated form of the ABR test called Automated Auditory Brainstem Response testing. The test is quick and pain free. Electrodes are placed on the baby's forehead and behind the ears to record neural responses to sound. It is important that the baby sleep during this test.

If a baby fails the screening, the test is repeated once. Possible reasons may include having debris in the ear canal, middle ear fluid, or more permanent hearing loss. If the baby fails again, we perform diagnostic testing.

Diagnostic ABR Test

Diagnostic ABR testing is performed when an infant fails to pass the newborn hearing screening after at least two attempts. Diagnostic ABR testing can also be performed on children when hearing cannot be reliably evaluated with routine behavioral test methods or other objective tests. ABR testing is available using both clicks and tone bursts to estimate hearing at different frequencies. The hearing levels and ABR response characteristics can help establish the degree and type of hearing loss, and if medical management or hearing aids are needed.