Pediatric auditory brainstem response (ABR)

What is a pediatric auditory brainstem response (ABR) test?

An auditory brainstem response (ABR) test measures auditory nerve reactions in response to sounds. An ABR is not a hearing test itself, but it can be used to detect hearing loss in infants and very young children. Only about 3% of babies are referred for further testing following an ABR test.

Auditory brainstem response tests measure a child’s hearing threshold over several frequencies. Audiologists can test and record by introducing low amplitude sounds into a child’s ear (or through bone conduction—BCABR) and the results are recorded to a computer.

An audiologist may recommend your child for an ABR test due to the findings of an otoacoustic emissions (OAE) screening or other hearing test. Children who aren't old enough for behavioral tests such as visual reinforcement or conditioned play audiometry may also be referred for an ABR test.

Some children – such as infants or those with developmental delays – are not able to have their hearing tested effectively with traditional behavioral tests. The auditory brainstem response (ABR) test is a painless test that measures your child’s hearing nerve’s response to sound. It can also tell doctors that each individual ear is working normally or, if not, what the level of hearing loss is.

What are the risks of a pediatric auditory brainstem response (ABR)?

Despite the gadgets needed for ABR/BCABR tests (electrodes, earphones/headphones), they are non-invasive and completely safe. The procedure takes an hour or two while your child sleeps.

What can I expect with the a pediatric auditory brainstem response (ABR)?

Auditory brainstem response (ABR)

The audiologist places small, sterilized electrodes (“stickers”) on your baby’s forehead and ears. The electrodes are connected to a computer that reads EEG activity. Earphones with neonatal ear tips (inserts) go inside your baby’s ear canals. The audiologist will play either “clicks” or a “tone burst” through the earphones.

• Clicks are a series of electronic impulses that cover a broad range of frequencies. Clicks are adequate for a hearing screening but they can’t measure information that is specific enough to prescribe hearing aids.

• Tone burst is a constant electrical signal. It usually provides the audiologist with enough information to recommend treatments.

Bone conduction auditory brainstem response (BCABR)

Bone conduction auditory brainstem response (BCABR) works in much the same way as standard ABR. In BCABR, bone conduction headphones replace the earphones. BCABR measures auditory responses by stimulating the cochlear.

What can I expect during the pediatric auditory brainstem response (ABR)?

While your child sleeps, the audiologist will place electrodes on your child’s forehead and ears, which send EEG readings to a computer. Low amplitude clicks and tone bursts are sent through the air (earphones) or bone conduction (headphones) to test your baby’s hearing threshold across a range of frequencies.

What can I expect after the pediatric auditory brainstem response (ABR)?

Once the audiologist finishes collecting data, she will tell you if your child's hearing is fine or if he needs further testing. Only about 3% of infants are referred on for other hearing tests.

How do I prepare my child for the pediatric auditory brainstem response (ABR)?

The best way to make sure your baby sleeps through the ABR test is to make sure they are tired and hungry. Parents should keep children up late the night before the appointment and wake them up early.

The key is to make sure your baby is ready for a feeding and a nap at the time of the appointment. He/she will sleep either in a crib or your arms for the duration of the test. Children older than 6 months usually need sedation so they can sleep through the test.

What are the prep instructions before the pediatric auditory brainstem response (ABR)?

Your baby should be tired and hungry prior to the test. You should keep her up late and wake her early so she’s ready for a nap during the appointment.