Auditory Brainstem Response Evaluation

An auditory brainstem response (ABR) test is a sleep hearing test that is used to estimate hearing sensitivity. ABR recordings are used to evaluate how sound travels along the hearing nerve from the ear to the brainstem. An ABR can identify the presence, type, and degree of hearing loss your child is experiencing. This test is not painful, nor uncomfortable, but it is necessary for your child to sleep during the test so our team can obtain clear responses. 

Your child will need to have an ABR completed by a member of our Audiology Program team if they:

• Did not pass the newborn hearing screening at the birth hospital
• Passed their newborn hearing screening but have risk factors for hearing loss
• Are older than 6 months and unable to complete a behavioral hearing test

It is best to schedule a natural sleep ABR evaluation within 21 days after your child is born, but these tests are often completed up to 6 months of age. Older patients who are able to rest quietly may have natural sleep ABRs completed to rule out auditory neuropathy spectrum disorder, retrocochlear pathology, and non-organic hearing losses. When ABR testing is administered after your child is 6 months old, sedation or general anesthesia may be considered.
 

Bring your child hungry and very tired, but not yet sleeping. It is helpful to have another adult keeping your baby awake during the drive to the appointment. The audiologist will bring you to the test room at the scheduled time. Then, you may feed your baby in a rocking chair. Testing will begin once your baby falls asleep. Please bring anything that will help your baby fall asleep, including swaddles, blankets, diapers, pacifiers, and extra milk.

• Please arrive 15 minutes before the appointment time to check in and complete paperwork.
• Please do not bring siblings to the appointment unless there is another adult who can stay with them in the waiting room.
• Please do not use lotion or cream on your child’s face, scalp, or ears on the day of the evaluation.

Before your child’s ABR begins, we’ll ask you to completely power off any electronic devices — or leave them outside of the testing room — so they don’t interfere with the test. If you’d like, you can bring a book or magazine to read.

It’s important for your child to be sleeping, quiet, and still for the entire ABR test. You or another caregiver can choose to hold your child throughout the test, or they can sleep in their car seat or stroller.

During the test, the audiologist will clean the skin on your child’s forehead and behind their ears, then place special stickers in both of those areas. They’ll also place small earphones in your child’s ears. The audiologist will then present different sounds to your child through the earphones and measure the response from the hearing nerve, all while your child is sleeping.

Testing may last up to two hours. Immediately after the ABR is completed, the audiologist will discuss the results and recommendations with your family.

Boston Children’s Hospital offers ABR testing with sedation and general anesthesia when hearing sensitivity cannot be confirmed via behavioral test methods, or through natural sleep/awake ABR testing.

Your child must have established care with an audiologist at Boston Children’s to proceed with any ABR testing under sedation or general anesthesia. This is so that your child’s team can determine necessity of testing and review the process and procedure for this type of assessment at Boston Children’s.

If your child doesn’t have established care with an audiologist at Boston Children’s, they will need to be seen for an assessment in the outpatient audiology clinic. You can schedule an appointment by contacting Audiology Program scheduling at 617-355-6461.

If your child is determined to be a candidate for this type of testing, the audiologist will provide further information at their visit.