The Auditory Brainstem Response (ABR) and how it relates to hearing loss

Traditionally, when people think about hearing tests they imagine sitting in a sound booth and raising their hands to beeps. But how do people who cannot raise their hands or press a button get a hearing test?

Some people are able to participate in other behavioral testing using conditioned responses to sound. This can look like turning the head to a sound or participating in an action-based game to sound. 

But there are populations of people who cannot do any behavioral testing. This can include infants, people with developmental delays, or physical limitations that prevent traditional testing methods. So what is done for these people if they are suspected to have a hearing loss?

These people or infants will typically have an auditory brainstem response or ABR test performed. These tests can measure the brain’s response through the auditory pathway as it relates to the sound being presented. 


How is the test performed?

Licensed professionals perform this ABR examination over a long period of time (different facilities have different appointment lengths but are generally longer than an hour). The best results are obtained when the patient is in natural or sedated sleep. A professional will place electrode stickers on the person or infant, and insert headphones or another transducer to present ear-specific sounds in the ears. 

The professional will present several different types of stimulations and find thresholds based on the brain waveforms that present themselves on the testing screens. The auditory brainstem response is recorded in relation to the presented sound and different loudness levels. 

The professional will need to examine the waveforms at the end of the test able to determine if there is any hearing loss and the best treatment plan. 


Who performs this test?

Only licensed professionals can perform an ABR test. 


How accurate is an ABR test? 

This test is fairly close to behavioral testing results. It should be noted that behavioral testing is more accurate when fitting a hearing aid but correction factors are used for ABR tests to allow for close reliability. 


If you have any questions about your hearing see your local hearing care professional