Hearing Test for Newborns: Auditory Brainstem Response (ABR) Evaluation Using Natural Sleep

Nearly every baby born in a hospital in the United States is screened for hearing loss before leaving the hospital. All 50 states, the District of Columbia and Puerto Rico have newborn hearing screening programs. Infants who do not pass their newborn screening will require further diagnostic hearing testing before they are 3 months old. 

The Auditory Brainstem Response (ABR) evaluation is a painless test that allows an audiologist to measure your baby’s hearing sensitivity and it is the test recommended for babies who do not pass their newborn hearing screening or for whom there is a concern about hearing.

Your baby must be in a deep sleep during the test. To accomplish this, we recommend that you try the following:

• Wake your baby earlier than usual before leaving the house.
• Keep your baby awake on the way to the hospital and in the waiting room prior to testing. Having a second adult who can sit in the backseat of the car with your baby may be helpful.
• If your baby has a scheduled feeding, wait until you are brought into the room for testing to feed them.

Once you arrive at the Department of Audiology at Children's Hospital of Philadelphia (CHOP), the audiologist will bring you and your baby to a quiet room where the testing will be performed. The skin on your baby’s forehead and behind each ear will be cleaned and small sticker sensors will be placed. At this time, lights will be dimmed and you will be given time to feed/soothe your baby so he/she can go to sleep. If you would like, you can hold your baby throughout the test procedure.

Once your baby is asleep, small foam earphones will be placed in the ears and the sensors will be attached to the audiologist’s computer. Sounds will be played through the earphones and the computer will record the hearing nerve’s response to the sounds in each ear. Any movement, such as sucking or eye blinking will interfere with the audiologist’s ability to interpret responses and complete testing.

The appointment length is typically two hours, but the time needed to complete testing will depend on many factors, including how well your baby sleeps. When testing is completed, the audiologist will explain all of the results and provide you with any additional recommendations and resources.