Babies and very young children cannot reliably respond to conventional hearing tests. If an infant does not react consistently to sound or does not pass a newborn hearing screening, a BERA test can provide objective information about the auditory pathway.
BERA stands for Brainstem Evoked Response Audiometry. It is also called an Auditory Brainstem Response or ABR test. The assessment records how sound signals travel through the hearing nerve and brainstem without requiring the child to press a button, raise a hand or give a spoken answer.
How is a BERA test performed?
Small earphones are placed in or over the child’s ears. Gentle clicking sounds or tones are then presented. Soft electrodes attached to the head and around the ears record the electrical activity generated as the sound travels through the auditory system.
The electrodes only record responses. They do not send electricity into the child’s body, and their placement is generally painless.
A computer analyses the recorded wave patterns. These patterns help the clinician estimate hearing sensitivity and assess whether sound signals are travelling normally through the hearing nerve and brainstem.
When may a child need BERA testing?
A paediatric ENT specialist may recommend the test when:
- A newborn does not pass the initial hearing screening
- Parents notice limited or inconsistent reactions to sound
- Speech and language development appear delayed
- Routine behavioural hearing tests are inconclusive
- The child cannot cooperate with standard audiometry
- There is a family history of childhood hearing loss
- The child has experienced medical complications associated with hearing risk
- Hearing loss is suspected in one ear
- Auditory neuropathy requires investigation
Not passing a screening test does not automatically confirm permanent hearing loss. Temporary middle-ear fluid, movement during testing or technical factors can affect screening results. A diagnostic BERA test provides more detailed information.
Does the child need to sleep?
The child must remain still because body movement can interfere with the recording. Newborns and young infants may complete the test while sleeping naturally. Parents may receive instructions to keep the baby awake before the appointment and feed the baby shortly before testing.
Older infants and children may occasionally need medically supervised sedation if natural sleep is unlikely to last long enough. The decision depends on the child’s age, ability to remain still and the expected duration of the assessment.
If sedation is planned, parents must carefully follow the fasting and preparation instructions given by the medical team.
What can the results indicate?
BERA findings may help identify:
- Normal auditory responses
- Possible hearing loss
- Differences between the two ears
- An estimated degree of hearing impairment
- Difficulty in neural transmission of sound
- The need for further hearing investigations
The results are normally interpreted alongside the child’s birth history, medical records, ear examination and other hearing tests. A single result should not be considered separately from the complete clinical picture.
Families in Dadar and surrounding parts of Mumbai can consult Dr. Milind Navalakhe at Dr. Navalakhe ENT Clinic when a child has suspected hearing difficulty. Carrying newborn screening reports, previous prescriptions and relevant hospital records can support a more complete evaluation.
Early hearing assessment matters because consistent access to sound supports speech, learning and social development. Prompt identification enables families to understand the child’s needs and plan appropriate medical, hearing or communication support.
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