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Auditory Brainstem Response Explained
Pediatric Ear, Nose & Throat of Atlanta, P.C.
BY: Avni
What is Auditory Brainstem Response (ABR) Evaluation? Auditory
Brainstem Response, most commonly abbreviated as ABR, is a test that
evaluates how well the sound travels from the ear to the level of the brainstem.
ABR responses are recorded by placing 3-4 stickers called electrodes on the
child’s head and behind the ears, stimulating the ear with brief auditory signals
via earphones.
By placing electrodes on the child’s head, the ABR is testing neural synchronysynchronous electrical activity of many neurons firing at the same time
from areas within the cochlea, 8th nerve, and the brainstem in response to
an auditory stimulus (Crumley, 2011). This synchronization allows clinicians
to mark neural responses on the waves recorded in response to stimulation
presented at different intensity levels across low and high frequencies. The
lowest level at which neural responses are obtained is considered the threshold
of hearing for that particular frequency (Hood, 1995).
Patankar, AuD, CCC-A
What are the preparations required prior to seeing an Audiologist for an
ABR evaluation under natural sleep?
THE ABR APPOINTMENT WILL TAKE ABOUT 2 HOURS.
IT IS VERY IMPORTANT FOR THE BABY TO SLEEP
THROUGHOUT THE ABR TEST. THE BEST WAY TO
PREPARE A BABY IS TO KEEP HIM OR HER HUNGRY
AND TIRED PRIOR TO THE APPOINTMENT.
Try to keep the baby awake and avoid feeding until the time of the appointment
or until the Audiologist has prepared for the test. It is recommended to bring a
blanket or anything that provides comfort to the baby during a nap.
What does it mean when the test results are abnormal? What are the
next steps? When test results are abnormal, the Audiologist will be able to
provide more details regarding the child’s hearing upon completion of the
ABR. Abnormal test results are mostly associated with a hearing loss that
needs further follow-up. The next steps would include a follow-up with the
Audiologist and with an Ear, Nose, & Throat (E.N.T) physician for medical
work-up of the hearing loss.
What is The Universal Newborn Hearing Screening and Intervention
(UNHSI) Program? UNHSI is a program that ensures that all babies born in
Georgia are screened for hearing loss at birth. UNHSI requires a re-screen
either at the hospital prior to discharge or as an outpatient visit for babies who
do not pass the initial hearing screen. UNHSI recommends that a diagnostic
ABR appointment be scheduled for all babies who do not pass the re-screen
for identification of hearing loss as early as possible. Diagnostic ABR testing
should be completed by 3 months of age according to UNHSI protocol.
When should I refer a patient for an AABR screen vs. diagnostic ABR? A
newborn baby should be referred for AABR screen if the baby has not had
an initial hearing screen at the hospital or has referred in one or both ears
during the initial screen.
What is the difference between screening ABR and diagnostic ABR?
Automated Auditory Brainstem Response (AABR) is used as a screening test
in newborn babies. Newborn babies are screened for hearing loss prior to
hospital discharge. Screening tests are performed using one loudness level and
the baby either passes or fails the screen. Newborns or infants who do not
pass the initial screen are re-screened either prior to discharge or as a separate
visit. Infants not passing in one or both ears after two screening attempts are
referred for a diagnostic ABR evaluation to further evaluate their auditory
function at different loudness levels across frequencies.
On whom can this test be performed? ABR can be recorded in newborns,
infants, children, and adults. ABR test is performed while the patient is asleep
or resting quietly as noise and movement can affect test results. If the child
is younger than 4-5 months, ABR can most likely be done while the child is
asleep. ABR testing under sedation is recommended for patients who are
unable to sleep naturally or rest quietly for the duration of the test. Sedated
ABR testing is also recommended on older children for whom there is a
concern or suspicion of hearing loss that could not be confirmed through
standard hearing test procedure.
A diagnostic ABR referral should be made if the baby refers in one or both
ears at the re-screen for further evaluation of hearing and identification of
hearing loss.
How can I schedule an appointment at PENTA? We offer non-sedated
diagnostic ABR services at the Marietta, Alpharetta, and the Atlanta-Scottish
Rite locations. We also offer screening AABR services at the Marietta location.
APPOINTMENTS CAN BE MADE BY CALLING OUR
APPOINTMENT LINE AT 404.255.2033.
RESOURCES:
Georgia Universal Newborn Hearing Screening and Intervention Program- http://health.
state.ga.us/programs/unhs/
American Speech-Language-Hearing Association (ASHA)
Children’s Hospital of Pittsburgh-Auditory Brainstem Response Test
Crumley, W. (2011). Good practices in auditory brainstem response, part 1. Retrieved
August 28, 2013, from www.audiologyonline.com
Hood, L. (1995). Estimating auditory function with auditory evoked potentials. The
Hearing Journal, 48(10), P32-42.
WE ARE ONE OF THE L ARGEST PRIVATE PEDIATRIC EN T/
AUDIOLO GY PROVIDERS IN THE COUN TRY.
EXCELLENCE IN
PEDIATRIC
AUDIOLOGY.
Our audiologists provide specialized care
to children from birth to 18 years of age.
All patients receive services from licensed
audiologists who have experience in
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will be cared for by a compassionate and
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REFER YOUR PATIENTS FOR
ANY OF OUR COMPREHENSIVE
AUDIOLOGY SERVICES:
• Auditory Brainstem Response Testing
• Otoacoustic Emissions Testing
• Follow up testing after a failed newborn
hearing screening
• Traditional Hearing Tests
• Hearing Aid Fittings
• Cochlear Implant Services
• Swim plugs and Musician’s Ear Plugs
DIRECTOR’S
CORNER
A SUCCESS STORY
BY:
Lisa Matesevac, Au.D.
DIRECTOR
OF AUDIOLOGY
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Making patient referrals should be quick and
painless. And, here at PENTA it is just that.
Our renowned Audiology team truly cares
about the well-being of your patients and
their families and is dedicated to the longterm success of every patient you refer to us.
Let our team simplify your next referral
with just one call knowing your patients will
receive only the highest level of care with the
knowledge and experience you deserve.
Cochlear Implants:
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The surgical team at PENTA has completed
over two hundred successful cochlear implant
surgeries, and we provide cochlear implant
programming services to hundreds of children
throughout Georgia and the southeast.
We work with all the major cochlear implant
device manufacturers as we feel “choice” is
important in the device each child receives.
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at Children’s Healthcare of Atlanta, one of the
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5455 Meridian Mark Road NE . Suite 130
Atlanta,
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3300 Old Milton Parkway . Suite 275
Alpharetta,
Georgia 30005
MARIETTA
355 Tower Road . Suite 201
Marietta, Georgia 30060
404.255.2033 TO SCHEDULE APPOINTMENTS
404.591.1884 AUDIOLOGY DIRECT
5455 Meridian Mark Road NE . Suite 130
Atlanta, Georgia 30342
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