Auditory brainstem response
Informed by recognized medical guidance
Overview
Auditory brainstem response (ABR) is a hearing test that checks how well the hearing nerve and brainstem respond to sound. It does not require you to say anything – you simply relax or sleep while earphones play sounds and sensors on your head measure the brain’s response.
Key facts
- It is painless and non-invasive – nothing is inserted into your ear canal or body.
- It is often used for newborn hearing screening and for adults who cannot complete standard hearing tests.
- The test can detect hearing loss and also help diagnose certain brainstem disorders.
ABR testing is a standard part of newborn hearing screening in many countries. It is also used for adults when a regular hearing test is not possible.
Anyone may have an ABR test, especially newborns, young children, and adults who cannot reliably respond in a hearing booth. It is also used for people with suspected brainstem problems.
Symptoms
- Sudden hearing loss in one or both ears
- Hearing loss accompanied by severe dizziness, facial weakness, or sudden ringing
- ⚠Hearing loss after a head injury
- ⚠New hearing problems in a child who previously responded to sounds
Common symptoms
- Difficulty hearing in noisy places
- Trouble understanding speech, especially on the phone
- Ringing in the ears (tinnitus)
Symptoms in children
- Not startling or turning to sounds
- Delayed speech or language development
- Frequent ear infections or ear pulling
Symptoms in older adults
- Gradual hearing loss that makes conversations hard
- Feeling that people are mumbling
- Turning up the TV or radio louder than others prefer
Causes
Main causes
- Hearing loss from birth (congenital) due to genetic factors or infections during pregnancy
- Damage to the hearing nerve (auditory neuropathy)
- Brainstem disorders such as multiple sclerosis or stroke affecting hearing pathways
Risk factors
- Premature birth or low birth weight
- Family history of hearing loss
- Certain infections during pregnancy, like rubella or cytomegalovirus
When to see a doctor
See a doctor urgently if:
- Sudden hearing loss in one or both ears
- Hearing loss with symptoms like dizziness, facial numbness, or difficulty walking
Book a routine appointment if:
- If your child fails a newborn hearing screening
- If you notice gradual hearing changes that affect your daily life
Diagnosis
An ABR test is performed by an audiologist or a doctor. You lie down or sit comfortably, small sensors (electrodes) are placed on your head and behind your ears, and you wear earphones that play clicks or tones. The test measures the electrical signals from your hearing nerve and brainstem.
Tests that may be done
- Auditory brainstem response (ABR) test
- Pure-tone audiometry (a standard hearing test)
- Otoacoustic emissions (OAE) test – checks the inner ear’s response to sound
What to expect at your appointment
The test is painless. You will need to keep still and may even fall asleep. For babies, the test is often done while they sleep naturally or after mild sedation. It usually takes one to two hours.
Treatment
If the ABR test detects hearing loss, treatment depends on the cause. Options range from hearing aids and cochlear implants to medical or surgical treatment for underlying conditions. Early intervention gives the best results.
Self-care at home
- Protect your ears from loud noises by wearing earplugs or earmuffs
- Keep your ears dry and avoid inserting objects like cotton swabs
- Clean hearing aids or assistive devices as recommended
Medical treatments
For some types of hearing loss, doctors may recommend hearing aids, cochlear implants, or medication to treat infections or inflammation. Always follow your healthcare provider’s advice – never take medication without a prescription.
When is surgery considered?
Surgery may be considered for conditions like otosclerosis (abnormal bone growth in the middle ear) or if a cochlear implant is needed. Your doctor will discuss the risks and benefits with you.
Living with this condition
If you have hearing loss, using hearing aids or other devices can help you communicate. Learning lip reading or sign language may also be helpful. Many people find it useful to let friends and family know about their hearing needs.
Lifestyle tips
- Use hearing protection in noisy environments like concerts or construction sites
- Keep your hearing aids or devices clean and dry
- Join a hearing loss support group to share tips and experiences
Diet and exercise
A balanced diet and regular exercise support overall health, but they do not directly improve hearing. Staying active can help reduce the risk of conditions linked to hearing loss, like diabetes and heart disease.
Mental health and emotional wellbeing
Hearing loss can sometimes lead to feelings of isolation, frustration, or sadness. It is important to talk to a counsellor or a trusted friend if you feel this way. Support groups and mental health services can help.
Prevention
Not all hearing loss can be prevented, but you can lower your risk by avoiding loud noise, treating ear infections promptly, and managing chronic conditions like diabetes.
Vaccines
Vaccines against illnesses such as meningitis, rubella, and mumps can prevent some causes of hearing loss.
Screening programmes
Newborn hearing screening using ABR is common and helps detect hearing loss early, allowing for prompt treatment.
Complications
If left untreated
- Delayed speech and language development in children
- Social isolation and depression in adults
- Difficulties at school or work that can affect learning and job performance
Long-term outlook
With early detection and proper treatment, most people with hearing loss can lead full, active lives. Many treatments are very effective, and support services are available to help you thrive.
Find support
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Always verify with your doctor
Health guidelines vary by country and region. The information in this article is based on international clinical guidelines but may not reflect the specific guidelines, medications, or practices in your country. Always discuss your health concerns with your own doctor or healthcare provider, and refer to your local national health guidelines where available.
Important notice This information is for educational purposes only. It does not replace professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider about your specific situation. If you are experiencing a medical emergency, call your local emergency services immediately.
Related conditions
Sources and guidance
This article is educational and is prepared with reference to recognized health information and clinical guidance sources where available. Specific source links may vary by topic.
Last updated: July 16, 2026
Educational note: This information is for education only and is not a diagnosis.
Use it to support, not replace, advice from a licensed clinician.
If symptoms are severe, worsening, or urgent, call your local emergency number or seek emergency care.
Guidance may differ by country or region. Confirm local recommendations with a qualified healthcare provider.