BERA Hearing Test in Children with Hearing Loss
                     BERA Hearing Test in Children with Hearing Loss
Brainstem Evoked Response Audiometry (BERA) is also known as Auditory Brainstem 
Response (ABR), Brainstem Auditory Evoked Response (BAER), Evoked Response 
Audiometry (ERA), and Brainstem Auditory Evoked Potential (BAEP). It is an objective test 
that determines how electrical waves go from the 8th cranial nerve to the brainstem in 
response to click sounds delivered through the ear.
The BERA hearing test is designed to assess hearing in children who are at high risk of 
hearing loss and cannot be tested using standard audiometry. BERA (Brainstem Evoked 
Response Audiometry) is an objective neurophysiologic test that aids in the diagnosis of 
retro cochlear lesions and hearing threshold in children. The BERA test for hearing helps 
in the early detection of lesions such as multiple sclerosis, trauma, vestibular 
schwannoma, etc. The BERA test for adults and children is a non-invasive technique that 
can be easily recorded and is not affected by sedation.
Why is the BERA Hearing Test Beneficial for Children?
Hearing loss affects the speech, cognitive, language, emotional, and social issues of 
children; early detection of hearing loss in children at a young age supports development 
and growth.
• The BERA test for hearing determines the location of the hearing problem, the type of 
impairment, and the hearing threshold (degree) of hearing loss in your children.
• It helps individuals with a single or asymmetrical hearing impairment by employing 
otoneurologic diagnosis in addition to evaluating hearing threshold.
• The BERA hearing test identifies the causes of hearing impairment in your children.
Procedure of the Brainstem Evoked Response Audiometry (BERA) Test
1. The steps involved in the procedure of the Brainstem Evoked Response Audiometry 
(BERA) hearing test are as follows:
2. The BERA test is typically administered to children while they are sleeping by 
audiologists.
3. The stimulus is delivered in the form of a click sound or tone pip via earphones and 
headphones. These stimuli have a frequency range of 1000–4000 Hz and vary in loudness.
4. The brainstem generates waveforms of impulses in response to sound stimuli.
The electrodes that are positioned across the skull at various locations record these 
waveforms as follows:
• A non-inverting electrode is placed over the apex of the head, which is the most 
conspicuous position at the back of the head.
• Each ear lobe or mastoid prominence receives an inverting electrode, which raises the 
bony firmament behind the ear.
• An earthing electrode is placed over the ear.
5. Through various electrical procedures, the generated waveforms are amplified, which 
makes the recording of waveforms easy.
6. The waveform’s peaks are identified as Wave I through Wave II.
7. Usually, there is a 10-millisecond time interval between the waveform and the click 
stimulus.
8. In different positions and polarities, various readings can be recorded and annotated.
The waves that are recorded are forwarded for interpretation.
Indications of a BERA Hearing Test
For young children, the BERA hearing test is recommended:
1. The BERA test detects pathologies from the vestibulocochlear nerve to the brainstem, 
allowing the source of the hearing problem to be identified.
2. Asymmetrical hearing loss occurs when one ear experiences more loss than the other.
3. A hearing screening test for children who are intellectually impaired, hyperactive, and 
have other conditions would not respond to conventional audiometry.
4. As a hearing test for infants who are highly susceptible to hearing loss, like:
•Those with a family background of congenital hearing loss
•High bilirubin levels, or hyperbilirubinemia
•Malformations (deformities) of the face and head
•Head injury
5. Abnormalities in the nervous system and possible acoustic neuromas, a benign 
tumour of the VIII cranial nerve.
Results of the BERA Hearing Test
The brainstem produces the auditory evoked potential signals, which are recorded in 
waves with peaks and troughs. Waves I, II, and III are the peaks recorded from the 
electrode at the vertex.
Conclusion
When a child’s auditory nerve can transmit sound impulses from the ear to the brain at 
a certain speed, they have healthy hearing. The BERA hearing test provides you with 
information on whether your child’s nerves convey sound impulses to the brain and 
whether the speed of sound delivery is within normal limits or not. 
The BERA hearing test aids in the identification of hearing abnormalities, hearing 
thresholds, and hearing loss in children. Hearing aid selection and fitting in children with 
hearing loss improves their hearing, which leads to their overall development and 
growth.
Source link: https://www.ashaspeechhearingclinic.com/bera-hearing-test-in-children-
with-hearing-loss/