TL: DR;
This blog is designed for parents of newborns and children with hearing or speech concerns, adults experiencing hearing-related symptoms, and anyone advised by an ENT specialist or audiologist to undergo a BERA test.
- Explains the purpose and procedure of the BERA test: The blog clearly describes BERA (Brainstem Evoked Response Audiometry) as a safe, painless, non-invasive hearing test that evaluates how the auditory nerve and brainstem respond to sound.
- Highlights when the BERA test is recommended: It outlines common situations in which the test is needed, including a failed newborn hearing screening, delayed speech development, unexplained hearing loss, tinnitus, vertigo, and suspected auditory nerve disorders.
- Simplifies understanding of BERA test results: The article explains how audiologists interpret brainstem waveforms, what normal and abnormal results may indicate, and why BERA findings are combined with other clinical assessments for accurate diagnosis.
- Builds trust in Resonnocare’s hearing care services: The blog emphasizes Resonnocare’s experienced audiologists, advanced diagnostic equipment, personalized care plans, home visits, video consultations, hearing aid guidance, and long-term aftercare support.
Hearing loss tends to happen gradually and be overlooked. However, if your doctor recommends a BERA test, you may have many questions to answer. What is the test? Why is it needed? Is it painful? What is the meaning of the results?
When you don’t know what to expect, uncertainty can only make it feel more stressful than it’s supposed to be.
At Resonnocare, we help make hearing care accessible. This guide offers an overview of the BERA test, how it is administered, why you may be recommended to have it, and what happens after.
What Is a BERA Test?
BERA assesses the brainstem’s reaction to sound. It is also referred to as the Auditory Brainstem Response (ABR) and is one of the most sensitive non-invasive hearing tests used in modern audiology.
BERA is a test that examines the function of your auditory nerve and brainstem. Once sound is detected, it is transmitted along the auditory nerve to the brainstem. These responses are assessed using tiny electrodes placed on the forehead and the backs of the ears during the BERA. What emerges is a series of waveforms that reflect the brain’s response to sound at specific locations along the auditory pathway.
A key benefit of the BERA test is that it is non-invasive and does not require the patient’s active cooperation. Since the test is performed while the patient is in deep sleep, it is especially useful for infants, children, or individuals who may not be able to participate in regular hearing tests.
Why Is the BERA Test Done?
The BERA test has a number of clinical uses. In these situations, our audiologists at Resonnocare may recommend it:
- Newborn and infant hearing screening: The BERA test is used regularly for infant hearing loss screening in the first few days after birth. The key to early intervention is early detection of hearing loss.
- The BERA test, an objective hearing function test that does not rely on the child’s ability to follow instructions, is used to diagnose hearing loss in noncooperative children.
- Diagnosis of hearing loss: The test can identify the type and location of hearing loss within the auditory system.
- Aid in diagnosis of unexplained tinnitus or vertigo: BERA can be used to rule out nerve involvement when a patient has an unexplained tinnitus or vertigo.
- Acoustic Neuroma: It is a non-cancerous tumor that forms on the auditory nerve. If a BERA test is abnormal, meaning there is an abnormal nerve conduction, it can be an indicator of issues that need to be further investigated.
- Monitoring auditory function: The BERA test can be used to monitor auditory function in patients receiving drugs that may affect hearing and/or undergoing surgery that can affect hearing.
How Is the BERA Test Performed?
Knowing what to expect can help reduce anxiety before the test. The BERA test is painless and non-invasive, and is usually performed while the patient is in deep sleep or fully relaxed.
- Patient preparation and relaxation: Adults are asked to lie comfortably on a test bed and relax deeply. For infants and toddlers, parents may be advised to keep the child awake and active before the appointment, then feed them just before the test so they fall into a deep, natural sleep. In rare cases, if a child cannot sleep, a mild sedative may be given under medical supervision.
- Skin cleaning and electrode placement: The audiologist gently cleans specific areas of the skin, usually the forehead, the area behind each ear, or the earlobes, using a mild exfoliating gel. This helps the electrodes make proper contact. Small sensor stickers called electrodes are then placed on these areas to record natural brain activity.
- Connecting earphones: Special insert earphones or headphones are gently placed in or over the patient’s ears. These deliver precise clicking sounds or tone bursts needed to stimulate the hearing pathway.
- Sound stimulus and recording: As the sounds are played, the electrodes detect tiny electrical signals produced by the auditory nerve and brainstem in response. The BERA machine filters, amplifies, and records these signals as wave patterns on a monitor.
- Waveform analysis and electrode removal: Once clear and repeatable waveforms are recorded for both ears, the test is stopped. The audiologist removes the earphones and electrode stickers, cleans off any remaining gel, and studies the timing and size of the recorded waves to assess hearing levels or nerve function.
- No pain or side effects: The BERA test does not involve injections, electric shocks, or pain. The electrodes only record responses; they do not send any electrical current into the body.
Understanding Your BERA Test Results
The BERA test result appears as a series of wave patterns, usually labeled Waves I to V. Each wave reflects electrical activity at a different point along the hearing pathway:
- Waves I and II: Activity from the auditory nerve.
- Wave III: Electrical activity within the lower brainstem, specifically the cochlear nucleus and superior olivary complex.
- Wave V: Activity moving through the upper brainstem and midbrain, including the lateral lemniscus and inferior colliculus.
The audiologist will look at these waveforms and take into account latency (the delay, or the time it took for the first wave to arrive) and amplitude (how strong the signal was).
Normal result: Show waveforms within the time range and normal amplitude range. This usually means that the pathway that carries sounds from the ear to the brainstem is functioning normally.
Unusual findings: These can be delayed latency, no waveforms, or an unequal ear response. The results can be due to sensorineural hearing loss, auditory nerve dysfunction, or a central auditory processing disorder, but will always need further clinical evaluation for diagnosis.
It’s worth noting that a BERA result is only a part of the diagnostic picture. The hearing test results are always interpreted in the context of your clinical history, symptoms, and other hearing tests.
When Should You or Your Child Have a BERA Test?
If you or your child is suspected of having hearing loss issues, or your doctor wants to evaluate the ability of the hearing nerve to react to sound, then a BERA test may be suggested.
If your child’s pediatrician, ear, nose, or throat specialist (ENT), or audiologist recommends a BERA test, it is likely because they are concerned about:
- A baby may not pass the first test for hearing loss.
- A young child with a delay in speech or language development.
- There is a family history of childhood hearing loss
- Hearing loss can start suddenly or over time, for no obvious reason.
- You have long-lasting tinnitus or ringing in the ears
- You feel dizzy, have vertigo, or have sound sensitivity
- Your doctor thinks you may have an acoustic neuroma or a hearing problem from a nerve problem
- If your child needs auditory nerve monitoring during an operation.
If you’re not sure if a BERA is appropriate for yourself or your child, please consult with a skilled audiologist. You’ll be taken through the assessment process at Resonnocare and be helped to select the tests that are suitable for you.
BERA Test in Children: What Parents Should Know
Parents are not at ease if their child is tested for anything. Thankfully, the BERA test is very safe and well-tolerated by children, including newborns.
Sometimes the test is performed in very young babies while they are sleeping. If the young child is having difficulty staying quiet, a light sedative may be necessary under medical supervision to obtain accurate results. We have experience and have a care plan for young children and families, and we try to make the process as relaxed and comfortable as possible.
Early hearing assessment is one of the most important things a parent can do for their child’s development. Hearing care tailored to all ages is something our team is deeply committed to at every stage of life.
What Happens After a BERA Test?
Once your BERA test results are ready, your audiologist or referring doctor will explain the findings and guide you through the next steps.
Depending on the results, they may recommend:
- Further hearing tests, such as pure tone audiometry, tympanometry, or OAE testing
- An ENT or neurology referral is required if a structural or nerve-related concern is suspected
- Hearing aid recommendations and fitting if hearing loss is identified
- Monitoring and follow-up if the results are borderline or need to be reviewed over time
If the BERA test confirms hearing loss, early support can make a meaningful difference. Modern hearing aids are highly advanced and can improve communication, confidence, and quality of life. At Resonnocare, our team will help you explore the right options, including a free hearing aid trial, so you can experience the benefits before making a decision.
Why Choose Resonnocare for Hearing and Audiology Care
We feel it’s important to provide accurate information and compassionate direction at Resonnocare to ensure that good hearing care starts here. Patients and families in India trust us with their hearing health for these reasons:
- Skilled audiologists and clinicians: Our staff has a broad range of clinical expertise in hearing disorders and audiology evaluations, including BERA testing and more.
- Evidence-based care with clinical guidance: All our suggestions are grounded in clinical evidence and tailored to you. We are not a one-size-fits-all organization.
- Accurate hearing assessments: We use advanced diagnostic equipment to ensure your results are precise and meaningful.
- Personalized care plans: Your hearing test, hearing aid fitting, and management plan are tailored to your lifestyle, preferences, and hearing goals.
- Flexible access to care: We understand that visiting a clinic is not always convenient. That is why we offer home visits and video consultations for those who need care in the comfort of their own homes.
- Long-term aftercare: Our relationship with you does not end after the test or the fitting. We provide structured aftercare support to help you get the most out of your hearing care journey.
Conclusion
The BERA test is a safe, painless, and highly informative diagnostic tool that plays a key role in the audiologist/clinician’s evaluation of how well the auditory nerve and brainstem are functioning. The BERA test is suitable for screening a newborn’s hearing, investigating unexplained tinnitus in an adult, assessing a child who is unable to take standard tests, and providing objective, reliable information to inform clinical decisions.
If you have been referred for BERA testing or have concerns about your or your child’s hearing, it is best not to delay evaluation. Identifying a hearing problem early means there are more options for handling it effectively. Contact the Resonnocare team today to schedule a hearing assessment or to speak with one of our audiologists with extensive experience. We are here to listen, guide, and support you throughout the process.
FAQ’s
What is the BERA test for?
Brainstem Evoked Response Audiometry (BERA) is a hearing and brainstem exam that tests the passage of sound from the ear to the brainstem. It is useful for diagnosing hearing loss, auditory nerve disorders, delayed speech development in children, and certain neurological disorders of the auditory pathways.
What if the BERA test fails?
When BEARS is abnormal, it can indicate hearing loss, auditory nerve dysfunction, or a delay in the transmission of sound to the brain. If the condition is severe and/or caused by an underlying issue, an extra hearing test or treatment planning is generally recommended.
Is the BERA test painful?
No, B.E.R.A. is neither painful nor invasive. Electrodes are attached to the scalp and ears to measure electrical reactions when sounds are played via earphones. The test is well-tolerated even by babies.
How much does the BERA test cost?
The cost of BEA varies across hospitals and cities, ranging from a few thousand rupees, and may also include additional hearing tests.
What is the success rate of the BERA test?
BEA is considered highly reliable for diagnosing hearing and auditory nerve anomalies and is indicated for patients who are unable to perform standard hearing tests, as well as for newborns. It is highly accurate as long as it is tested under proper conditions.