BERA Test: Purpose, Procedure, Results and Who Needs It
TL; DR: This blog is intended for parents of newborns and young children, adults with suspected hearing problems, caregivers, and individuals who need a clear understanding of BERA testing, hearing loss diagnosis, and auditory nerve health. Explains the Purpose of BERA Testing: The article describes how Brainstem Evoked Response Audiometry (BERA) measures the transmission of sound signals from the ear to the brainstem, making it especially useful for infants and people who cannot participate in conventional hearing tests. Identifies When a BERA Test Is Needed: The blog outlines common reasons for recommending a BERA test, including failed newborn hearing screenings, developmental delays, suspected auditory nerve disorders, unexplained hearing loss, and inconclusive audiometry results. Details the Procedure and Results: Readers learn what happens during a BERA test, including electrode placement, sound stimulation, brain response recording, and how audiologists interpret waveform patterns to assess hearing levels and nerve function. Highlights Early Diagnosis and Treatment Benefits: The article emphasizes the importance of timely hearing assessment, explains potential treatment and management options after testing, and shows how Resonnocare supports patients and families through diagnosis, hearing aid solutions, and ongoing hearing care. A BERA is a test recommended for babies who do not respond to loud noise, or for adults with hearing impairment when behavioral tests have not fully explained the loss. One of the most frequently asked questions from parents and patients at Resonnocare is: What does a BERA test actually measure, and how is it different from a normal hearing test? This guide makes it easy for you to understand. What Is a BERA Test? Brainstem Evoked Response Audiometry (BERA) is a hearing test that measures how sound signals travel from the inner ear through the auditory nerve to the brainstem. In a BERA test, the brain’s electrical activity is recorded in response to clicks or tones played through headphones, whereas a normal hearing test requires an active response, such as pressing a button when a sound is heard. This is particularly important for newborns, infants, and those unable to respond accurately, such as because of age, cognitive status, or other factors. What Is the Purpose of a BERA Test? The main goal of a BERA test is to assess the health of the auditory pathway (from the inner ear (cochlea) to the brainstem). It helps identify: Whether hearing loss is present and the approximate degree of hearing loss. If the hearing nerve is working fine or not. If it’s in the ear or in the nerve that leads from the ear to the brain (auditory nerve) Hearing concerns in infants who cannot undergo reliable behavioral hearing tests. As it does not need the patient’s cooperation, a BERA test is sometimes regarded as an objective hearing assessment that can be used in situations where subjective testing is not possible. What Causes the Need for a BERA Test? There are a few scenarios that can prompt an ENT specialist or audiologist to order a BERA test: Failing newborn hearing screening A family history of hearing loss or hearing problems that are genetically linked Auditory neuropathy, a condition in which sound enters the ear normally but is not transmitted properly along the auditory nerve. Failure to get reliable data from standard audiometry tests Tumors or lesions that are suspected along the auditory nerve pathway Developmental delays when hearing loss is not suspected as a cause of the delay. If a child or family member has noticed unusual signs alongside hearing concerns, it may help to review general ear symptoms and conditions so your audiologist has a complete picture before testing begins. What Are the Early Signs That a BERA Test May Be Needed? Given the frequency with which a BERA test is performed in babies and young children, it is common for signs to be detected by parents rather than by the child. These may include: Lack of reaction to unexpected, sudden noises Failure to respond to environmental sounds and voices. Language delay and/or language disorders in speaking and/or language disorders in listening comprehension. Failure to respond to sound by expected developmental milestones A newborn hearing screening that was failed, missed, or produced inconclusive results. A BERA test might be ordered for adults when hearing loss is not typical, or when nerve-related hearing loss is suspected. How Is a BERA Test Performed? The procedure for a BERA is not painful, and it usually goes through the following steps: Preparation: As with an ECG, small electrodes are carefully placed on the scalp and earlobes to capture brain waves. Tone bursts or clicking sounds: These sounds are played through soft earphones, one ear at a time. Brain response recording: The electrodes record the brainstem’s response to these sounds and measure how effectively the auditory pathway responds. Natural sleep or optional sedation (if necessary): In infants or young children who must be still, natural sleep or mild sedation (as indicated) may be used. Waveform analysis: The recorded waveforms are evaluated by an audiologist to estimate hearing thresholds and assess auditory nerve function. The entire test usually takes between 45 minutes and a couple of hours, depending on the patient’s age and cooperation. What Do BERA Test Results Mean? The BERA results are reported as waveforms that demonstrate the response of the auditory nerve and brainstem to sound at various intensities. This will help your audiologist to decide: Whether hearing levels fall within the normal range The severity of the hearing loss (mild, moderate, severe or profound) Whether the response pattern is indicative of a cochlear or neural problem Please note: A BERA test result is not a diagnosis in itself. It’s usually read in conjunction with other tests, medical history, and clinical observations, as waveform patterns can change with age, sedation, and test conditions. An audiologist or an ENT specialist should always interpret the results. When Should You See an Audiologist or Doctor? Some of the signs may require immediate professional attention without regard to age, although a pediatrician or ENT specialist may recommend a BERA test:
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