Best Practices in BERA Testing

Brainstem Evoked Response Audiometry (BERA/ABR) is a vital tool in pediatric audiology, providing objective insights into auditory pathway integrity. To ensure accurate diagnosis and effective rehabilitation, clinicians must follow structured best practices.

Testing Environment for BERA testing

• Quiet and Isolated Place: BERA should be performed in a sound‑treated, distraction‑free environment to minimize noise and electrical interference.

• Controlled Setup: Proper grounding and shielding prevent artifacts that can distort waveforms.

Patient Preparation

• Sedation in Children: For infants and toddlers, sedation under medical supervision is often necessary to ensure cooperation and stable recordings.

• Comfort & Monitoring: The child should be comfortable, monitored continuously, and prepared in a safe clinical setting.

Equipment Standards

• Calibration: Instruments must be calibrated regularly for accuracy.

• Connections: Electrodes should be properly insulated, intact, and securely connected.

• System Check: All equipment should be tested before starting to avoid interruptions.

Recording & Interpretation

• Waveform Reproducibility: BERA waveforms must be correlated and reproducible across trials to confirm validity.

• Threshold Estimation: Testing should continue until:

  • No response is observed at lower intensities, or

  • Normal intensity levels are reached.

• Clinical Correlation: Results should always be interpreted alongside patient history and other audiological findings.

Special Considerations for Children < 2 Years

• Tone Burst ABR: Provides frequency‑specific information, especially for low‑frequency hearing.

• ASSR (Auditory Steady State Response): Generates an objective audiogram across frequencies, crucial for:

  • Identifying residual hearing

  • Accurate hearing aid fitting

  • Pre‑surgical evaluation during cochlear implant candidacy

Complementary Audiological Tests

While BERA with Tone Burst ABR and ASSR provides valuable information about a child’s hearing status, it should always be complemented with other audiological tests:

• OAE (Otoacoustic Emissions) → Assesses cochlear (outer hair cell) function.

• Impedance Audiometry (Tympanometry) → Evaluates middle ear status.

• Free Field Audiometry → Observes behavioral responses to sound in natural listening conditions.

👉 Without these complementary tests, it is unfair to jump to conclusions or prescribe treatment, as a comprehensive diagnosis requires a multi‑test approach.

Expertise at Unicare Speech & Hearing Clinic

At Unicare Speech & Hearing Clinic, we strictly adhere to these best practices. Our team of renowned pediatric audiologists combines professional competency with the right temperament to perform hearing tests in children. This ensures:

• Accurate diagnosis even in challenging pediatric cases

• Compassionate handling of young patients

• Reliable results that guide effective rehabilitation

Conclusion

BERA testing is not just about recording responses—it is about precision, reproducibility, and clinical excellence. By performing the test in a controlled environment, ensuring proper sedation, maintaining equipment standards, and supplementing with tone burst ABR, ASSR, OAE, impedance audiometry, and free field audiometry, clinicians can deliver a comprehensive and accurate diagnosis. At Unicare, our pediatric audiology team ensures every child receives the best possible start in their hearing journey.

To book appointment with our pediatric audiologists, call: +91-9716088173 or visit www.unicareclinics.com