The parent of a 4-month-old infant is concerned that the infant cannot hear. Which test should be ordered to evaluate potential hearing loss in this infant?

The parent of a 4-month-old infant is concerned that the infant cannot hear. Which test should be ordered to evaluate potential hearing loss in this infant?

• A. Acoustic reflectometry
• B. Audiometry
• C. Auditory brainstem response (ABR)
• D. Evoked otoacoustic emissions (EOAE) testing

Answer: (C)

When assessing hearing in a nonverbal infant, you need an objective test that doesn’t require the child to respond. Auditory brainstem response uses electrodes placed on the scalp to record neural activity in response to sound, while the infant sleeps or rests. It directly evaluates the auditory pathway from the inner ear through the brainstem and can estimate hearing thresholds without any behavioral responses. This makes it the best choice for a 4-month-old with possible hearing loss. Acoustic reflectometry mainly assesses middle-ear mechanics and tympanic membrane status, not true hearing sensitivity, so it doesn’t tell you how well the infant hears. Behavioral audiometry isn’t reliable in a baby this age because they can’t reliably indicate when they hear a sound. Evoked otoacoustic emissions test cochlear outer hair cell function and is great for screening, especially at birth, but it doesn’t provide information about neural conduction or precise hearing thresholds and can miss certain types of neural or conductive issues.

When assessing hearing in a nonverbal infant, you need an objective test that doesn’t require the child to respond. Auditory brainstem response uses electrodes placed on the scalp to record neural activity in response to sound, while the infant sleeps or rests. It directly evaluates the auditory pathway from the inner ear through the brainstem and can estimate hearing thresholds without any behavioral responses. This makes it the best choice for a 4-month-old with possible hearing loss.

Acoustic reflectometry mainly assesses middle-ear mechanics and tympanic membrane status, not true hearing sensitivity, so it doesn’t tell you how well the infant hears. Behavioral audiometry isn’t reliable in a baby this age because they can’t reliably indicate when they hear a sound. Evoked otoacoustic emissions test cochlear outer hair cell function and is great for screening, especially at birth, but it doesn’t provide information about neural conduction or precise hearing thresholds and can miss certain types of neural or conductive issues.