Comparison of ABR and OAE Audiology Hearing Tests

An ABR (auditory brainstem response), or an OAE (otoacoustic emissions testing) hearing test is done when a baby is born or a child is very young. The two tests are similar, yet different. Neither test indicates whether a child is definitely deaf or hard of hearing. Both tests are intended only to determine whether further, more accurate hearing testing is needed.

Which test is more effective? An OAE is usually done at birth, followed by an ABR if the OAE test results indicate a possible hearing loss. However, the American Journal of Audiology reported in Vol. 9 (Dec 2000) in an article "Outcome of newborn hearing screening by ABR compared with four different DPOAE pass criteria," suggested that ABR was less effective. As both tests are performed routinely, some infant hearing screening equipment combines both tests in one product. An example of such a combined product is the Clarity screener from Sonamed.

Doctor testing boy with cochlear implants
Geroge Stainmetz / Getty Images 

Books on ABR and OAE

One book on ABR is the book The ABR Handbook: Auditory Brainstem Response. In addition, the American Academy of Otolaryngology, Head and Neck Surgery has published the book Otoacoustic Emissions.

Visitor on ABR vs OAE

A visitor wrote: I am an Audiology student at Idaho state university and am currently doing a research project on ABR screenings as compared to OAE screenings. The article that you cite, to my knowledge, suggests that automated ABR screenings are much more effective than OAE. Likewise from more research I have seen statistics that would support the claim that ABR screenings are more effective.

Articles cited by a visitor:

  • "Universal Infant Hearing Screening by Automated Auditory Brainstem Response Measurement," in Pediatrics Vol. 101 No. 2 February 1998, pp. 221-228.
  • "Auditory Brain Stem Response Screening for Hearing Loss in High-Risk Neonates," in Turkish Journal of Medical Sciences, vol. 30, no. 5, pp. 479-482.

Another visitor wrote:
I think it might be helpful to clarify a couple of points. The way that the technologies work is actually very different, even though they are both used to screen for hearing loss in young infants and children. In addition, both tests are also used diagnostically in older populations for various reasons.

When a baby does not pass an OAE or ABR screening, ABR is still the method used to get more complete information about the hearing status.

Another method of testing hearing is the auditory steady-state response (ASSR), a test that can distinguish between a severe loss and a profound loss.


Auditory Brain Stem Response (ABR) Otoacoustic Emissions Testing (OAE)
Measures brain's response to sound Measures otoacoustic emissions generated by sound
How it works: A device near the ear makes clicking sounds. Earpieces in ear canals conduct the sound and electrodes on the scalp/earlobes track sound moving through the ear to the brain. How it works: An earplug-like device with a microphone measures the cochlea's response to sound, listening for otoacoustic emissions (an otoacoustic emission is a weak echo sound made by the ear soon after it hears)
Asleep/Awake: Younger — asleep because movement interferes with results. Older — awake but quiet. Asleep/Awake: OAE tests are routinely done on sleeping newborns.
Hearing/Not Hearing: Results are averaged and compared to normal hearing. Hearing/Not Hearing: If no otoacoustic emissions, possible hearing loss.
Cost: ABR is said to be more expensive Cost:OAE is said to be less expensive
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