As soon as we got pregnant we knew our baby had a 50/50 chance of being born deaf and at 4 months Lily was referred for an AABR test. My partner, Ben, has sensorineural hearing loss which was caused by the hairs in his cochlea not developing properly (read his post about his struggle with accepting his deafness here). He was born severely deaf and requires hearing aids to hear anything basically so we always knew our children would need more hearing tests than average.
Lily passed her newborn screening after a bit of a struggle, they were unable to get a result on her left ear to begin with but eventually we got the all clear. As the weeks went on we grew more and more concerned over her hearing, she wouldn’t react to sound or turn her head and didn’t so much as flinch when we were cutting wooden floor boards with a jigsaw, so at around 4 months, after speaking to our wonderful health visitor, she was referred for a hearing screening early.
The first test we got sent for was an Visual Reinforcement Audiometry. This is generally aimed at babies who are 8 months+, this was the test she would have been referred at 8 months regardless of any concerns due to her family history of deafness. There were speakers that play words repetitively and random clapping monkeys placed around the room and the audiologist sets them to go off at certain volumes and the idea is, that if baby can hear it, baby will look towards it and be rewarded with a flashing screen or a cute toy. Once they have began to associate the sound with a visual reward the test will start. Lily sort of managed it, although she only turned for the very loud noises which we worked out were at the levels her Dad can hear so obviously this test left us feeling quite concerned rather than reassured as we had initially hoped for.
They looked inside her ears although they only managed to see one properly as she objected pretty strongly to having things shoved in her ear. It was then discovered that she had fluid behind her ear drum, which would explain why she wasn’t reacting to noises. Because of this and the fact the test hadn’t been completely successful they referred her for an AABR test which stands for Automated Auditory Brainstem Response which is were clocking sounds are played directly into your baby’s ear canal along with sensors on your baby’s head and behind their ears. These sensors pick up the brainstem reaction to the sounds and throw the results onto the connected computer screen.
You will need to keep your baby awake and not feed them for 2 hours prior to the test. I felt like the worlds shittest parent doing that because she was so tired and hungry but they need baby to feed and go into a deep sleep in order to carry out the test. The test itself will take place in a special sound proof room, any phones, wifi signals, etc will need to be turned off or they will interfere with the equipment. The audiologist performing Lily’s tests had to go into the waiting room and ask people to turn their phones off because they were causing so much interference.
After briefly explaining the process, the audiologist used some very fine filing paper which looks pretty much exactly like sand paper, and will gently rubbed it on Lily’s skin around her forehead and behind her ears. Next they attached the electrodes, normally three to four of them, Lily had three – one behind each ear and then one of her forehead. The lines on the screen should start going crazy, this is normal and means the contact between the skin and the electrodes is where it should be. The spiking is caused by the immense amount of brain activity which will settle down once baby is asleep.
This is where the fun part starts, now you must get the baby into a deep sleep. They will lower the lights in the room and luckily it’s perfectly fine for you to hold your baby during the test which makes it so much easier! I held Lily the entire time and switched boobs half way when she woke up. They test one ear at a time so it is relatively easy to cradle hold them. I read google posts about how they will need the baby lay flat on a bed and I immediately panicked because no way would Lily sleep like that.
Once baby is asleep and the brain activity lessens, the lines on the screen will settle down and stop spiking. The audiologist will insert the probe a little way into the ear canal and the test will begin. A click or a pip will be played into your baby’s ear and the brainstem response will appear on the computer screen. I tried to watch intently and try and figure it out but it’s incredibly confusing and it’s best not to try and drive yourself insane with worry and wait until it’s over.
The time it takes to complete depends on your baby but they allow 3 hours for the entire appointment. The test itself took about 40 minutes for us not including getting her to sleep but in total we were there for a couple of hours.
Here is a vlog we did of the day she had her test!
If you are wanting more information about childhood deafness or are looking for further advice then please visit the National Deaf Children’s Society where you will find an abundance of help an support.