It can be done! Objective testing on older children in natural sleep.

Ms Nicola Camporeale1

1The Royal Children’s Hospital, Melbourne, Australia


Electrophysiological methods of hearing assessment (Auditory Brainstem Response and/or Auditory Steady State Response) are widely used to define hearing for children who are not developmentally able to perform behavioural hearing assessments. Typically, these tests are used to assess infants and are performed in natural sleep.

What happens, however, when objective testing is required on babies and children who are considered “too old” for testing in natural sleep? Traditionally, we have turned to sedation or general anaesthetic to help us complete diagnostic assessment. Unfortunately, the complicated logistics of organising diagnostic assessments under sedation/anaesthetic mean that it is a lengthy process. This often delays diagnosis and early intervention, as families and specialists involved in the child’s care are in a “holding pattern” while they wait for conclusive results.

We propose that (in most cases) sedatives and anaesthetics can be avoided, thus facilitating a smoother pathway to intervention.

This presentation will give an overview of children >6 months of age who have completed testing in natural sleep at our clinic. We will also discuss the challenges faced by our Audiologists when attempting to test older children in natural sleep, as well as some helpful strategies to increase the likelihood of success.


Nicola is a paediatric diagnostic audiologist at the Royal Children’s Hospital in Melbourne. Her special areas of interest are infant diagnostic testing, and the management of infants with permanent hearing loss.

Nicola has a Masters of Audiology from Flinders University, as well as a Bachelor of Psychology (Hons) from the University of Adelaide.