srjmSRJMSRJM2788-9440https://doi.org/10.47310/srjm.2023.v03i02.013Auditory Brainstem Response Testing in Infants: Applications and InterpretationDhadwalSKumariSAuditory Brainstem Response (ABR) testing has evolved as a cornerstone in the assessment of auditory function, particularly in infants. This review article comprehensively explores the applications, methodology, clinical utility and interpretation of ABR testing in the context of infant audiology. ABR, a non-invasive electrophysiological technique, elicits and records neural responses along the auditory pathway, providing invaluable insights into auditory processing, neural integrity and hearing thresholds in infants who are unable to provide behavioral responses. The article begins by elucidating the underlying physiological principles of ABR generation, outlining the sequence of neural events and waveform components that reflect different stages of auditory processing. A thorough examination of the practical considerations for ABR testing in infants is presented, encompassing electrode placement, stimulus parameters and sedation protocols to ensure accurate and reliable recordings. The evolving methodologies, including tone burst, click and chirp stimuli, are critically reviewed for their respective advantages and limitations. The clinical applications of ABR testing in the infant population are expounded, spanning both diagnostic and screening contexts. ABR plays a pivotal role in diagnosing Auditory Neuropathy Spectrum Disorder (ANSD), a complex condition characterized by abnormal auditory nerve function. Moreover, ABR assists in the identification of hearing loss in Neonatal Intensive Care Units (NICUs) and serves as a valuable tool in newborn hearing screening programs. The integration of ABR into a comprehensive diagnostic battery is explored, elucidating its synergy with other assessments such as Otoacoustic Emissions (OAE) and behavioral testing. Interpretation of ABR results is a multifaceted endeavor that demands a nuanced understanding of waveform morphology, latency-intensity functions and interaural comparisons. This article provides a comprehensive guide to the interpretation of ABR findings, encompassing the distinction between normal and abnormal responses, estimation of hearing thresholds and the recognition of waveform asymmetries that may signal underlying pathologies. The challenges and limitations of ABR testing in infants are addressed, including factors that contribute to variability in results such as developmental maturation, sedation effects and electrode artifact. Strategies to mitigate these challenges through advanced signal processing techniques and data-driven algorithms are explored, shedding light on the evolving landscape of ABR interpretation. Finally, the article underscores the symbiotic relationship between ABR testing and clinical decision-making, emphasizing the role of ABR in tailoring interventions and rehabilitation strategies. A case-based approach illustrates the application of ABR in diverse clinical scenarios, showcasing its efficacy in optimizing treatment plans and therapeutic outcomes.