SummaryThe use of auditory brainstem response (ABR) for assessment of hearing in the neonate has not been without challenge. Although numerous articles have appeared, agreement regarding the utility of neonatal ABR testing does not exist. In review of the current studies and commentaries, a clear majority are favorable to neonatal ABR testing. These studies along with current test procedures are discussed. (38); procedures for the assessment of that potential were initiated. Since 1975, the research reported in the literature has grown exponentially each year. In spite of the large and increasing amount of research reported, sever! issues have remained unresolved, viz., the applicability, reliability, and validity of neonatal ABR testing. In fact, because of these and other factors, some authors have begun to seriously question using ABR with neonates (13,35,42).. The need for early identification of infants with hearing loss is apparent. Normal language, learning, and social skill acquisition is contingent upon hearing. Although the incidence of hearing impairment in the general neonatal population is relatively low (0,26%) (41), in NICU neonates the incidence is considerably higher (2-10%) (16, 39). Furthermore, the improved survival rate of neonates born weighing less than 1500 g (19, 31) has increased the pool of infants in which a high incidence of hearing impairment is seen (16). Because the need for early identification of hearing loss does exist and the current procedures that could identify hearing impairment in the neonate are open to question (ABR), a critical review of ABR testing is in order. The purpose of this article is to summarize the current ABR literature, both pro and con, and to draw conclusions regarding its use based on the literature and the experience of the writer. The summary will not attempt to review early ABR literature primarily due to excellent reviews that are already published. The interested reader, however, would find Downs (13) very thorough.The current literature pertinent to ABR testing of neonates and NICU populations is discussed and from several aspects (5)(6)(7) II,12,17,20,25,34,36,47). Weber (47) The influence of various factors on the ABR have been explored