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Visual Reinforcement Audiometry

Purpose

vra test Image
Assesses hearing acuity using conditioned responses to sound (i.e., head turning). Appropriate for testing children from 7 months through 30 months of age.

Procedure
The child is conditioned to provide a specific response to an acoustic stimulus. For example, a head turn in the direction of the sound source is rewarded by lighting and/or activating an animated toy. Once the child is conditioned to respond to the sound, the intensity of the signal is reduced to determine threshold of hearing.

Results
This procedure can be used to determine threshold of hearing.

Sample test results

Sample Results Chart

Limitations
Because signals are typically presented through a loudspeaker, thresholds obtained indicate acuity of the "better hearing ear."

Resources
Buttross, S. L., Gearhart, J. G., & Peck, J. E. (1995). Early identification and management of hearing impairment, American Family Physician, 51(6), 1437-1447.

Stelmachowicz, P. G., & Gorga, M. Audiology: Early Identification and Management of Hearing Loss.

In Cummings, Fredrickson, Harker, Krause, Richardson, Schuller (eds.) Otolaryngology-Head and Neck Surgery, 3rd Edition. Mosby-Year Book, Inc., pp 401-417. 1998. This chapter provides an overview of early identification and quantification of hearing loss, as well as management strategies and amplification.