Pediatric Audiology - Behavioral Tests
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| child hearing development - at birth | infant has already had hearing ability for four months; prefers mother's voice
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| child hearing development - at 4 months | infant can discriminate between two phonemes
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| child hearing development - 6 months | infant had learned all sounds/phonemes of language
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| child hearing development - 8 months | infants can distinguish between all phonemes of all languages; e.g. Japanese infants can discern /l/ and /r/ even though these are allophones in Japanese
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| child hearing development - 28 weeks | cochlea fully developed and adult sized
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| initial aspects of pediatric audiometry | 1. obtain case history, 2. physical inspection of ears, 3. observe and interact informally with child
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| auditory behavior index: 0 - 6 weeks | eye-blink, eye-widening, startle, arousal/stirring from sleep; 40 dB HL speech
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| auditory behavior index: 6 weeks - 4 months | eye-blink, eye-widening, eye shift, quieting, rudimentary hear rusn starts by 4 months; 47 dB HL speech
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| auditory behavior index: 4 - 7 months | head turn laterally toward sound, listening attitude; 21 dB HL speech
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| auditory behavior index: 7 - 9 months | directly localizes to side, indirectly localizes below ear level; 15 dB HL speech
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| auditory behavior index: 9 - 13 months | directly localizes to side and below ear level, indirectly localizes above ear level; 8 dB HL speech
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| auditory behavior index: 13 - 16 months | directly localizes to side/below/above ear level; 5 dB HL speech
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| minimum response level | MRL; not a hearing threshold
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| pediatric audiometry - two types of measures | 1. behavioral, 2. physiological; audiologist will always complete one of each with child
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| behavioral measures | Behavioral Observation Audiometry, Visual Reinforcement Audiometry/Localization Audiometry, Tangible & Visual Reinforcement Operant Conditioning Audiometry, Play Audiometry
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| BOA | Behavioral Observation Audiometry
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| VRA | Visualization Reinforcement Audiometry (also known as Localization Audiometry)
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| TROCA | Tangible Reinforcement Operant Conditioning Audiometry
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| VROCA | Visual Reinforcement Operant Conditioning Audiometry
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| CPA | Conditioned Play Audiometry
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| Behavioral Observation Audiometry | < 4 months; watch baby's response to relatively sudden intense sounds; stimuli presented in sound field; response judged by two examiners
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| BOA - sources of variability | examiner judgement subject to bias; measure responsiveness to sound, not threshold; responses vary with age; habituation; normal range is large
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| Visual Reinforcement Audiometry | 5 months - 2 years; single loudspeaker and reinforcer used; reinforcement device is a toy that is illuminated and moves; infant's response must be a clear head to the loudspeaker/reinforcer; responses judged by two examiners
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| Tangible and Visual Reinforcement Operant Conditioning Audiometry | 6 - 24 months; speaker placed in front of child; requires simple but specific motor response within range of neuromotor capabilities; reinforce by delivery of tangible or visual reward; fake positives discourages by time out periods
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| Play Audiometry | 2 - 5 years; 2 examiners communicate via intercom; requires specific motor response within framework of a game; tell and demonstrate what to do; social reinforcement such as smile, praise, etc.
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