Auditory Behavioral Audiometry Case Study

4. Topic: Behavioral Audiometry

In Behavioral Observational Audiometry the observer decides if an infant is responding to a stimulus based on changes in sucking, eye gaze, and other potential reactions. The responses are then measured against the Auditory Behavior Index, which lists where the minimum response level is for typical hearing children for the first two years of life. Unfortunately, BOA is not appropriate for pure tone threshold testing of infants because the Auditory Behavior Index does not measure sensitivity, it measures responsivity, so it is not a reliable source of audiometric information. BOA is also a very limited style of testing due to several limitations. There is a high level of intersubject variability in responses

VRA addresses many of the limitations of BOA to give us a much more reliable form of threshold testing. With VRA starting at 5 months of age to 18 months of age thresholds are much better and the variability is significantly reduced from where it was with BOA testing. Unlike the differences in MRL when testing with BOA, you get very similar pure tone sound field thresholds with similar variability regardless of age when using warble-tone stimuli based on Wilson and Moore’s research in 1978. They achieved these results when testing a group of 6-7 month olds against a group of 12-13 month olds. VRA also reduces examiner variability because a conditioned head turn is much less subjective. Based on the videos we watched in class, it is much clearer when a response is a true response in VRA than in BOA. There was even some discrepancy between my classmates as to when a subject was responding to the stimulus in BOA. However, BOA is not without its benefits. It is a great guide when looking into an infant’s functional use of hearing. We just all agreed in class that we were significantly more confident in the results from VRA when establishing pure tone thresholds for an infant and would prefer to use it in our future as