Visual Reinforcement Audiometry Using Digital Video Disc and Conventional Reinforcers

Abstract

Visual reinforcement audiometry (VRA) is a test procedure routinely used to evaluate hearing in infants and young children (6 months to 2 years). Most research and current clinical practice uses flashing lights and/or animated toys to provide reinforcement to a child during VRA. New technology capable of generating a moving video image is now available for providing visual reinforcement to infants during VRA testing. It is reasonable to expect that video images, with presumed greater novelty and complexity, would be more interesting and rewarding to children than conventional, animated mechanical toy reinforcers. On the other hand, in today's society, children are frequently exposed to video images in the home and elsewhere. Therefore, three-dimensional animated toys may present with greater novelty than video images. The purpose of this study was to compare auditory localization behavior, as defined by the number of head turn responses until habituation, during VRA with 2-year-old children using two types of reinforcers: (a) moving images generated by a digital video disc player/monitor and (b) a conventional, animated mechanical toy. Twenty children were selected randomly from a total group of 40 and tested using conventional reinforcement. The remaining 20 children were tested using video reinforcement. The average number of head turn responses prior to habituation was approximately 15 for the video-reinforced group and approximately 11 for the conventional toy-reinforced group, suggesting that during VRA a video image may be more reinforcing than a conventional animated toy.

Behavioral Bone-Conduction Thresholds for Infants with Normal Hearing

“…Each infant participant sat in the center of the booth on his or her parent's lap, facing forward. Visual reinforcers were placed approximately 90 degrees to the infant's right and left at eye level, similar to studies done by Schmida et al (2003) and Widen et al (2000). An assistant was also present in the booth, sitting at a 45 degree angle in front of the infant such that both examiners had a good view of the infant's reactions.…”

Comparisons of Auditory Steady State Response and Behavioral Air Conduction and Bone Conduction Thresholds for Infants and Adults With Normal Hearing

“…This arrangement allowed for the four visual reinforcers to be positioned approximately 90 degrees to both the left and right of the infant, two per side. Both animated toys, as well as video reinforcement, were available to be used on either side of the infant (Widen et al 2000;Schmida et al 2003). Each parent was instructed on the procedure and the importance of not distracting the child with noises or cueing the child with their own movement.…”

Avaliação do nível mínimo de audição em lactentes de seis a 24 meses por meio do reforço visual

“…Por apresentarem menor idade, os lactentes do Grupo I têm menor desenvolvimento e maturação neuronal, além de tempo de atenção reduzido (7) . Já os do Grupo III podem ter menor motivação para responder ao teste, uma vez que a técnica do reforço visual já não é tão interessante nessa faixa etária, fazendo com que o desinteresse pelo reforço aconteça mais rapidamente.…”

“…Há uma crescente preocupação dos profissionais envolvidos com crianças, em identificar o mais cedo possível as alterações auditivas (1)(2)(3) , o que favorece a eficiência dos tratamentos de (re)habilitação. Neste contexto, a avaliação audiológica de crianças pequenas, nos últimos anos atingiu significativos progressos no que diz respeito a métodos, técnicas e tecnologia (4)(5)(6)(7)(8) . Esses avanços ocorreram tanto no que se refere aos métodos eletrofisiológicos quanto aos comportamentais de avaliação da audição.…”