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Visual reinforcement audiometry (VRA) with young Down's syndrome children
Insights
Visual Reinforcement Audiometry (VRA) effectively assesses hearing in young children with Down syndrome. Success is linked to developmental age, with 10 months being a critical threshold for reliable auditory responses.
Area of Science:
- Audiology
- Developmental Pediatrics
- Genetics
Background:
- Down syndrome is associated with a higher incidence of hearing loss.
- Early hearing assessment is crucial for developmental outcomes.
- Visual Reinforcement Audiometry (VRA) is a common audiological assessment for infants and young children.
Purpose of the Study:
- To investigate the efficacy of Visual Reinforcement Audiometry (VRA) in assessing hearing thresholds in young children with Down syndrome.
- To determine the relationship between VRA success and developmental age in this population.
Main Methods:
- Visual Reinforcement Audiometry (VRA) was performed on 41 subjects with Down syndrome (6 months to 6 years).
- A head-turn response to auditory stimuli was monitored and reinforced visually.
- The Bayley Scales of Infant Development (BSID) was administered to 24 subjects to correlate with VRA results.
Main Results:
- 68% of subjects initially oriented to the sound source.
- VRA thresholds were obtained in 81% of responsive subjects during a single visit.
- A critical developmental age of 10 months was identified for consistent VRA responses, correlating with BSID Mental Age Equivalent.
Conclusions:
- VRA is a viable method for assessing hearing in young children with Down syndrome.
- Developmental age, particularly reaching 10 months, is a key factor for successful VRA implementation.
- The study suggests a potentially higher prevalence of hearing loss in the Down syndrome population.
Abstract:
Visual Reinforcement Audiometry (VRA) was investigated with 41 Down's syndrome subjects between the ages of six months and six years. The VRA procedure involved monitoring a head-turn response to a complex noise signal presented in a sound field with an ascending presentation paradigm and reinforced by a complex visual reinforcer. Twenty-four of the infants and young children also were evaluated with the Bayley Scales of Infant Development (BSID) to allow for analysis of the efficacy of VRA as a function of developmental age. Results were as follows: (1) 28 (68%) of the infants and young children initially oriented towards the source of the auditory stimulus, (2) only a few of the subjects who did not initially orient could be taught to respond, (3) of the children who initially oriented or were taught to respond, thresholds were obtained on a large number (81%) in one visit, and (4) a systematic relationship was demonstrated between consistency of subject response using the VRA technique and BSID Mental Age Equivalent with 10 months being the critical age for determining the potential success of the procedure. In addition, the results implied a higher incidence of hearing loss in the Down's syndrome subjects than found in normal pediatric population.