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Updated: Jul 9, 2026

Behavioral Assessment of Hearing in 2 to 4 Year-old Children: A Two-interval, Observer-based Procedure Using Conditioned Play-based Responses
Published on: January 23, 2017
Incidence of responses at the lower audiometric limits
1Department of Audiology, Massachusetts Eye and Ear Infirmary, 243 Charles Street, Boston, MA 02114, USA. cfhalpin@meei.harvard.edu
Purpose:
To put forward a symbol extension, consisting of an upward arrow added to current symbols, to denote that a patient continued to respond at the audiometric limit (i.e., -10 dB HL). Also, to present survey data to characterize the incidence of these responses.
Method:
A retrospective survey of 2,821 sequential audiometric evaluations was performed. Responses at the audiometric limits were counted, along with the stimulus conditions (i.e., transducer, frequency, and masking) and the age of the patient.
Results:
A total of 307 instances of responses at the lower audiometric limits were seen in 173 of these cases (6.13%), with the majority by bone conduction.
Conclusions:
The overall rate of responses at the audiometric limits was low, as expected. However, these responses were primarily seen in the age group from 4 to 15 years, and at least one such response occurred in 26% of cases in that age range.
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