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A comparison of two conditioning procedures in the use of visual reinforcement audiometry (VRA)
Insights
Two visual reinforcement audiometry (VRA) conditioning procedures showed similar effectiveness in testing high-risk infants. Age influenced the number of stimuli needed, with 2-year-olds requiring fewer presentations than 1-year-olds.
Area of Science:
- Audiology
- Pediatric audiology
- Hearing assessment
Background:
- Visual Reinforcement Audiometry (VRA) is crucial for pediatric hearing assessments.
- Optimizing VRA conditioning protocols is essential for accurate results in infants.
- High-risk infants often require specialized audiological evaluations.
Purpose of the Study:
- To compare two distinct VRA conditioning procedures in 1- and 2-year-old infants.
- To evaluate the impact of initial stimulus level and conditioning trials on VRA outcomes.
- To determine if age affects the efficiency of VRA conditioning in young children.
Main Methods:
- Two groups of high-risk infants (1- and 2-year-olds) were assessed using VRA.
- Procedure 1: Initial stimulus at 30 dB HL with 2 conditioning trials.
- Procedure 2: Initial stimulus at 60 dB HL with 5 conditioning trials.
Main Results:
- No significant differences were found between the two VRA conditioning procedures regarding minimum response levels (MRLs).
- The number of stimulus presentations needed to establish MRL (excluding conditioning trials) and false-positive rates did not differ significantly between procedures.
- Age was a significant factor, with 2-year-olds requiring fewer stimulus presentations than 1-year-olds.
Conclusions:
- Both tested VRA conditioning procedures are equally effective for assessing hearing in high-risk infants.
- Clinical decisions on VRA protocol may depend on specific patient factors and auditory stimuli used.
- Younger infants (1-year-olds) may require more time or stimuli for successful VRA testing compared to older infants (2-year-olds).
Abstract:
This study compared the effects of two conditioning procedures in the use of visual reinforcement audiometry (VRA) with 1- and 2-year-old high-risk infants. One conditioning procedure used a relatively soft initial stimulus presentation level (30 dB HL) and only two conditioning trials prior to minimum-response-level (MRL) exploration. The other procedure used a 60-dB HL initial presentation level and five conditioning trials prior to MRL exploration. Results indicated no significant differences between conditioning procedures in regard to obtained MRLs, number of stimulus presentations required to establish MRL (discounting conditioning trials), and number of false-positive responses observed during control trials. Age was a significant factor only in regard to the number of stimulus presentations required to establish MRL. 2-year-olds required fewer presentations than 1-year-olds. Results are discussed in relation to the auditory stimulus used to obtain responses and in regard to individual clinical circumstances which may dictate the use of one procedure over the other.