Visual reinforcement audiometry in children using new technology reinforcers: Digital video disc vs. animated toy

Visual Reinforcement Audiometry (VRA) is a test procedure routinely used to evaluate hearing in infants and children (6 months to 2 years). VRA involves presenting a sound stimulus to the infant or child and then looking for a head turn response. If the desired head turn response occurs then it is reinforced with a pleasant, visual reward (e.g., lighted toy animal). Most research and current clinical practice utilizes flashing lights and/or animated toys during VRA. New technology (digital video disc player and t.v. monitor) capable of generating a moving, video image is now available that may be equally or perhaps more effective than the conventional toy reinforcer. It was hypothesized that the changing video images, with presumed greater novelty and complexity, would be more interesting and rewarding than a conventional, animated mechanical toy reinforcer. It is not known whether a video image presented on a t.v. monitor is as rewarding to a young child as a conventional lighted toy reinforcer during VRA testing. The purpose of this research was to compare auditory localization behavior, as defined by the number of head turn responses until habituation, with VRA in a population that has been historically difficult to test (i.e., approximately two years of age) using two types of reinforcers: (1) moving images generated by a digital video disc (DVD) player/monitor, and (2) a conventional, animated mechanical toy.; Twenty children were randomly selected from a total group of 40 and tested using conventional reinforcement. The remaining 20 subjects 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. On average, the video-reinforced group had about four more head turns per test session than the conventional toy-reinforced group suggesting that during VRA a video image may be more reinforcing than a conventional animated toy. Other possible clinical applications of this technology are discussed.