Evidence on the Efficacy of Insert Earphone and Sound Field VRA with Young Infants

TLDR

Visual reinforcement audiometry with insert‑earphone delivery enables early, ear‑specific assessment of infant hearing. The study examined the effectiveness of VRA in young infants and compared sound‑field versus insert‑earphone stimulus presentation. Forty‑one normally developing infants aged 20–42 weeks underwent VRA, with 22 tested in sound field and 19 with insert earphones. Sound‑field testing produced more minimum response levels, yet insert‑earphone testing yielded two or more MRLs in 36 % of infants ≥32 weeks and at least one MRL in 25 % of infants ≤25 weeks, confirming efficacy of both methods and supporting VRA use in 20–26‑week‑olds.

Abstract

Visual reinforcement audiometry (VRA) with insert-earphone stimulus delivery provides a means of obtaining early ear-specific information on the auditory status of infants. The aim of this study was to investigate the efficacy of VRA in young infants, and to compare the use of sound field and insert-earphone stimulus presentation. VRA was performed on 41 normally developing infants aged between 20 and 42 weeks. Infants were tested in the sound field (n=22) and with insert earphones (n=19). Results showed significantly more minimum response levels (MRLs) obtained with sound field testing, and with older children. Nevertheless, in the insert-earphone group, 36% of those aged 32 weeks or more gave two or more MRLs, and 25% of the infants aged 25 weeks or less gave one or more MRLs. This study provides data from developmentally normal infants which confirms the efficacy of insert-earphones as well as sound field VRA with 32–42-week-olds, with reasonable expectation of success. The data in this study also suggest that VRA could be usefully employed for younger infants aged approximately 20–26 weeks where information, although less easily obtained, may be of particular value to early diagnosis and habilitation.