Conditioned Play Audiometry (3 – 5 years)

Conditioned play audiometry (CPA) works the same way as pure tone audiometry (person indicates when they can hear a tone). However, when the child hears a tone, they put a marble in a marble race, press a computer key, or place a piece in a puzzle. CPA allows an audiologist to test the hearing of very young toddlers and preschoolers. It can be a vital tool to ensure that your children will not be disadvantaged in the classroom when they head off to school.

Why does CPA differ from adult hearing tests?

CPA uses a machine known as an audiometer to test a child’s hearing threshold levels. A pure tone audiometer usually relies on a user feedback button and, so, isn’t practical for younger kids. CPA makes a game out of the hearing test by replacing the feedback device with activity-related toys such as blocks or pegs. CPA measures hearing sensitivity to determine both a child’s type and degree of hearing loss, if any. The audiologist can then refer parents to another specialist, if necessary.

Games

Conditioned play audiometry may rely on one or more of the following games:

• Blocks or balls: Using positive reinforcement, the screener “trains” the child to place blocks or balls in a basket whenever he hears a tone.
• Pegs: As with blocks, the screener teaches the child to place pegs in a hole whenever she hears a sound.
• Rings: Like the above, the screener teaches the child a simple game. In this case, the child places a ring over a cone when he hears the beep.
• Tablet games: A 2013 study found that a tablet-based audiometer might give audiologists another way to perform hearing tests on young kids in the future. The child plays simple games on an iPad or other device and receives rewards similar to the above.

Tests

Conditioned play audiometry takes place in a soundproof booth or sound-treated room. There are two parts to CPA: conditioning and screening.

• Conditioning: During this phase, the audiologist will tell your child that they are going to play a game. She will begin by pressing the tone and getting the child excited by saying, “Wow, you get a block!” The screener then gives the child the toy. She then tells the child to place the block in a basket every time she hears the beep. She will then work with your child to perform the task as quickly as possible. Once the child understands the game, screening can begin.
• Screening: For screening, the audiologist will place headphones (or earphones) on your child. Tests continue using different frequencies until the audiologist has a complete set of data about your child’s hearing in both ears.

Tympanograms and Reflex Tests

Tympanograms measure the movement and flexibility of the tympanic membrane to identify whether it is moving normally. Results may indicate a problem in the middle ear that can cause a conductive hearing loss. When a child has a normal tympanogram, it may also be possible to test for the presence of a muscle reflex – the acoustic reflex – in the middle-ear. The absence of this reflex to different sounds gives information about the functioning of the auditory system.

Auditory Processing Assessments

Auditory Processing assessments are for children who display normal hearing sensitivity but have listening difficulties, such as difficulty understanding speech in the presence of background noise. Testing takes approximately 90 mins. First, a hearing test and memory tests are performed. These are followed by the auditory processing tests.

Procedure

1. Auditory Memory Tests: This assesses your child’s short-term auditory memory for numbers and sentences.
2. Auditory Processing Tests: Dichotic Digits Test (binaural integration) and Competing Sentences Test (binaural separation). These two tests (1 & 2) assess your child’s ability to process information presented simultaneously to both ears.
3. Frequency Pitch Pattern Test (temporal patterning): This test checks your child’s ability to detect and sequence subtle differences in sounds
4. Low Pass Filtered Word Test (monaural low redundancy speech test): This assesses the ability to understand the whole word when part of the message is missing
5. Masked Level Difference test (binaural interaction): This test assesses the ability of your child to use subtle sound cues to hear in the presence of background noise
6. Gaps in noise test (temporal processing): This test assesses your child’s ability to detect when one sound has ended and another has begun.

Before booking with another professional, please check the number of tests that are performed, as no one test is definitive of a diagnosis.

Further testing

If required the audiologist may suggest electrophysiological testing. These tests measure the brain’s response to sounds. Appropriate referrals to other professionals will also be discussed.

Reports

Following the assessment, the audiologist will provide you with a brief summary of the results. A detailed report will then be sent within 1 week of the appointment. A follow-up consultation can also be arranged to arrange remediation.

 

Make an appointment

You can call us to make an appointment for your child’s hearing test on 02 9999-6314 or click here to use our online Make an Appointment form.