Visual Reinforcement Audiometry (VRA) with Young Down’s Syndrome Children

Abstract

Visual Reinforcement Audiometry (VRA) was investigated with 41 Down's syndrome subjects between the ages of six months and six years. The VRA procedure involved monitoring a head-turn response to a complex noise signal presented in a sound field with an ascending presentation paradigm and reinforced by a complex visual reinforcer. Twenty-four of the infants and young children also were evaluated with the Bayley Scales of Infant Development (BSID) to allow for analysis of the efficacy of VRA as a function of developmental age. Results were as follows: (1) 28 (68%) of the infants and young children initially oriented towards the source of the auditory stimulus, (2) only a few of the subjects who did not initially orient could be taught to respond, (3) of the children who initially oriented or were taught to respond, thresholds were obtained on a large number (81%) in one visit, and (4) a systematic relationship was demonstrated between consistency of subject response using the VRA technique and BSID Mental Age Equivalent with 10 months being the critical age for determining the potential success of the procedure. In addition, the results implied a higher incidence of hearing loss in the Down's syndrome subjects than found in normal pediatric population.