Adding objectivity to infant behavioral audiometry.

This article deals with the limitations of infant behavioral audiometry, which have led us to seek objective methods of audiometry for determining hearing sensitivity in infants. It describes efforts to add objectivity to (or reduce the subjectivity of) behavioral methods of infant audiometry. Several aspects of visual reinforcement audiometry (VRA), including the head turn response, the use of control trials, and adherence to the principles of operant conditioning, serve to reduce the subjectivity inherent in behavior observation audiometry. In addition, computer control of VRA procedures can relieve the examiner of potentially subjective decision-making during the course of evaluation and can facilitate testing with sophisticated algorithms that could not be done manually by a single examiner. Computer simulations to determine the best VRA test parameters are described.