Behavioral observation audiometry

Behavioral Observation Audiometry

Behavioral Observation Audiometry (BOA) is a method used in audiology to assess the hearing abilities of infants and young children who are unable to provide reliable responses in conventional hearing tests. This technique relies on observing the child's behavioral responses to auditory stimuli, which can include changes in facial expression, eye movements, or body movements.

Overview

Behavioral Observation Audiometry is typically used for children from birth to approximately six months of age. It is a subjective test, meaning that the audiologist must interpret the child's responses to determine their hearing ability. BOA is often used as an initial screening tool to identify potential hearing loss, which can then be further evaluated using more objective methods such as Auditory Brainstem Response (ABR) or Otoacoustic Emissions (OAE).

Procedure

During a BOA session, the child is usually seated on a caregiver's lap in a sound-treated room. The audiologist presents a series of sounds at different frequencies and intensities through speakers or earphones. These sounds can include pure tones, speech sounds, or noise stimuli. The audiologist observes the child for any behavioral changes that may indicate a response to the sound.

Common responses observed during BOA include:

• Startle reflex
• Eye widening or blinking
• Cessation of sucking
• Head turning
• Changes in breathing pattern

The audiologist records these responses and uses them to estimate the child's hearing thresholds.

Limitations

BOA has several limitations:

• Subjectivity: The test relies heavily on the audiologist's interpretation of the child's behavior, which can vary between practitioners.
• Limited age range: BOA is most effective for infants and very young children. As children grow older, more reliable and objective tests are preferred.
• Environmental factors: The child's state (e.g., alertness, hunger) and the testing environment can influence the results.

Clinical Significance

Despite its limitations, BOA is a valuable tool in the early detection of hearing loss in infants. Early identification and intervention are crucial for the development of speech and language skills. BOA can help guide further diagnostic testing and management strategies.

Also see

• Audiometry
• Pediatric Audiology
• Hearing Loss in Children
• Visual Reinforcement Audiometry
• Conditioned Play Audiometry