Visual Response Audiometry - 19 month old baby - not a good test?

[Wrecktal]

Anyone any experience of this? Seems to measure compliance rather than hearing?

I just can’t imagine him wanting to sit still and respond in an unfamiliar environment. But, I do think an assessment in the home where he feels comfortable would give a clearer picture. I imagined someone would simply look in his ears/test with headphones like when he was a newborn!

Yes. Very good results at GOSH with this test up to about 2 then stopped complying so well with the tests after that. 50% deaf due to 2x severe glue ear. Haven’t had any reliable tests from then until now which is 3 1/2 as apparently 2 plus gets more difficult and with COVID it all gone to pot.

Also it’s not so much “sitting still” as engaging the child in play the therapists are very good at it.

And I’m trying to work out whether his lack or responsiveness is an issue. He’s exactly the same as his dad - in that I can call his name until I’m blue in the face (with no response) - but say ‘cake’ softly from another room, or if he hears me picks up the car keys - he’s there like a shot!

DS pokes his fingers in his ear a lot! And it’s the lack of clear sounds in his speech, but he can copy the tune of a song...

@gah2teenagers - I just know he won’t engage in the play - he takes a long time to warm up to other adults, we haven’t been to playgroups since Covid

Did they also do different physical tests on him, looking inside the ear etc, we had 2 or 3 things I think.

Was he sitting on your knee?

@doadeer no looking inside ear. He was greeted by a v sweet, nervous, OTT nurse - and then a second grumpy nurse who decided to abandon the test after various toy waving didn’t work - and big major meltdown from DS

He sat on my knee with instructions that I make him face forward.

Just because your child did not cope today does not mean the test is flawed, it means your child found the test tricky for whatever reason. Mine found it hard some days and other times was fine with it. They can't do it at home as they need the right conditions to ensure the only sound available is that which is played to him apart from anything else.

The test done on babies at birth is generally just a ‘screen’ (unless baby needs further more detailed tests). The screen can be repeated in older kids but most audiology clinics would not discharge a 18month old based on a screening test alone, particularly if the concern is speech clarity. VRA can and should be used (or at least attempted, twice usually) for a kid aged 8months-2yrs(ish) as it can give a lot more detailed info than a screening test (when it goes well :)). Around 18-24months is often a tricky age for VRA though and some kids at that age are a bit old for the puppets, but a bit young for the test that is usually done with slightly older kids. Some kids will need a few appointments before they are comfortable in the test environment, some kids will have an ‘off day’ where they won’t play/be interested in the puppets but will be fine a few weeks later, some kids will be scared of one puppet but happy with another. I know it is frustrating but if the first appointment doesn’t go well it doesn’t mean that subsequent ones will be the same.
If after a second appointment they haven’t established the hearing levels the clinicians should make a plan with you for next steps, Ask them about this at the next appointment. You could ring the clinic for a chat about your concerns before the next appointment - the clinicians should be used to explaining the benefits and limitations of VRA to slightly disheartened parents. Unfortunately accurate detailed hearing tests can’t be done at home. Your reports of things like how DS responds to ‘cake’ quietly but not his name loudly etc are really helpful for clinicians so keep an eye out for examples like this.