Validation of play-conditioned audiometry in a clinical setting.

The aim of the present study was to investigate at what ages children were able to participate in play-conditioned audiometry in a clinical setting. Data concerning age and gender for 294 children (182 boys and 112 girls) were continuously recorded with details regarding audiometric method and number of successfully determined thresholds. Some children were tested more than once, resulting in a total of 449 examinations. The results are compared with those of other studies in which visual reinforced audiometry (VRA), condition-orientation reflex audiometry (COR) and play-conditioned audiometry are used, and show that in a clinical setting it is possible to determine at least one threshold in more than 35% of children tested at ages above 16 months. At 2 years of age, about 50% of the children are able to establish thresholds at least at three frequencies and from 3 years of age nearly 75% of the children could establish 6 thresholds or more. It is concluded that VRA, COR and play-conditioned audiometry should be considered along with objective hearing tests like brainstem audiometry (ABR) or measurement of otoacoustic emissions (OAE) when assessing hearing in infants and small children.