The results of behavioral audiometry can not only reflect the status of peripheral hearing, but also show the ability of auditory center. Therefore, it is considered as a “real sense of hearing test”, which is more meaningful for predicting the wearing effect of hearing aids.


Behavioral audiometry for different age groups:


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According to the individual differences of the examinee, the appropriate listening test method can also be selected.







Behavior observation

Applicable group: for infants and young children from 0 to 6 months

Objective: To observe the behavioral response of infants to sound stimulation under the condition of unconditioned reflex

Definition: emergence of stimulus sound → observation of auditory behavior change of infants → assessment of hearing status of infants; it can only be used as a primary indicator of normal hearing or suspected hearing loss, and needs objective test to confirm the results

Test environment: sound insulation room

Subject status: make sure the child is awake or not sleeping very well during the test. 3-month ideal is between light sleep & quiet awake




Testers and practices


Induced observer

1. Establish close relationship with children as soon as possible, attract children, let them pay attention to the toys in front of them, and keep them in a quiet state, but don’t invest too much;

2. Timing of giving voice to the tester;

3. Encourage children accordingly;

4. Record the relevant information, such as the frequency and intensity of the stimulus sound, the side of the given sound, the side of the response, and accurately describe the situation and the way of the child’s head turning movement;



Control the intensity and frequency of the given stimulus sound, and judge whether the response of the subject is auditory response. Pay attention to children’s response. If children have no response to the stimulation sound, give the sound again until there is a response.

Each ear was measured with the toy of high-frequency stimulation sound and low-frequency stimulation sound, and the control method without stimulation sound was repeated and used randomly — four effective stimulation sounds were given, and one ineffective stimulation sound was given randomly as the control examination.

Finally, the most powerful signal is used to elicit the startling response, which may frighten the child to cry. Before giving the voice, it is necessary to explain to the parents.

Test distance: the distance between the toy and the test ear and the microphone of the sound level meter is 30-45cm, and the toy should be at the same level. The sound source should be placed behind the ear of the child to ensure that it is outside the field of vision of the child


Test location



Suitable position for children: the best position is to sit in a high chair, feel comfortable, and turn your body from one side to the other at will; you can sit on the mother’s leg, and the mother gently holds the child’s waist, but the mother does not respond to the voice;

Children under four months can be put into light sleep.

Parents don’t move, don’t give tips


Position of induced Observer: in the opposite side of the subject, guide with toys

Location of tester: behind the parent’s side, use equipment or toys to make voice


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Choice of stimulus sound


Frequency calibrated sounding toys, portable evaluators, narrowband noise, wideband noise, language (especially familiar sound)


(reference for the main frequency of common vocal toys for children’s behavior audiometry:

The main frequency of the drum is about 250 ~ 500Hz, which belongs to low-frequency sound generator;

The main frequency of the woodfish is about 800 ~ 1000Hz, which belongs to the medium frequency sound generator;

The main frequency of delta iron is about 6000Hz, which belongs to high frequency sound generator)


Stand by and measure the sound

Sound giving time: the sound giving duration is 3-5s, and the sound giving interval is at least 10s



Observation of children’s response by giving stimulus sound


Children’s reaction: closed eyes (eyelid reaction) or whole body shaking (Moro reflex) are more common. Some babies are suddenly stimulated by sound during sleep


Head or eyeball turn to sound source direction

Open your eyes (wake up reflex)

Eyebrow activity


Limb movement

Stop activity or sound

Temporary deep breath

Sucking reflex (stop sucking or make an “ah” sound)

Spike reflex

Changes in respiratory rate


Moro reflex: the sound of 50-60db (a) in children born 0-3 months with normal hearing can be manifested as eyes opening, whole body shaking, hands clenching, forearm flexion and extension.

Record and explain: record the frequency and intensity of the stimulus sound of the toy, give the side of the sound and the side of the response, and accurately describe the situation and the way of the child’s head turning movement; < br >
Behavioral observation and audiometry

It should not be used to: screen hearing; estimate the threshold of hearing at the beginning; determine the target value of hearing aids – this must be obtained through ABR and ASSR; this may play an auxiliary role in interpreting ABR results

Link:Children's behavioral audiometry

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