CONDITIONED PLAY AUDIOMETRY
(CPA)

Watch this short video of a 2 years 8 month old being tested via ear inserts using CPA, at Sound Steps.

Once your child is 2 ½ years old, s/he can give more advanced responses (i.e. listen and drop task), to sounds presented. This method of testing hearing in young children with a cognitive age of 30 months and above, is called Conditioned Play Audiometry (CPA). CPA is accomplished easily with children who are cognitively older than 3 years, and will not be accomplished easily with children who are below 2 ½ years old. Infants who have been raised to listen, may transition to Conditioned Play Audiometry (CPA), before they are 30 months old.

CPA requires a child to be seated in a high chair. The audiologist presents Warble Tones or Pulsed Pure Tones across the speech frequency range of 250 Hz (Hertz) upto 8000 Hz (Hertz). Each ear is tested individually, at each of these frequencies, to obtain ear specific and frequency specific information, that is reliable. Ear inserts or insert earphones are used to deliver the sound stimulus reliably to your child's ears, in order to obtain individual ear information.

CPA requires a child to be seated in a high chair. The audiologist presents Warble Tones or Pulsed Pure Tones across the speech frequency range of 250 Hz (Hertz) upto 8000 Hz (Hertz). Each ear is tested individually, at each of these frequencies, to obtain ear specific and frequency specific information, that is reliable. Ear inserts or insert earphones are used to deliver the sound stimulus reliably to your child's ears, in order to obtain individual ear information.

Young children have a short attention span and tire easily with the same task. Changing the toy or activity before the child loses interest in it, helps sustain your child’s attention.

Children find listening to speech, especially the voice of the primary care-giver, much more interesting than tones. Your audiologist may ask you to sing familiar nursery rhymes or songs to your child, while s/he monitors the intensity levels and observes your child’s responses.

The responses that your child gives to both sounds (i.e. tones) and speech over the frequency range, in each ear, are then plotted on an audiogram or graph to obtain your child’s unaided audiogram. Your child’s audiogram measures his or her hearing loss. It will help you understand whether your child has the access to sounds, his or her brain needs to understand spoken language and to learn like other children the same age. These responses will help determine

  1. whether hearing loss is present
  2. which model of hearing aid best supports your child’s hearing loss
  3. the settings for your child’s hearing aids
  4. whether your infant needs a cochlear implant

Once your child is using hearing aids during all his or her waking hours for approximately three to four weeks, your audiologist will measure his/her responses to sound (i.e. tones) and speech, with hearing aids, one ear at a time, using CPA. The audiologist will then plot these responses, to obtain your child’s aided audiogram.

Your child in his or her fourth year, may be ready to transition to the hand-raising task as a way to respond to the tone or speech stimulus presented.

Other Tests That Can be Relevant to Your Case

Visual Reinforcement Audiometry (VRA)

VRA is the method of testing hearing in babies and young children between the ages of six months and thirty-six months, observing the child's head turn towards a visual reinforcer such as a toy that lights up.

Behavioural Observation Audiometry (BOA)

BOA is the method of testing hearing in newborns from birth to six months, observing their sucking response to sound.

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