Pediatric audiologists are experts on conditioned-play audiometry (CPA). They often work in teams of two, with one operating the audiometer and the other sitting with the child in the booth to help keep the child on task. I recently found myself on my own in a primary-care medical setting testing four- to five-year-olds using tablet-based SHOEBOX Audiometry.

These children presented with active otitis media and were not feeling up to the manual testing task. I turned to conditioning them with play audiometry and was able to complete the testing needed on all four children in under an hour—solo. I was initially skeptical, as I was in full view of the child and was using one hand to assist with conditioning and the other to operate the tablet simultaneously. I was pleasantly surprised to see that my proximity did not distract the child from the task at hand. I employed false taps to replicate pressing the stimulus button and did not observe false-positive responses to those movements.

There are precautions to take to ensure good reliability. For example, an effective conditioning phase: less talking, more demonstrating with visual reinforcement in the form of no-sound clapping, a thumbs-up, and smiles and nods. False taps are important to ensure the child is abiding by the listening task and not visual cues. Tablet audiometry facilitates adding solo-play audiometry to your mobile test offering.

Visit www.shoebox.md for more information.