A two-interval, forced-choice, observer-based procedure for evaluating hearing sensitivity in children with motor and developmental impairments

Purpose: It can be challenging to collect reliable behavioral responses to sound from individuals with significant motor or developmental impairments, the most common types of comorbid disability found in children with hearing loss (e.g., Gallaudet Research Institute, 2011). The purpose of this study was to test the feasibility of using a 2-interval, forced-choice, observer-based method for individuals considered to be difficult-to-test using behavioral audiometric assessments. Method: Participants were 5 children with motor and developmental impairments, ages 5–15 years (M = 11.6, SD = 4.6). The functional abilities of all participants were greater than 2 SDs below the mean, as measured by the Vineland-II Parent Caregiver Rating Form. Participants listened to either a male talker saying the word “playground” or a 1000-Hz warble tone, presented via an insert earphone or a sound field speaker. An observer, blind to signal presentation, selected 1 of 2 temporal intervals, determining which contained the signal based only on participant behavior. Criterion was reached when the observer correctly identified the interval containing the signal for 8 of the last 10 trials. Results: An 80%-correct criterion was met for all participants, suggesting feasibility for use in children with motor or developmental impairment. Two participants were tested using an adaptive tracking procedure; a reliable threshold estimate was obtained for both children. This method offers promise for children who have difficulty performing behavioral audiometric assessments currently in use clinically.