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Visual Reinforcement Audiometry (VRA)

About VRA

The Visual Reinforcement Audiometry (VRA) test measures hearing sensitivity and is for patients who are not able to perform traditional testing due to age or developmental limitations. The test is typically performed on children aged seven months to two and a half years.


During the test, the child sits on parent’s lap in a sound booth (booth with a window that is insulated to outside noise), where speech sounds and tones are presented through two speakers in corners of the booth. The typical response is a head turn in the direction of the speaker, reinforced by lighting an animated toy above the speaker. Once the child is conditioned to respond to the sound, intensity of the signal is decreased to determine his or her child’s hearing sensitivity.


Results obtained while testing through the speakers represent the hearing sensitivity of the better hearing ear, should a difference between ears exist. In order to obtain ear-specific information, testing must be conducted under headphones, which may not be tolerated by younger children. In addition, results may be limited by developmental level and/or attention span.