Description Of Various Tests; Reflex Audiometry By Neonates - Interacoustics PA5 Gebrauchsanweisung

3.2

Description of various tests

As found by Professor Sanford E. Gerber complex signals like White Noise (WN) assure better
responsiveness on neonates and up to the age of approximately seven months than e.g., pure tones and
Narrow Band Noise. Therefore, PA5 has the possibility of stimulating with WN.
The APR Test:
The Auropalpebral Reflex is a startle reflex of the eyelid elicited by relatively strong sounds, approximately
80 - 100 dB SPL (PA5 is calibrated in dB HL).
The test can be performed on neonates from the day of birth, and it is not based on co-operation with the
new-born child. Other responses than the APR can be arousal from sleep, crying or diminished activity.
The COR Test:
The Paediatric Audiometer PA5 can perform Conditioned Orientation Audiometry based on a technique
described by Suzuki and Ogiba (1961). The phenomenon called "Orientation Reflex" is not a learned
response, but a natural reflex movement elicited by sound or visual stimulation.
If the visual stimulation elicits a reflex which is conditioned by a tone, the child will look towards the visual
stimulation, e.g., flashing light, as soon as the tone is heard. If the conditioning is effective the child will look
in the direction of the sound source even before the visual stimulation is presented. The COR method
requires cooperation from the child.
The VRA Test:
The Paediatric Audiometer PA5 can perform the Visual Reinforcement Audiometry (Liden and Kankunen,
1969), which is an extension and modification of COR, where the co-operation with the child is less
important. Liden and Kankunen accept not only the sound localisation orientation reflex, but also four other
reactions: reflex reactions (body and face), search reactions, orientation reactions and spontaneous
reactions.
3.3

Reflex audiometry by Neonates

The reflex pattern elicited by sound can be divided into the following types of reflexes (Relke and Frey 1966).
The sound intensity is 75 – 90dB.
Breathing Reflex
The breathing rhythm is changing when the sound is heard and should stabilise after 5-10 seconds.
Auropalpebral Reflex (APR)
The open eyelids will be closed fast and clear.
Moving Reflex
The neonatal child will move heavily after a quiet period.
Crying Reflex (Scream)
The face of the child will indicate discomfort and shortly after followed by weeping or a scream.
Astonishment Reflex
Crying and body movements stop momentarily as if the child is asking: "What is going on"?
Waking up Reflex
The breathing rate is accelerating; the child starts moving, wakes up and opens the eyes.
PA5 Instructions for Use - EN
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