A Study on Play Audiometry

Abstract

The author devised a new method of play audiometry. This is an improvement on the peep show test originated by Dix and Hallpike, which uses, in place of pictures, an electric locomo-tive set more attractive to children as a reward. When the tested child presses a button at hand hearing a tone, an electric locomotive drawing passenger-cars starts, signal lights go on and off and crossing bars go up and down. A panorama is developed in which stations and tunnels are placed. At the test the author used conditioned reflex and used light stimulus as nonconditioned stimulus. In order to carry out the test by only one person, the author so designed that opening and closing of the whole circuit could be operated by a switch on the tester's side. It was also arranged that the switch could be operated in the test room when conditioning, and could be operated in the neighboring instrument room when testing. A magic mirror was put in the wall between test room and instrument room and the test was performed by observing actions of the child. With the child who disliked wearing of the receiver, biaural hearing was tested on the free field.
The author studied some problems on the measurement, test results and application ages in the 230cases tested by this method during the past year. She also measured hearing acuity of normal children aged 3-6. She also investigated the test reliability by means of a study on threshold variations between test and retest, and a comparison with the thresholds measured by the standard pure tone audiometry (hand rising method).
The results obtained are as follows.
(1) The measurement of hearing thresholds by this method was very difficult with children under 3. The application limit of play audiometry is considered to be about 3 years of age.
(2) In general, the test was easy with normal children, with mildly and severely deaf child- ren and was difficult with moderately deaf children.
(3) The hearing thresholds of normal children aged 3 - 6 showed an average rise of 5-20db as compared with those of normal adults. The thresholds were high especially in low tone and high tone areas and tended to approach those of adults with the increase of ages. The audiogram was knoll-shaped.
(4) When the test cannot be performed more than once, it must be always borne in mind that the hearing might be better than the thresholds obtained show.
(5) With normal children and older children, thresholds near true ones can often be obtained at the first test, but with deaf children especially moderately deaf children it is dangerous to de-termine thresholds at the first test. True thresholds, however, can be obtained at the second test.
(6) With younger children aged 3-5, determination of thresholds in low tone and high tone areas requires circumspection.
(7) This method was particularly valuable for determination of hearing acuity in profoundly deaf children and for detection of residual hearing in totally deaf children.
(8) In pre-school age children the results obtained by this method are superior to those obtain- ed by the standard pure tone audiometry (hand rising method).