Visual reinforcement audiometry (VRA) is a test procedure routinely used to evaluate hearing in infants and young children (6 months to 2 years). Most research and current clinical practice uses flashing lights and/or animated toys to provide reinforcement to a child during VRA. New technology capable of generating a moving video image is now available for providing visual reinforcement to infants during VRA testing. It is reasonable to expect that video images, with presumed greater novelty and complexity, would be more interesting and rewarding to children than conventional, animated mechanical toy reinforcers. On the other hand, in today’s society, children are frequently exposed to video images in the home and elsewhere. Therefore, three-dimensional animated toys may present with greater novelty than video images. The purpose of this study was to compare auditory localization behavior, as defined by the number of head turn responses until habituation, during VRA with 2-year-old children using two types of reinforcers: (a) moving images generated by a digital video disc player/monitor and (b) a conventional, animated mechanical toy. Twenty children were selected randomly from a total group of 40 and tested using conventional reinforcement. The remaining 20 children were tested using video reinforcement. The average number of head turn responses prior to habituation was approximately 15 for the video-reinforced group and approximately 11 for the conventional toy-reinforced group, suggesting that during VRA a video image may be more reinforcing than a conventional animated toy.
