Behavioral audiometry in children: clinical effectiveness and assessment of key clinical outcomes

Overview

The aim of this study was to describe the clinical applicability of behavioral audiometric methods in routine pediatric audiological practice and to evaluate selected clinical variables associated with obtaining a valid behavioral audiometric result. A retrospective observational analysis was performed in a cohort of 534 children examined using behavioral audiometry in 2024 at a specialized pediatric audiology center. The evaluated parameters included the success rate of obtaining a valid behavioral result, the behavioral audiometric method used (BOA, VRA, CPA), the occurrence of non-valid results (CNT –⁠ Could Not Test), and the number of examinations required to assess the functional integrity of hearing. A valid behavioral audiometric result was obtained in 94.5% of examined children. In the subgroup of children assessed within the differential diag­nosis of developmental disorders, a clinically usable result was achieved in most cases during the first visit, with a mean number of examinations of 1.19 ± 0.47. A non-valid result (CNT) was recorded in 5.4% of children and was primarily associated with the child’s developmental profile and limited stability of behavioral responses. The choice of behavioral audiometric method was guided by the child’s developmental level and cooperation rather than chronological age. Behavioral audiometry provides clinically useful information in the majority of pediatric patients when applied using a developmentally oriented and flexible approach. Evaluation of basic clinical variables provides a practical framework for the interpretation of behavioral audiometric findings in routine pediatric audiological practice and highlights the continued importance of behavioral audiometry for monitoring auditory development in young children.

Keywords:

child – VRA – CPA – behavioral audiometry – global hearing capacity – CNT – hearing diagnostics