Behavioral observation audiometry is a test performed in children under 3 years of age, non-cooperating children, children with disabilities, with a diagnosis of autism or CP. The test is performed in order to evaluate the response of auditory child when choosing a hearing aid or to assess the benefits of the hearing aid or the cochlear implant. As the name suggests is based on the study of behavioral and involuntary reflexes of the child.


What is behavioral observational audiometry performed for? 

BOA test is performed primarily as a subjective test of complementary test to the objective test (OAE, AI, ABR). It is performed in order to confirm the results of the research objective and in order to observe the child’s behavioral response to the given sound stimulu. Test involves administration of stimuli known to the child or adequate to the developmental age, ie. onomatopoeias, the sounds of musical instruments. It can also be used as an auditory reactions screening test. This test provides very important information for the hearing care professional, as in the case of the occurring and recurring reactions it shows the actual threshold of child’s hearing for a given frequency.

How is the BOA performed??

The examining doctor or the professional observes the child’s response on a given sound stimulus. Children under 1 year of age are examined on the changing table, which is placed in a calibrated free-field. From the speakers are sounds at a specific frequency and volume played, while the researcher observes characteristics, scope, intensity and frequency of the child’s responses. For older children, the test is carried out on the parent’s lap or unassisted on the chair / wheelchair / baby carrier.

Test result: Behavioral observation audiometry ends with a filled table showing the occurrence of response to the stimulus sound of a specific volume and frequency (or frequency band for broadband sounds). The table is also often accompanied by a brief description of the test, which may be issued at the request of a parent or a guardian.

Behavioral reflex and play audiometry in children:


Due to the nature of the test, BAO is typical for newborns, infants and non-cooperating children. It is a supporting test for the selection of hearing aids and allowing the evaluation of the benefits of the proposed hearing aid.

PLEASE NOTE! Behavioral observation audiometry is completely non-invasive. It does not require the cooperation of a child, but it is important that the child is sated, well-rested and awaken. It is not recommended to perform the test before the phase of sleep in which the child’s responses may be reduced and diagnostically unreliable.

Author: Aleksandra Stojak