Behavioral Techniques in Pediatric Audiology

By James Peck

This article is a part of the January/February 2020, Volume 32, Number 1, Audiology Today issue.

The standard behavioral procedures used to assess the hearing of very young children are powerful tools. Yet, even in the hands of a skilled clinician, they are nearly worthless unless the child is ready to be tested. Thus, it is helpful—indeed necessary—to draw on techniques that get the child to do what we want the child to do.

Behavior-changing methodology can help in selecting tactics that increase the chances of obtaining a child’s compliance. These methods shape behavior in a desired direction using established techniques: reinforcing desired behaviors, not reinforcing undesired behaviors, modeling the desired response, desensitizing to aversive stimuli, and successive approximations (Peck, 2007). Combining behavior-altering strategies with principles of child psychology can guide us in making a child more amenable to testing.

This article offers practical ways to increase a child’s acceptance of audiological interactions. The intention is to blend various elements into an overall manner of clinician behavior.

Naturally, what children will accept is influenced by their personalities and age. If a child’s body language indicates comfort, there may be no need for these techniques. However, even if things are going well, one does not know at what juncture a child may become noncompliant, perhaps torpedoing the rest of the session.

General Interactions

Adaptability

Whether to cultivate cooperation or to maintain it, it is advisable to adopt a path of likely acceptance. In behavioral terms, proceed with activities that are presumably less aversive to the child. If resistance appears probable, there may be merit in deferring for the moment a procedure you deem paramount in favor of a different one that the child is more apt to accept.