The new age of play audiometry: prospective validation testing of an iPad-based play audiometer

OBJECTIVE The timely diagnosis of hearing loss in the pediatric population has significant implications for a child's development. However, audiological evaluation in this population poses unique challenges due to difficulties with patient cooperation. Though specialized adaptations exist (such as conditioned play audiometry), these methods can be time consuming and costly. The objective of this study was to validate an iPad-based play audiometer that addresses the shortcomings of existing audiometry. METHODS We designed a novel, interactive game for the Apple® iPad® that tests pure tone thresholds. In a prospective, randomized study, the efficacy of this tool was compared to standard play audiometry. 85 consecutive patients presenting to the Audiology Clinic at the Children's Hospital of Eastern Ontario (ages 3 and older) were recruited into this study. Their hearing was evaluated using both tablet and traditional play audiometry. OUTCOME MEASURE Warble-tone thresholds obtained by both tablet and traditional audiometry. RESULTS The majority of children in this age group were capable of completing an audiologic assessment using the tablet computer. The data demonstrate no statistically significant difference between warble-tone thresholds obtained by tablet and traditional audiometry (p=0.29). Moreover, the tablet audiometer demonstrates strong sensitivity (93.3%), specificity (94.5%) and negative predictive value (98.1%). CONCLUSION The tablet audiometer is a valid and sensitive instrument for screening and assessment of warble-tone thresholds in children.