Classical T/C level fitting for Children: observation

With very small children it may be necessary to rely completely on observation to set both T- and C-levels. This is done by slowly increasing stimulation until a reaction is observed; this should be supra-threshold stimulation. A reaction can be a conscious attention-related movement (e.g. looking up while playing), or an unconscious (so called ideo-motive) movement like eye-blinking, change in breathing rhythm, etc. After setting a threshold in this way the stimulation can be increased until signs of discomfort are seen to get an idea of C-level. Typically the observation or behavioural threshold found in this way is above the real threshold since children tend to respond to a clearly audible level. As a first map, the audiologist could for instance set the T-level 2 dB below the observation threshold, and the C-level 1 dB above. This should give a map that is soft but audible, which is acceptable for a first setting.
Advantage: Can be used with very small children.
Disadvantage: Difficult to interpret, requires skill and experience, does not get the real threshold but rather a ‘mid-dynamic range’ indication that needs to be refined at a later stage.
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