Change The Way You VRA – ONE DEVICE – ONE CLINICIAN
VRA Reimagined. A New Form Of Visual Reinforced Audiometry
Test – Store – Reward – Review – Interact. MedRx has integrated National Acoustic Laboratories technology and is now offering Visual Reinforced Audiometry as an add-on to the new MedRx Studio Software. The VRA system takes a new approach to VRA testing. This system uses an iOS device to act as an audiometer and VRA controller. A clinician is able to adjust level, frequency, presentation ear, presentation and visual rewarding from the MedRx iVRA iOS app. Take advantage of the four test modes: conditioning, manual, automatic and video only testing. Change the way you VRA with the all new MedRx iVRA. A2D+ Audiometer, Stealth Audiometer and ARC compatible.
- iPod Audiometer Control
- iPod Video Reward Control
- Testing with One Clinician
- 29 Animated Videos (Default)
can add custom videos too
- Any Size Monitor
- Wireless Monitor Communication (Optional)
- Automatic, Manual, Conditioning and Video Only Modes
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VRA Reimagined. A New Form Of Visual Reinforced Audiometry
MedRx is now offering Visual Reinforced Audiometry as an add-on to the new MedRx Studio Software. This system uses an iOS device to act as an audiometer and VRA controller. Change the way you VRA with MedRx.
Visual Reinforced Audiometry with MedRx iVRA
The MedRx iVRA is designed to allow clinicians to perform traditional VRA* and a new innovative form of VRA. The MedRx iVRA is a combination of the MedRx Studio Software and the MedRx iVRA iOS application. The Studio Software allows a clinic to host up to three VRA monitors (left, right and center) to present visual rewards to the child. The MedRx iVRA iOS application will act as the reward presentation remote or when paired with a MedRx audiometer it will be the audiometer controller and reward presentation remote. The pairing of MedRx software and an iOS device allows for new and innovative VRA strategies.
The MedRx iVRA system will allow for traditional VRA through the use of our video only mode. In this mode, you can pair our VRA system with any audiometer no matter the brand or age. Simply connect the monitors to a PC with the VRA software and you can present video rewards with the use of our iOS app. The iOS app is our video activation remote allowing the clinician to present rewards on up to three screens individually or simultaneously. Our software has incredible flexibility which will allow you to randomize videos, upload custom videos or order the videos so the clinician can select specific videos.
MedRx has exclusively partnered with National Acoustic Laboratories (NAL) to provide clinicians a new way of performing visual reinforced audiometry. The MedRx iVRA allows clinicians to step beyond the traditional limitations of visual reinforced audiometry procedures by eliminating the need for an assistant during testing. Our system can do this with the use of an iOS device that acts as an audiometer and VRA controller. A clinician is able to adjust level, frequency, presentation ear, presentation and visual rewarding from the MedRx iVRA iOS app. The iVRA app allows clinicians to take advantage of four tests modes: conditioning, manual, automatic and video only testing.
The new and innovative way to perform visual reinforced audiometry occurs when the MedRx iVRA is paired with a MedRx audiometer. The combination of the technologies allows clinics to transfer from a two person VRA test into a clinician only VRA test. We accomplish this using the MedRx iVRA app. The iOS app creates a connection between the MedRx Studio software, reward screens and the audiometer. The iOS app can then control our audiometer by presenting tones, adjusting presentation frequency, changing presentation ears, choosing videos, presenting visual rewards and saving results. All this with a simple user interface that can be controlled discretely without the need to look at the application. The connection between the MedRx iVRA app and audiometer allow the clinician to then walk away from the audiometer and perform both assistant and clinician functions in the booth with the child. No more coordinating schedules and limited slots. A clinician now has the flexibility to perform visual reinforced audiometry at any time their schedule permits.
MedRx iVRA when paired with MedRx audiometers have the ability to perform two types of testing. The app has manual and automatic testing functions. The two types of testing have their own benefits and help the clinician during visual reinforced audiometry which can be a dynamic test. In general, the manual testing allows full control for the clinician while the automatic lowers bias and allows the clinician to focus on the child.
The manual function provides the clinician with full control of the stimulus presented to the child. Quickly and easily change ears, frequency and level all from the app to keep the child’s interest during testing. We have built in catch trials and masking for the clinician to help prevent any bias from being in the room with the child during testing. In manual testing, we will log all presentation levels, correct responses and false positives for viewing during testing and after the test is complete. A clinician can determine threshold from the app and send it to the audiometer software and continue testing seamlessly.
The automatic function allows the clinician to start the testing at any desired frequency and level. Once the testing begins, the stimulus will adjust levels automatically until threshold is determined. The clinician simply needs to signal when the child is ready to receive the stimulus and whether there is a response. NAL has developed automatic protocols which will adapt the presentation level of the stimulus and allow the clinician to focus on the child they are testing. The clinician then chooses the next frequency to test and continues until complete. As with manual testing, we have built in catch trials and masking for the clinician to help prevent any bias during testing. MedRx iVRA will also store everything that occurred during testing. This includes all presentation levels, correct responses and false positives to allow clinicians to view the test afterwards to determine accuracy.
Awards and Recognition
The MedRx iVRA product was entered into the 2020 Hearing Health Innovator awards under the Equipment category. Clinicians voted for and determined that the MedRx iVRA was an innovative solution and awarded it the Bronze award. We are very proud of the changes that this product will provide in the industry. This great innovation will allow individual clinicians to broaden the services provided to customers by allowing them to perform full VRA testing without the need of an assistant.
*Traditional Visual Reinforced Audiometry
Visual Reinforced Audiometry, also known as VRA, is audiometric testing designed for pediatric patients between the ages of 6 months and 2-3 years. The testing may also be called visual reinforced orientation audiometry (VROA) in certain countries. Visual reinforced audiometry is an ideal test for children unable to provide verbal or push-button responses. Instead, VRA uses a head turn response that is a natural reaction to sound presented from the side. This is paired with a visual reward when the stimulus is being played to encourage responses. The initial association of the stimulus and visual reward is called Conditioning. Conditioning is required for most children prior to the test start. The child is presented tones at a comfortable volume and the stimulus is paired with the visual reward. After several presentations the child will begin to look for the visual reward and the clinician is now ready for testing.
There are two types of visual rewards in VRA testing: animated puppet and animated video clips. The visual rewards need to capture the child’s attention so that they are encouraged to look in the direction of the stimulus.
The visual reward and the speaker need to be next to each other in order for the child to associate the sound with the visual reward. The ideal system will provide a base set of videos and the ability to upload new videos that are relevant to children as time passes.
Traditional visual reinforced audiometry is performed with a clinician and an assistant. The clinician will present the stimulus and monitor the child for response. The child is monitored during testing through a window or camera for head movements indicating a response. An assistant will be in the room with the child teaching the task, cueing rewards and helping to bring the child back to center using various distractors. Many times, the assistant is under masking noise to prevent any bias. The process requires both the clinician and assistant to understand the task at hand and have open time in their schedule for the visual reinforced audiometry appointment.