Use to record child’s Minimum Response Levels (MRL’s) and reflexive responses (eg. APR) to noisemakers and speech. Recorded in the free-field measuring a binaural response.
Use to record an overall interpretation of response levels and response qualities to provide an indication of the probable hearing status.
BOA is generally used as a secondary testing technique in infants under 6mo to provide supporting information to objective measures of hearing levels (ABR/ SSEP). In cases where an infant cannot be conditioned to VROA, is not developmentally able to perform VROA, or if VROA equipment is unavailable, BOA may be used to obtain information about behavioural hearing.
Details about assisted hearing devices used as aids in this test should be recorded in the EVALUATION.assisted_hearing_summary.
| ARCHETYPE ID | openEHR-EHR-OBSERVATION.behavioural_observation_audiometry_result.v0 |
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| Concept | Behavioural observation audiometry (BOA) result |
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| Description | Observations of an infant or young child’s unconditioned response to sound, and associated clinical interpretation. |
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| Use | Use to record child’s Minimum Response Levels (MRL’s) and reflexive responses (eg. APR) to noisemakers and speech. Recorded in the free-field measuring a binaural response. Use to record an overall interpretation of response levels and response qualities to provide an indication of the probable hearing status.
BOA is generally used as a secondary testing technique in infants under 6mo to provide supporting information to objective measures of hearing levels (ABR/ SSEP). In cases where an infant cannot be conditioned to VROA, is not developmentally able to perform VROA, or if VROA equipment is unavailable, BOA may be used to obtain information about behavioural hearing. Please note: - MRL: the lowest intensity level at which a response to a stimulus is recorded. An ascending technique should be used when establishing MRL’s.
- dBA: Decibels measured in the sound field using the A scale sound level filter. Using this filter, the sound level meter is thus less sensitive to very high and very low frequencies
Details about assisted hearing devices used as aids in this test should be recorded in the EVALUATION.assisted_hearing_summary. |
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| Misuse | Not to be used to record hearing threshold levels (HTL’s)
Not to be used to record any other assessments such as;
-VROA
-PTA
-Play
-Objective Assessments. |
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| Purpose | To record unconditioned responses of an infant or young child’s response to auditory stimuli. To record the interpretation of responses. |
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| References | |
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| Copyright | © Northern Territory Department of Health, Australia |
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| Authors | Author name: Jade Frederiksen
Organisation: Hearing Health Program, Northern Territory
Date originally authored: 2013
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| Other Details Language | Author name: Jade Frederiksen
Organisation: Hearing Health Program, Northern Territory
Date originally authored: 2013
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| Other Details (Language Independent) | - Custodian Organisation: nehta, Australia
- Current Contact: Heather Leslie, Ocean Informatics
- Original Namespace: au.org.nehta
- Original Publisher: nehta, Australia
- Custodian Namespace: au.org.nehta
- MD5-CAM-1.0.1: 95A706B902FDF1A2D72B33B859592F53
- Build Uid: 70f74d3c-1c9b-4946-9856-6d0a707ffe2f
- Revision: 0.0.1-alpha
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| Keywords | hearing, test, audiometry, MRL, decibels, observation, infant |
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| Lifecycle | in_development |
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| UID | 4766ddcb-0622-413a-b40b-521a9cd11468 |
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| Language used | en |
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| Citeable Identifier | 1013.1.1702 |
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| Revision Number | 0.0.1-alpha |
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| data | |
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| Result details | Result details: The test result observations and interpretations. |
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| Stimulus | Stimulus: The type of stimulus used in the test.
The frequency or range of frequency used by each stimulus will need to be managed in a clinical system. In most situations as a stimulus is selected by the clinician, the relevant frequency or range will be inserted into the 'Frequency' data element. |
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| Frequency | Frequency: The frequency or range of frequency of the identified stimulus.
Choice of:
 Interval of Quantity
Lower: Property: Frequency Units: Upper: Property: Frequency Units:  Quantity
Property: Frequency
Units:
|
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| Latency | Latency: * |
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| Minimum response level | Minimum response level: Lowest intensity at which a response to a stimulus is observed.
Property: Loudness
Units: dB |
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| Response | Response: *
- at0057::No response [*]
- at0058::Arousal [Baby has heightened state of arousal in response to the stimulus.]
- at0059::Stilling [Baby ceases current activity.]
- at0060::Eye response [Eye widening, eye movement or eye turn.]
- at0061::Head turn [Baby turns head in response to stimulus.]
- at0056::Auropalpebral reflex [An involuntary blink of the eye caused by contraction of the orbicularis oculi muscle in response to loud sounds.]
- at0055::Startle reflex [Moro reflex in response to stimulus.]
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| No test result | No test result: No test result is available for the side stimulated. |
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| Reason for no test result | Reason for no test result: Reason why no result is available for the side stimulated. |
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| Multimedia representation | Multimedia representation: Digital image, video or diagram representing the test results.
Include:
openEHR-EHR-CLUSTER.multimedia.v1 and specialisations |
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| Overall interpretation | Overall interpretation: Overall clinical interpretation of the responses for both ears. |
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| Exam not done | Exam not done: Details to explicitly record that this examination was not performed.
Include:
openEHR-EHR-CLUSTER.exclusion_exam.v1 and specialisations |
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| Comment | Comment: Additional narrative about the test responses, not captured in other fields. |
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| events | |
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| Any point in time event | Any point in time event: Default, unspecified point in time event which may be explicitly defined in a template or at run-time. |
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| state | |
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| Response state | Response state: The response state of the child during the test.
- at0037::Light sleep [The child was lightly sleeping.]
- at0038::Quiet and alert [The child was awake, quiet and alert.]
- at0039::Crying [The child was crying.]
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| Confounding factors | Confounding factors: Narrative description of factors, not recorded elsewhere, that may influence the response results. |
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| protocol | |
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| Extension | Extension: Additional information required to capture local content or to align with other reference models/formalisms.
For example: local information requirements or additional metadata to align with FHIR or CIMI equivalents.
Include:
All not explicitly excluded archetypes |
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| Air presentation | Air presentation: Presentation of the air conduction test stimulus indirectly to the inner ear through the atmosphere, via the auditory canal and middle ear structures.
- at0051::Soundfield [The stimulus is presented via a loudspeaker located at least one metre away from the subject.]
- at0052::Insert earphone [The stimulus is presented via insert earphones.]
- at0053::Headphone [The stimulus is presented via external headphones - either circumaural or supraaural.]
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| Test environment | Test environment: The environment in which the test is administered.
- at0041::Audiometric booth [Sound-treated test environment that meets audiometric standards for ambient noise.]
- at0042::Non-sound treated room [Test environment that does not meet audiometric standards for ambient noise.]
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| Background noise | Background noise: The amount and nature of noise in the environment that may influence the test results.
If testing is conducted in an audiometric booth, this data element is redundant.
- at0045::Clinically significant [The background noise may compromise test results.]
- at0044::Not clinically significant [The background noise is not likely to compromise test results.]
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| Calibration reference dB | Calibration reference dB: Scale used for acoustic calibration of the test signal.
- at0047::dB SPL [The test stimuli are calibrated using the sound pressure level scale.]
- at0048::dB HL [The test stimuli are calibrated using the hearing level scale.]
- at0049::dB A [The test stimuli are calibrated using the A-weighted scale.]
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| Reliability | Reliability: Narrative description of the reliability of the response, as determined by the tester. |
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| Other contributors | Rebecca Matthews, NT Hearing
Amarjit Anand, NT Hearing |
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| Translators | |
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