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Discover Flex VRA — a modern Visual Reinforcement Audiometry system designed for pediatric clinics. Flexible, clinician-led, and trusted in 1000+ clinics worldwide. Flex Visual Reinforcement Audiometry Starting at $2,450 Discover Flex VRA Get A Quote Video Toy Custom Content I absolutely love the Flex VRA system. Complete game changer. Kelly Jobe, Au.D., Stephen F. Austin Univserity A modern VRA system that scales from basic reinforcement to advanced testing workflows. Simple by design. Flexible by choice. Flex Toy Simple VRA thoughtfully updated. Engagement through variation. Starting at $1,250 Discover Flex Toy Get A Quote We love this system. The nurses even commented on how modern and engaging it is compared to our older system. Audiologists @ Texas Children's Hospital, Houston, TX Flex Window Cover Visual control for sound booths. Keeps the visual environment controlled during testing. $800 Discover Flex Window Cover Get A Quote Accurate sound where it matters. Flex Speaker A reliable speaker option commonly used in VRA testing environments. $650 Discover Flex Speaker Get A Quote What's New For the Flex VRA System? Smarter hardware. More flexible setups. Expanded software tools. Expanded wireless compatibility across VRA components Improved durability and mounting options New software features including Targeted Content and House Rules See Full Details Used by leading pediatric clinics

Learn how to select a reliable, flexible VRA system for pediatric audiology. Flex VRA supports integration, visual reinforcers, & seamless clinic workflows. Not all VRA systems are designed the same. As pediatric hearing evaluations have evolved, the expectations for VRA equipment have changed, as well. Clinics now look for systems that are reliable, flexible, and easy to use while supporting consistent patient responses. Here are the key factors to consider when selecting a VRA system. 1. Reliability and Timing A VRA system must respond instantly when the clinician triggers a reinforcer. Any lag or delay makes the test harder and can disrupt the child’s attention. Software driven systems tend to offer faster activation times compared to older mechanical VRA boxes. For instance, Flex VRA utilizes a paired zoned 433 MHz radio frequency wireless transmission protocol to send signal from the remote control to the reinforcer. This means that the lag time between button press to activation would be similar to that of a lag time of a wireless keyboard to your computer...instantaneous. Moreover, because each system's transmission is zoned between paired reinforcers, there is no overlap from other systems or interference from any higher frequency RF signals. 2. Quality of Visual Reinforcers Children respond best to bright, engaging, but not overstimulating content. Look for a VRA system that allows you to customize content and adjust how exciting the reinforcer should present. Features like House Rules in Flex VRA let you control how the center monitor behaves so you get clearer head turns, and more focus on the left and right reinforcers. 3. Integration With Audiology Equipment The best VRA equipment connects smoothly with your audiometer, remote, or clinic workflow. Consider whether the system supports: • Remote control activation • Audiometer integration • PC or software-based triggering Seamless integration allows clinicians to stay focused on the patient instead of the equipment. And Flex VRA includes all three of those options with every Flex VRA shipped at no extra cost . 4. Durability and Build Quality VRA equipment is used daily in pediatric settings. Look for a system designed to withstand constant use, movement between rooms, and long clinical schedules. 5. Versatility and Future Features Clinics benefit from VRA systems that grow with them. Software based systems often release updates, new reinforcers, and feature improvements that extend the life of the system without requiring new hardware. 6. Support and Service Make sure the company behind your VRA system offers reliable support. Pediatric audiology depends on smooth daily operation, so access to fast assistance matters. By evaluating these factors, clinics can choose VRA equipment that improves workflow, supports accurate Visual Reinforcement Audiometry, and creates a better experience for both the child and family. Choosing the Right VRA System for Your Clinic

Flex VRA Tech Note: Not booting to proper boot device Download Tech Note Overview Issue Flex VRA turning on to a black screen that says the VRA cannot find the proper boot device. Cause The VRA is not booting to the correct boot device and it cannot find the correct Solid State Drive to launch the operating system. Resolution Confirm the user is using a Generation 2 remote control by having them identify the QR code on the bottom of the remote. Have them turn the device off by pressing the silver power button under the left-hand side of the screen behind the screen bezel. Find the “Toy” button on the remote control (the VRA sees this button as an ESC key). Press the power button again to turn the monitor on and immediately start tapping the “Toy” button until they see a blue and gray BIOS screen. Use the red right arrow on the remote control to navigate to “Boot” in the menu. Use the lights off button (icon on the bottom of the white circle on the remote control) to arrow down to “Boot Option 1”. Press the center green circle on the remote control (ENTER) to see your boot options and scroll to the “Windows Boot Manager” device and press the green circle again. Arrow over to Save and Exit and press the green circle button on the remote control to reboot. Note: If you do not see an option for “Boot Manager Device”, there is an issue with SSD card and it would need to be replaced. Please contact Flex VRA directly to coordinate a resolution.

Find clear answers to common audiology questions about VRA testing, calibration, and equipment. Learn how Flex VRA supports modern pediatric audiology. Frequently asked questions Questions about the Flex VRA company Questions of Purchasing Flex VRA Questions about the Flex VRA How long has Flex VRA been in business? Flex VRA shipped it's first commercial system in October of 2018. Who owns Flex VRA? Flex VRA is an independently owned LLC based in Cedar Park, TX. While we have partnered with a number of distribution partners throughout the years to bring Flex to clinics all over the world, Flex has always been and remains a private company.

Get in touch with Flex VRA for questions on audiology equipment. Our team supports clinics worldwide with reliable, modern VRA solutions for children. Questions about Flex VRA? We’re happy to help. A member of our team will respond within one business day. Submit Thanks for submitting! 100 E. Whitestone Blvd., St. 148, #160 Cedar Park, TX 78613 512-777-0016 sales@flexvra.com Find a representative near you Distribution

Flex Screen Mirror allows audiologists to view and interact with audiometric data inside the booth during pediatric VRA testing. Flex Screen Mirror In-booth access to audiometric tools Brochure Installation Manual Screen Mirror allows audiologists to view and interact with audiometric data directly inside the booth. Review completed audiograms with patients inside the booth View a video otoscope directly on a Flex VRA monitor Support counseling with on-screen annotation, drawings, and visuals Control audiometric software during testing with a wireless keyboard How It Works Demonstration of screen mirror being used on a computerized audiometer Screen Mirror works on PCs and audiometers with HDMI video out. Not sure if your device is compatible? Contact sales@flexvra.com Demonstration of screen mirror being used with a GSI Video Otoscope Screen Mirror works with most video otoscopes that act as camera devices in Windows. Not sure if your device is compatible? Contact sales@flexvra.com

Learn about VRA calibration, reinforcer placement, and how to best position visual reinforcement audiometry equipment for optimal performance. One of the most common questions in pediatric audiology is whether a VRA system needs to be calibrated. The answer depends on what the term “calibration” refers to. Audio Calibration VRA equipment itself does not generate calibrated sound. The audiometer is the device responsible for delivering calibrated signals. As long as the audiometer is calibrated according to ANSI standards, the audio portion of the VRA test remains accurate. The VRA system simply presents the visual reinforcement once the child responds. Visual Calibration There is no formal visual calibration standard in Visual Reinforcement Audiometry. However, consistency matters. Clinics should verify that: • The left and right reinforcers activate at the correct moment • The reinforcers are bright and visible from the child’s position • The timing of activation matches the audiologist’s expectations Modern software-based systems make this easier because they remove the mechanical delays found in older VRA boxes. Positioning and Setup Although VRA systems do not require calibration in the same way an audiometer does, proper setup is essential. • Reinforcers should be placed at roughly 45 degrees to the child minimum to 90 degrees maximum • The height should match eye level • The center reinforcer should help maintain attention without overpowering the side reinforcers New features like House Rules in Flex VRA allow clinics to keep the center screen simple and add consistency to the test. When to Recheck Your VRA Equipment You should review your VRA system if you notice: • Delayed activation • Dim or inconsistent displays • Loose mounts or shifted positions • Software not responding correctly These checks help maintain accurate and repeatable VRA sessions. Summary A VRA system does not require formal calibration, but proper setup, clean activation timing, and consistent visibility are essential for reliable Visual Reinforcement Audiometry. Using well designed VRA equipment ensures accurate responses and smooth pediatric hearing evaluations. Does a VRA System Need Calibration?

Flex Toy is a simple, clinic-ready VRA toy designed to maintain engagement through variation during pediatric visual reinforcement audiometry testing. Flex Toy Configurations FLEX COMBINATION SYSTEMS Make any combination of Left, Right and Center reinforcers using the same remote control. (Maximum of 6 reinforcers) Includes Go To Combo Systems (R=Right L=Left C=Center) FLEXTOY-C Single Center Box 2 Remote Controls Flex PC Audiometer Integration Includes $1,250 FLEXTOY-RL Point of View Demonstration Right and Left Boxes 2 Remote Controls Flex PC Audiometer Integration Includes $2,250 FLEXTOY-RLC Right, Left, and Center Boxes 2 Remote Controls Flex PC Audiometer Integration Includes $2,950 International customers: Prices shown are in USD and exclude shipping, duties, and taxes. Pricing does not include the cost of shipping, applicable taxes, and installation. Sold through authorized distributors . We believe pricing transparency saves clinicians time. You can read more about why we post prices online here. Get Flex Toy Quote Flex Toy Brochure Engagement Through Variation Flex Toy comes equipped with LED light panels that changes pattern on each activation. Included With Every Flex Toy (No Additional Cost) Cat (Left) Dog (Center) Bus (Right) Flex PC Remote Control (2) Audiometer Integration Optional Character Packages Add additional character sets — $150 per package (5 characters) Flex Toy's lift up cover is designed to make swapping characters between tests easy. Toy Story Cars Mickey and Friends Princesses William Baron, Au.D. I absolutely love the new wireless system. It has been great in the clinic. It really gets the children’s attention, and has helped me perform even better in the clinic! Jack Hitchens, Au.D. The extra lights are very helpful during the initial conditioning to the task. I was unsure about the school bus toy, but our unscientific research shows they seem to be more interested in it than the Disney characters. The Remote Two Remote Controls Included With Every Flex Toy VRA TOY VIDEO For use with Flex VRA video systems For use with Flex VRA video systems ACTIVATORS Left (Blue), Right (Red), and Center (Green) LIGHTS ON/OFF Toggle the surrounding flashing LED light bar on/off LIGHTS ONLY For use with Flex VRA video systems For use with Flex VRA video systems. CUSTOM VOLUME CONTROL Volume up, down, and mute control of the VRA boxes DISTRACT Use the VRA box as a focal point to keep patients still during tympanometry, otoscopy, or OAE testing.

Download various Conditioned Play Audiometry apps and support tools from Flex VRA. Free CPA Games Download Flex Farm Game This application was developed for the Flex VRA but can be used on any Windows PC. This application will display various fruits on the screen that can be dragged to an animal to eat. When the task is completed, the animal will move and make a noise in response as a reward. This can be used during play audiometry so that when a child hears the sound, they can feed the animal of their choice. Download Bubble Game This application was developed for the Flex VRA but can be used on any Windows PC. This application will float bubbles on the screen and when "popped" (touched or clicked with a mouse), an animated cat will appear and music will play as a reward. Download SRT Board This application was developed for the Flex VRA but can be used on any Windows PC. This provides a visually reinforced SRT board that will move and play sound when correct selections are made by the patient. Download Flex Ball Game This application provides a "drop the ball in the bucket" game for pediatric patients to play during play audiometry. The application works both with a drag and drop mouse interface or a touch screen interface.

Buy Flex VRA, a modern visual reinforcement audiometry system designed for pediatric testing. View configurations, pricing, and authorized distributors. Buy Flex VRA Flex VRA is sold all over the world through authorized distribution partners For pricing, quotes, and local support, please contact the distributor for your region United States e3 Diagnostics Canada Electro-Medical Instruments (EMI) Australia Sonic Equipment New Zealand Diatec United Arab Emirates AMICO Group

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Learn about what Visual Reinforcement is and why it is so important in audologic testing. Visual Reinforcement Audiometry (VRA) What is it and how does it work? Visual Reinforcement Audiometry (VRA) is a behavioral hearing test used to evaluate hearing sensitivity in infants and young children, typically between 6 months and 2–3 years of age, by conditioning a head-turn response to sound using visual reinforcement. Rather than asking a child to respond verbally or press a button, VRA relies on a natural behavioral response. When a child hears a sound, they learn that turning toward it results in something visually interesting. Over time, that association allows clinicians to estimate hearing thresholds based on consistent responses. VRA is most often used with children between approximately 6 months and 2 to 3 years of age, although developmental level is often a more important factor than age alone. Why is VRA used in pediatric audiology ? Standard hearing tests require cooperation, instruction following, and sustained attention. For very young children, that expectation simply is not realistic. Visual Reinforcement Audiometry was developed to bridge that gap. By pairing sound with visual reinforcement, clinicians can collect meaningful hearing information during a critical window for speech and language development. For many children, VRA provides the first reliable behavioral data in the diagnostic process. How Visual Reinforcement Audiometry Works At its core, VRA is a conditioning task. A sound is presented, typically through speakers or earphones. When the child responds appropriately, a visual reinforcer is activated. Over repeated trials, the child learns that responding to sound leads to a visual reward. From there, the clinician can adjust stimulus levels and frequencies to estimate hearing sensitivity. VRA being performed at the University of North Carolina A Typical VRA Session includes: Presentation of calibrated auditory stimuli Conditioning the child to associate sound with visual reinforcement Observing head turns or eye movements toward the sound source Reinforcing correct responses Gradually reducing stimulus levels to identify response thresholds The process is flexible and adapts to the child’s attention span and engagement on a given day. Types of VRA Testing Sound-field VRA Sound-field testing uses speakers positioned to the left and right of the child. This approach measures the response of the better-hearing ear and is commonly used early in the evaluation process. Ear-Specific VRA When a child tolerates earphones or insert phones, ear-specific information can be obtained. This allows clinicians to evaluate each ear independently and is preferred whenever possible. Below is a real-world example of visual reinforcement audiometry performed in a pediatric clinic. Equipment used in Visual Reinforcement Audiometry Visual reinforcement may take different forms: Animated or video-based displays Mechanical or illuminated toys Modern VRA systems often allow clinicians to choose or adjust reinforcement types based on the child’s age, preferences, or attention level. A VRA setup typically includes: An audiometer Speakers or earphones Visual reinforcers positioned to the left and right A control interface or remote Appropriate cabling and accessories Many newer systems use software-based control, allowing clinicians to customize how reinforcement behaves during a session rather than relying on fixed hardware responses. Does VRA Require Calibration? Yes and no. The actual VRA reinforcers do not require any formal calibration because they are not putting out any kind of calibrated stimuli utilized for testing hearing threshold. They are simply the reward stimulus for after the patient has heard oand recognized a calibrated stimuli from the audiometer. It is important to remember that although the VRA does not require acoustic calibration, consistent placement and predictable behavior are important to reliable testing. With that said, in order to properly perform VRA testing, a calibrated audiometer is required to ensure accurate threshold detection. Benefits of Visual Reinforcement Audiometery VRA allows clinicians to: Obtain behavioral hearing information in very young children Perform testing in a non-invasive, child-friendly way Estimate frequency-specific thresholds Adapt testing strategies based on engagement and development For many pediatric patients, VRA represents the most practical balance between accuracy and cooperation. Limitations to keep in mind Like all behavioral tests, VRA has limitations. Results depend on the child’s attention, motivation, and conditioning. Sound-field testing does not provide ear-specific data, and fatigue or loss of interest can limit session length. For these reasons, clinicians often combine VRA with other test methods using combinations systems and emphasize flexible system design. For patients who struggle with traditional visual reinforcement audiometry, VROCA testing offers an operant, visually reinforced alternative. When VRA is the preferred approach Visual Reinforcement Audiometry is typically used when: A child is too young for conditioned play audiometry Behavioral observation alone is insufficient Behavioral data is needed to cross-check objective results Ear-specific thresholds are possible but not guaranteed Professional organizations such as the American Academy of Audiology and the American Speech-Language-Hearing Association recognize VRA as a standard behavioral assessment method in pediatric audiology. Choosing a VRA System When evaluating VRA equipment, clinicians often look beyond basic functionality. Considerations commonly include: Ease of setup and room integration Flexibility of reinforcement options Compatibility with existing audiometers Consistency and reliability during testing Ability to adapt to different patient behaviors Systems that allow customization during the session can reduce frustration and improve efficiency for both clinicians and families. In Summary Visual Reinforcement Audiometry plays a critical role in pediatric hearing assessment. By pairing sound with visual reinforcement, VRA allows clinicians to collect meaningful behavioral data during early stages of development when traditional testing is not possible. As VRA technology continues to evolve, modern systems increasingly focus on flexibility, adaptability, and clinician control, all with the goal of improving test reliability and the overall experience for children and parents alike. FAQ Review What age is visual reinforcement audiometry used for? Visual reinforcement audiometry is typically used for infants and young children between approximately 6 months and 2.5 years of age. It is most effective once a child is developmentally able to localize sound and turn their head toward a visual stimulus. The exact age range may vary depending on the child’s developmental level and attention skills. How does visual reinforcement audiometry work? During visual reinforcement audiometry, a child is conditioned to turn toward a visual stimulus, such as a lighted display or animated image, when a sound is presented. When the child correctly responds to the sound, the visual reinforcement is activated as a reward. Clinicians observe these head-turn responses to determine hearing sensitivity across frequencies and ears. Is visual reinforcement audiometry reliable? Yes, visual reinforcement audiometry is considered a reliable and widely accepted behavioral hearing test when performed correctly. Reliability depends on factors such as patient engagement, clinician experience, and proper test setup. VRA is commonly used in pediatric audiology as part of comprehensive hearing assessment. How long does a VRA hearing test take? A typical visual reinforcement audiometry session lasts 15 to 30 minutes, depending on the child’s cooperation and the information being gathered. Testing may be shorter or longer based on attention span, age, and whether additional assessments are needed. Breaks are often incorporated to maintain engagement. What is the difference between VRA and play audiometry? Visual reinforcement audiometry is generally used for younger children and relies on head-turn responses reinforced by visual stimuli. Play audiometry is used for older toddlers and preschool-aged children who can perform a task, such as placing a block in a bucket, when they hear a sound. Both are behavioral tests, but they are matched to different developmental stages.