Search Results

Discover how Flex VRA modernizes pediatric audiometry with flexible, software-based visual reinforcement to improve hearing assessments for infants & children. Flex VRA: A Modern Visual Reinforcement Audiometry System Overview Flex VRA is a modern visual reinforcement audiometry system used in pediatric audiology clinics to assess hearing in infants and young children through visual reinforcement. The system is designed to support reliable behavioral responses during hearing evaluations by presenting engaging visual stimuli when an auditory response is detected. What problem visual reinforcement audiometry solves Visual reinforcement audiometry is commonly used to assess hearing in children who are too young for conditioned play audiometry or standard behavioral testing. Traditional VRA systems often present challenges such as: Limited stimulus variety, which can reduce engagement over repeated trials Fixed or mechanical reinforcers that cannot adapt to different patients Rigid room layouts that restrict monitor placement or test configuration Flex VRA was developed to address these limitations while preserving the core clinical principles of VRA testing. How Flex VRA differs from traditional VRA systems Flex VRA is designed as a software-driven alternative to traditional toy-based or mechanically reinforced VRA systems. Key differences include: Visual reinforcement delivered through digital stimuli rather than fixed toys Multiple stimulus options available within a single test session Greater flexibility in system configuration and room layout Consistent stimulus presentation without mechanical wear or maintenance The goal is not to replace established VRA methodology, but to modernize how visual reinforcement is delivered in the clinic. Who uses Flex VRA Flex VRA is used by clinicians and institutions that perform pediatric hearing evaluations, including: Pediatric audiologists Children’s hospitals University audiology clinics ENT practices offering pediatric diagnostic services The system is designed to integrate into standard audiometric workflows without changing how clinicians conduct testing. Clinical considerations Flex VRA functions as a visual reinforcer and does not perform sound generation, calibration, or audiometric measurement. The system: Does not replace an audiometer Does not require independent calibration Is used alongside existing audiometric equipment This allows clinics to adopt Flex VRA without altering established testing protocols. Adaptability and workflow Flex VRA supports a wide range of patient behaviors and attention levels by allowing clinicians to vary visual reinforcement during a session. This flexibility can be especially useful for: Patients with reduced attention span Children who habituate quickly to static reinforcers Clinics that test a wide range of ages and developmental levels Optional advanced features may be used when appropriate, but the system is designed to function effectively without them. Summary Flex VRA is a modern visual reinforcement audiometry system designed to support pediatric hearing assessments through flexible, software-based visual reinforcement. By modernizing how visual stimuli are delivered, Flex VRA helps clinics maintain engagement while preserving the core principles of VRA testing. About Flex VRA Flex VRA systems are used in pediatric audiology clinics and medical centers worldwide and are distributed through established audiology suppliers . The system is designed to evolve with clinical needs while remaining compatible with standard audiometric practices.

The site exists to show Flex VRA customers how to select the appropriate boot device on older Flex VRA systems. 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.

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

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 (GSI Audiostar Pro, Interacoustics EVO and Affinity) • PC or software-based triggering (Madsen Astera by Natus, MedRx Avant, Inventis) 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

Terms, conditions, and warranty information on Flex VRA systems. Terms and Conditions Flex VRA (“Flex VRA,” “we,” “us,” or “our”) values your privacy. This Privacy Policy explains what information we collect when you visit our website (the “Site”), contact us, or purchase our products and services, how we use it, and the choices you have. If you have questions, contact us at sales@flexvra.com . 1) Information We Collect Information you provide to us We may collect information you choose to share, including: Contact details (name, email, phone number, organization, job title) Inquiry details (messages submitted through forms, emails, or chat) Order and shipping details (billing/shipping address, purchase history) Support details (device information you share with support, troubleshooting notes, photos/videos you provide, and related communications) Marketing preferences (newsletter signups, communication preferences) Information collected automatically When you use the Site, we may automatically collect: Device and browser data (IP address, browser type, operating system, device identifiers) Usage data (pages visited, time on site, referring page, clicks) Approximate location (derived from IP address) Cookies and similar technologies We use cookies and similar technologies to operate the Site and understand usage. You can control cookies through your browser settings. Some features may not work properly if cookies are disabled. 2) How We Use Information We use the information we collect to: Provide and improve the Site and our products and services Respond to requests, questions, and customer support needs Process orders, payments, shipping, and returns Send service-related messages (order confirmations, updates, support communications) Send marketing communications (where permitted), and measure marketing performance Monitor, prevent, and investigate fraud, abuse, or security incidents Comply with legal obligations and enforce our terms and policies 3) How We Share Information We do not sell your personal information. We may share information in these situations: Service providers We may share information with vendors that help us run our business, such as: Website hosting and analytics providers Payment processors Shipping and logistics partners Customer support tools Email and marketing platforms These providers are authorized to use your information only as needed to provide services to us. Distributors and fulfillment partners If you purchase Flex VRA products through an authorized distributor (for example, E3 Diagnostics), or if fulfillment/support involves a partner, we may share information needed to process your request, fulfill the order, and support you. Legal and safety reasons We may disclose information if required by law, subpoena, or similar legal process, or if we believe disclosure is necessary to protect rights, safety, and security, or to investigate fraud. Business transfers If Flex VRA is involved in a merger, acquisition, financing, reorganization, or sale of assets, information may be transferred as part of that transaction. 4) Analytics, Advertising, and Tracking We may use analytics tools (such as Google Analytics or similar services) to understand how people use the Site. These tools may use cookies and collect usage data. We may also use advertising and conversion tracking tools (such as a Meta pixel, Google Ads, LinkedIn insight tag, or similar) to measure the effectiveness of our marketing. Depending on how your Site is configured, these tools may collect information about your visits and interactions. Your choices: You can disable cookies in your browser settings. You can opt out of certain interest-based advertising through industry opt-out tools (availability varies by region). 5) Email and Marketing Preferences You can opt out of marketing emails at any time by using the unsubscribe link in the email or by contacting us at sales@flexvra.com . Even if you opt out of marketing, we may still send non-promotional messages, such as order updates or support communications. 6) Data Retention We keep personal information as long as needed for the purposes described in this Policy, including to provide services, comply with legal obligations, resolve disputes, and enforce agreements. Retention periods vary depending on the type of information and why we collected it. 7) Security We use reasonable administrative, technical, and physical safeguards designed to protect personal information. No method of transmission or storage is 100% secure, and we cannot guarantee absolute security. 8) Children’s Privacy The Site is intended for a general audience and is not directed to children under 13. We do not knowingly collect personal information from children under 13. If you believe a child has provided personal information to us, contact us and we will take appropriate steps to delete it. 9) Your Privacy Rights Depending on where you live, you may have rights regarding your personal information, such as: Accessing the personal information we hold about you Requesting correction of inaccurate information Requesting deletion of certain information Objecting to or restricting certain processing Withdrawing consent (where processing is based on consent) To make a request, contact [privacy@flexvra.com ]. We may need to verify your identity before fulfilling certain requests. “Do Not Track” Some browsers offer “Do Not Track” signals. Because there is no consistent industry standard, our Site may not respond to these signals. 10) International Visitors If you access the Site from outside the United States, your information may be processed in the United States or other locations where we or our service providers operate. These locations may have different data protection laws than your jurisdiction. 11) Third-Party Links The Site may link to third-party websites or services. This Privacy Policy does not apply to those third parties. We encourage you to review their privacy policies. 12) Changes to This Policy We may update this Privacy Policy from time to time. The “Last updated” date above shows when it was last revised. Changes take effect when posted on this page. 13) Contact Us Flex VRA 100 E. Whitestone Blvd., St. 160 Cedar Park, TX 78613 Email: sales@flexvra.com Phone: 512-2549953

Peer-reviewed research and published literature referencing modern, software-enabled visual reinforcement audiometry approaches, including Flex VRA. Relevant Research and Literature If you are conducting or planning research related to visual reinforcement audiometry, conditioned play audiometry, or operant control approaches, and would like to discuss resources or technical considerations, you are welcome to get in touch . Concepts related to modern, software-enabled visual reinforcement audiometry have been referenced in published research, including: Bonino AY, Hemann A, Mood D, Kay E, Pancoast ES, Sommerfeldt KK. Visual reinforcers designed for children with developmental disabilities. Journal of Early Hearing Detection and Intervention. 2021 Apr 22;6(1):69–76. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC8061901/ This scoping review examines factors that influence the effectiveness and optimization of visual reinforcement audiometry in pediatric hearing assessment. Visram, A., Jackson, I., Almufarrij, I., Stone, M., & Munro, K. (2024). Optimisation of visual reinforcement audiometry: a scoping review. International Journal of Audiology. Optimisation of visual reinforcement audiometry: a scoping review This document presents the British Society of Audiology’s recommended procedure for visual reinforcement audiometry, outlining clinical standards for test setup, execution, and interpretation. British Society of Audiology. Recommended Procedure: Visual Reinforcement Audiometry. Visual Reinforcement Audiometry RP by the BSA, January 2024. https://www.thebsa.org.uk/wp-content/uploads/2024/01/OD104-37-BSA-RP-Visual-Reinforcement-Audiometry-v2.pdf This presentation hosted by Audiology Online covers the new tools and strategies for Visual Reinforcement Audiometry available from Flex VRA. New Tools and Strategies for Visual Reinforcement Audiometry | 39687 Course 39687

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?

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.

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.

Free videos to help children prepare for hearing tests. Improve cooperation for VRA and CPA. Download and use in your clinic instantly. Free Audiology Videos for Pediatric Testing Professionally produced, clinic-ready videos designed to improve pediatric testing outcomes. Used in audiology clinics. Built into every Flex VRA. What Happens At A Child's Hearing Test Helps children understand exactly what will happen during a pediatric hearing test, reducing fear and improving cooperation during audiology appointments. Get Video File The Listening Game: Preparing for VRA Introduces the listening game so children are ready to respond during Visual Reinforcement Audiometry (VRA) testing. Get Video File Toy in the Bucket Game: Preparing for CPA Prepares children for Conditioned Play Audiometry (CPA) by showing the exact task they’ll perform during testing. Get Video File Pictured Word Game: Preparing for SRT/WRS Prepares children for pediatric speech hearing tests. Perfect for preparing children (and parents!) for audiology appointments. Get Video File Why Preparing Children for Hearing Tests Matters A pediatric hearing test can be unfamiliar and sometimes overwhelming for young children. When a child doesn't know what's going to happen, it can lead to hesitation, inconsistent responses, or an incomplete test. When children know what to expect, they participate more readily, respond more consistently, and stay engaged throughout the appointment. For Visual Reinforcement Audiometry (VRA) and Conditioned Play Audiometry (CPA) especially, a child's responses directly impact the accuracy of the results. A few minutes of preparation can mean fewer delays, a smoother session, and clearer answers for everyone involved. These videos are used in audiology clinics, and built directly into Flex VRA. Download a clinic-ready poster patients can scan to watch these videos

Download brochures, manuals, quick guides, and support documents from Flex VRA. Downloads 2026 Catalog Flex Halo Brochure - Product overview and specs for clinic decision makers Flex VRA VROCA Button Brochure -Product overview for clinic decision makers Installation and User Manual -Guide for installers and end users Brochure - Product overview and specs for clinic decision makers Installation and User Manual - Guide for installers and end users Remote Control Pairing Guide - Guide for Installers Integration Cable Pairing Guide (Audiostar Pro and EVO) - Technician Support Flex VRA Video Monitor Cleaning and Caring Guidelines- Guide for End Users Screen Mirror Brochure - Product overview and specs for clinic decision makers Installation and User Manual -Guide for installers Flex PC Download Flex PC (For use on installation of new VRA with Flex PC transmitter. Contact us if adding Flex PC on to an existing system) Brochure Installation Instructions - Installation guide for technicians and end users PC Pairing Guide Flex Integration Cable Integration Cable Pairing Guide and Setup - Guide for installers and end users Setting Up Interacoustics Suite to Work with Flex VRA - Guide for installers and end users Flex Toy Brochure - Product overview and specs for clinic decision makers Installation and User Manual -Guide for installers and end users Remote Control Pairing Guide Integration Cable Pairing Guide and Setup - Guide for installers and end users Flex Mobile Brochure - Product overview and specs for clinic decision makers Installation and User Manual Remote Control Pairing Guide - Guide for Installers Flex Speaker Brochure - Product overview and specs for clinic decision makers Installation and User Manual - Guide for installers and end users Installation Video Demo - Short video demo for Flex Speaker installers Flex Window Cover Brochure - Product overview and specs for clinic decision makers Installation Manual - Installation guide for technicians and end users. Remote Control Pairing Guide Video Tutorial: Installing Flex Window or Door Cover Video Tutorial: Setting Upper and Lower Limits on Window Cover

VROCA is a pediatric VRA response button designed to support consistent, child-initiated responses during visual reinforcement audiometry testing. Comparison of VRA, CPA, and VROCA testing Test Type Typical Age Patient Response Reinforcement VRA Infants, toddlers Head turn Lighted toy or animation CPA Young children Play task Game-based reward VROCA Older children, adults Operant response Visual video reinforcement Learn how VRA compares to CPA in pediatric audiology. Better engagement By reinforcing correct responses with visual content, VROCA keeps patients engaged without over-stimulating the test environment. Clinicians gain greater confidence in responses while patients experience a clearer, more intuitive testing process. Every Flex VRA's software is built-in with VROCA functionality once a wireless and battery-free VROCA button is plugged into it. Plug and play, literally. Flex VROCA Button VROCA Audiology Testing (Visual Reinforcement Operant Conditioning Audiometry) Brochure Visual Reinforcement Operant Conditioning Audiometry (VROCA) is a behavioral hearing test used for older children and adults who are unable to reliably complete traditional VRA audiometry . Instead of requiring a simple hand raise or button press alone, VROCA combines an operant response with a visual reward, improving attention, compliance, and response accuracy. How to Conduct VROCA Testing VROCA testing combines an operant response with visual reinforcement to support attention and response reliability. Before testing begins, the patient is instructed to perform a simple action, such as pressing a response button, whenever they hear a sound. With the Flex VROCA button, that button press will automatically trigger the Flex VRA to activate. Once conditioning is established, each correct button press response triggers a brief visual reinforcer. The clinician can suppress the reinforcer at any time to ensure reinforcement occurs only when appropriate. This helps preserve the conditioning relationship and prevents accidental reinforcement during setup or repositioning. Below is an example of VROCA being conducted on a Flex VRA system. Note how when incorrect button presses are made, the VRA does not reinforce, and the patient is instructed to wait until they hear the tone. Throughout testing, reinforcement duration can be adjusted on the Flex VRA to match the patient’s attention span. Shorter reinforcement intervals help maintain focus, while longer intervals may be useful during initial conditioning or with patients who require additional engagement. In audiology, VROCA is particularly useful when traditional audiometry or conditioned play testing results in inconsistent responses, allowing clinicians to obtain more reliable behavioral thresholds with fewer repeated instructions. Features Wireless A wireless button reduces distraction during VROCA testing by eliminating cables that can interfere with posture, attention, and engagement. It also protects your Flex VRA from being pulled on by an attached cable. For pediatric patients, this supports more natural responses and improves consistency throughout the test session. Suppression Holding down the Custom button temporarily suppresses stimulus activation, giving clinicians precise control over when reinforcement is delivered. This prevents accidental or premature reinforcement and helps preserve the conditioning relationship until testing is ready to begin. Time Reinforcement duration can be customized from 2 to 10 seconds through the Flex VRA service menu, giving clinicians control over stimulus length to match patient attention span and reduce over-engagement. Frequently Asked Questions What does VROCA stand for in audiology? VROCA stands for Visual Reinforcement Operant Conditioning Audiometry. What age is VROCA used for? VROCA is typically used for older children and adults who are unable to reliably complete traditional audiometry or conditioned play testing. Is VROCA the same as VRA? No. VROCA requires an operant response, while VRA relies on a head-turn response to sound. Is VROCA appropriate for neurodivergent patients? Yes. VROCA is commonly used with patients who have attention, developmental, or sensory challenges, where traditional testing methods may be difficult to complete reliably.