Flex VROCA Button
VROCA: Visual Reinforcement Operant Conditioning Audiometry
VROCA is a behavioral hearing test for older children and adults who can’t reliably complete traditional VRA audiometry. It pairs a simple operant response, like a button press, with a visual reward to improve attention, compliance and response accuracy.
Wireless · Battery-free · Works with every Flex VRA
How VROCA compares to VRA and CPA
VRA, CPA and VROCA are all behavioral hearing tests. They differ in who they suit, how the patient responds, and how a correct response is rewarded.
Better engagement
By reinforcing correct responses with visual content, VROCA keeps patients engaged without over-stimulating the test environment. Clinicians gain more confidence in responses, and patients get a clearer, more intuitive test.
Built into every Flex VRA
VROCA functionality is already built into every Flex VRA’s software. Plug in the wireless, battery-free Flex VROCA Button and it works. Plug and play, literally.
How to conduct VROCA testing
VROCA combines an operant response with visual reinforcement to support attention and response reliability. On a Flex VRA it works in three steps.
1
Instruct the patient
Before testing begins, the patient is told to perform a simple action, such as pressing a response button, whenever they hear a sound. With the Flex VROCA Button, that press automatically triggers the Flex VRA.
2
Reinforce correct responses
Once conditioning is established, each correct button press triggers a brief visual reinforcer. The clinician can suppress the reinforcer at any time, which preserves the conditioning relationship and prevents accidental reinforcement during setup or repositioning.
3
Match the attention span
Reinforcement duration can be adjusted on the Flex VRA. Shorter intervals help maintain focus, while longer intervals help during initial conditioning or with patients who need more engagement.
Watch VROCA testing on a Flex VRA
In this example, incorrect button presses are not reinforced, and the patient is reminded to wait until they hear the tone.
VROCA is especially useful when traditional audiometry or conditioned play audiometry (CPA) gives inconsistent responses. It helps clinicians obtain more reliable behavioral thresholds with fewer repeated instructions.
Flex VROCA Button features
A wireless, battery-free response button made for VROCA testing on the Flex VRA.
Wireless
A wireless button reduces distraction by eliminating cables that can interfere with posture, attention and engagement. It also protects your Flex VRA from being pulled on by a cable. For pediatric patients, this supports more natural responses and more consistent results.
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 until testing is ready to begin.
Adjustable time
Reinforcement duration can be set from 2 to 10 seconds in the Flex VRA service menu, so stimulus length matches the patient’s attention span and avoids over-engagement.
See the Flex VROCA Button set up
VROCA 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, such as a button press, 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.
Do I need new software to run VROCA on a Flex VRA?
No. VROCA is built into every Flex VRA’s software. Plug in the Flex VROCA Button and it’s ready to use.
How long does the visual reinforcement last?
Reinforcement time can be set from 2 to 10 seconds in the Flex VRA service menu.
Add VROCA testing to your Flex VRA
The Flex VROCA Button plugs into any Flex VRA. Get a quote, or email sales@flexvra.com with questions.