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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 |
Better engagement. Better data.
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.
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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)
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.
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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.
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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.
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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.
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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.
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Is VROCA the same as VRA?
No. VROCA requires an operant response, while VRA relies on a head-turn response to sound.
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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.