The Peep-Show Technique for Pure Tone Audiometry in Young Children

Mr. Hallpike said that the test procedure to be described had been designed to solve the difficult clinical problem of the young child, under the age of 5 years, in whom backwardness was associated with failure of speech development. The failure might be due to deafness, to mental defect, or to a purely motor disorder of speech. The otologist was called upon for an authoritative opinion on the hearing, and here the question of a suitable test was a very difficult one. Ordinary speech tests were very difficult in the presence of deafness with defective vocabulary, while young children found pure tone audiometry very boring, and their responses were in consequence unreliable. A still greater difficulty attended the standard test procedure for pure tone audiometry; namely that before the test could be applied the child needed to be given and to assimilate an explanation of the nature of listening and hearing with the telephone receiver. This was often impossible. In designing the Peep-Show procedure they had endeavoured to overcome these difficulties: First, by giving an arresting significance in the child's consciousness to the usually uninteresting pure tone stimuli; secondly, by so devising the test that the child was persuaded to respond to the sound stimulus with no explanation other than a very simple dumb show.