The audiologist uses video animation or lights up a toy hidden in a dark Plexiglas box in conjunction with a sound. Once the child understands the test, this "reinforcer" acts as a reward when he shifts his eyes or turns his head toward the sound.
Visual reinforcers are located at eye level, 90 degrees to either side of the child's head. The audiologist reduces the intensity of both the sound and visual stimuli until she determines your child's minimum hearing threshold. She will continue using different frequencies in both ears until she has a complete set of data for your child.