Aided cortical testing - tips and tricks

In this video, Amanda Goodhew, International Clinical Trainer with the Interacoustics Academy, will discuss some of her top tips and tricks for performing, and getting the most out of, the aided cortical test, with a particular focus on utilizing this test for the pediatric population.

You can read the full transcript below.

Tip 1: Use markers to denote equipment placement

My top tips and tricks for aided cortical testing, I'd say first think about the equipment, particularly if this is a setup where you have to pack it away, bring it back out again, you really need to make sure that you put it back in the right place.

So, when you have your original calibration, it's ideal to put some markers on the floor to denote where the speaker should be, where the patient should be, the right distance so that when you bring that equipment back out you can put it in the right place so that it retains the calibration value.

Tip 2: Perform sound field analysis before each test

And the other thing that's important to make use of is the sound field analysis feature in the aided cortical test. This is quick and easy to do. It's basically your kind of stage A check before you start your clinic and it takes about five seconds.

You can do this before each patient, you can do it at the start of the day, you can do it once the patient's even in the room if they do come in with you know large amounts of equipment such as buggies and prams and things like that.

But what it does is ensure that the presentation levels of the stimuli from the loudspeaker are stable and match the original calibrated value.

So, it is important to do if you are moving that equipment around and as I say, it's so quick and easy, five seconds, there's no reason not to do it. So that's a good thing to use to make sure that you're getting accurate presentation levels and therefore accurate results.

Tip 3: Two clinicians to perform the test

I would say it's important to have two testers for doing the aided cortical test. For an older patient or an adult, one tester is usually fine, but for this population that we're thinking about in terms of the infants and younger children, then it's hard to focus on the child and control the software and the equipment at the same time.

Inevitably, you're going to end up missing something on one of those which we don't want to do. So, I would really encourage you to have one tester who's focused on the child, doing the engagement, reading the child, and then another tester who is focusing on the Eclipse, the decision-making, and the stimuli levels.

And they can read the patient's EEG and then feed that back to the tester who is engaging with the child and that can then be used to alter the engagement. So, if they're too excited we might need to bring it down. If the response starts to diminish, it might be that the patient's getting a bit too sleepy and we need to liven up the engagement activity.

So, really useful to have two testers for this age group. I think it's always useful to have two testers anyway in terms of reading the results, you know cross-checking, "Oh have I got this right, should we do this next, what's my next steps", that sort of sanity check of having somebody alongside you to back up what you're thinking.

So, I really like having two testers for the aided cortical test. As I say, particularly for this age group.

Tip 4: A wide variety of engagement toys

And then when it comes to engaging with the child, I've got loads of suggestions here. So you want to have lots and lots and lots of toys. For this particular – you know, three-to-seven-month age group, they've got very limited attention span.

So, you might be changing toys every few seconds, you might need lots and lots of toys so that you've got lots of options that you can cycle through.

Sensory toys are the best for this age group. You can turn the lights down and then you have these lovely flashing toys, light-up toys, toys that feel nice, they're very engaging for this age group where they can get their hands stuck into them.

And that can really keep them in the right state of mind of still and quiet and in awe of the thing that they're playing with and not too noisy, not too active that that disturbs the test. So, sensory toys are your best friend for the aided cortical test.

Tip 5: Show videos and cartoons to captivate the child

As are videos. I think videos are important and there's so many ways that you can show these. It might be the parents’ phone, you might have something like a tablet or a computer screen that you could show some cartoons on there, some videos on there.

You could have a big TV screen where you have the big cartoons there and that gets quite a sort of wow factor effect, it's you know full visual field for these children. But by far one of the best setups I've ever seen is having a projector and either a massive white wall or a big projector screen.

Again, turning the lights down, shutting the window blinds and having those cartoons shown from the computer via the projector onto this big screen. It just creates this wonderful cinematic effect that captivates the children, and it will keep them sitting there for such a long period of time to allow you to do the testing that you want to.

So that's such a great setup to have, it keeps them quite calm, keeps them quite engaged but really you know keeps them happy and content, which is super important for the test.

Tip 6: What are the child's favorite toys or videos?

And think about whether they have any favorites, you know is there a favorite toy, is there a favorite cartoon, do they like looking at videos of themselves? I don't know, there's all sorts of things that you can ask the parents about. It's surprising how much favoritism these children can develop at quite a young age.

We want the kid to be happy with the tests, not bored, not too excited, so pick the content in terms of the toys and the videos that you're going to show them that they are going to find engaging and interesting and that is how you will get a successful aided cortical test.