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Peer-reviewed research and published literature referencing modern, software-enabled visual reinforcement audiometry approaches, including Flex VRA. Relevant Research and Literature If you are conducting or planning research related to visual reinforcement audiometry, conditioned play audiometry, or operant control approaches, and would like to discuss resources or technical considerations, you are welcome to get in touch . Concepts related to modern, software-enabled visual reinforcement audiometry have been referenced in published research, including: Bonino AY, Hemann A, Mood D, Kay E, Pancoast ES, Sommerfeldt KK. Visual reinforcers designed for children with developmental disabilities. Journal of Early Hearing Detection and Intervention. 2021 Apr 22;6(1):69–76. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC8061901/ This scoping review examines factors that influence the effectiveness and optimization of visual reinforcement audiometry in pediatric hearing assessment. Visram, A., Jackson, I., Almufarrij, I., Stone, M., & Munro, K. (2024). Optimisation of visual reinforcement audiometry: a scoping review. International Journal of Audiology. Optimisation of visual reinforcement audiometry: a scoping review This document presents the British Society of Audiology’s recommended procedure for visual reinforcement audiometry, outlining clinical standards for test setup, execution, and interpretation. British Society of Audiology. Recommended Procedure: Visual Reinforcement Audiometry. Visual Reinforcement Audiometry RP by the BSA, January 2024. https://www.thebsa.org.uk/wp-content/uploads/2024/01/OD104-37-BSA-RP-Visual-Reinforcement-Audiometry-v2.pdf This presentation hosted by Audiology Online covers the new tools and strategies for Visual Reinforcement Audiometry available from Flex VRA. New Tools and Strategies for Visual Reinforcement Audiometry | 39687 Course 39687

Flex Toy is a simple, clinic-ready VRA toy designed to maintain engagement through variation during pediatric visual reinforcement audiometry testing. Traditional VRA Toys Repeat. Flex Toy Changes. Unlike traditional VRA toys that repeat the same response every time, Flex Toy creates changing light patterns on each activation to maintain novelty and engagement throughout testing. William Baron, Au.D. I absolutely love the new wireless system. It has been great in the clinic. It really gets the children’s attention, and has helped me perform even better in the clinic! Jack Hitchens, Au.D. The extra lights are very helpful during the initial conditioning to the task. I was unsure about the school bus toy, but our unscientific research shows they seem to be more interested in it than the Disney characters. Flex Toy Configurations FLEX COMBINATION SYSTEMS Make any combination of Left, Right and Center reinforcers using the same remote control. (Maximum of 6 reinforcers) Go To Combo Systems R=Right L=Left C=Center FLEXTOY-C Single Center Box 2 Remote Controls Flex PC Audiometer Integration $1,250 FLEXTOY-RL Point of View Demonstration Right and Left Boxes 2 Remote Controls Flex PC Audiometer Integration $2,250 FLEXTOY-RLC Right, Left, and Center Boxes 2 Remote Controls Flex PC Audiometer Integration $2,950 International customers: Prices shown are in USD and exclude shipping, duties, and taxes. Pricing does not include the cost of shipping, applicable taxes, and installation. Sold through authorized distributors . We believe pricing transparency saves clinicians time. You can read more about why we post prices online here. Get Flex Toy Quote Flex Toy Brochure Included With Flex Toy Cat (Left) Flex PC Dog (Center) Remote Control (2) Bus (Right) Audiometer Integration Optional Character Packages Add additional character sets — $150 per package (5 characters) Flex Toy's lift up cover is designed to make swapping characters between tests easy. Toy Story Cars Mickey and Friends Princesses The Remote Two Remote Controls Included With Every Flex Toy VRA TOY VIDEO For use with Flex VRA video systems For use with Flex VRA video systems ACTIVATORS Left (Blue), Right (Red), and Center (Green) LIGHTS ON/OFF Toggle the surrounding flashing LED light bar on/off LIGHTS ONLY For use with Flex VRA video systems For use with Flex VRA video systems. CUSTOM VOLUME CONTROL Volume up, down, and mute control of the VRA boxes DISTRACT Use the VRA box as a focal point to keep patients still during tympanometry, otoscopy, or OAE testing. Specifications Remote/Flex PC/Audiometer Integration Transmission Wireless Zoned Radio Frequency .05 Seconds (Instantaneous) Activation Latency 18 months Remote Control Battery Life Input: 100-240V 50/60Hz 1.5A MAX Output: +12V, 5A, 60W Power Specifications Dimensions 10 inch (L) x 8 inch (W) x 10 inch (H), 1 lbs Warranty 2 Years

Flex PC provides wireless control of Flex VRA systems, allowing audiologists to manage reinforcement and workflows directly from a computer. Turn Your Keyboard Into a VRA Remote Control Flex PC lets audiologists trigger VRA directly from their keyboard using fully customizable hotkeys. Included with every Flex VRA System. Download Flex PC User Guide Trigger Reinforcement Instantly Using Keyboard Hotkeys Example Custom Configuration Left Reward Center Reward Right Reward Keep Your Hands On The Keyboard And Your Eyes On The Patient. Faster reinforcement helps maintain engagement and keeps testing on track. No Separate Remote. No Broken Workflow. No Lost Focus. ✓ Custom hotkey control ✓ Wireless operation ✓ Instant reinforcement activation ✓ Works alongside computerized audiometers ✓ Included with every Flex VRA system Specifications Required Operating System Windows 10 or Higher Transmitter Connection USB-A Transmitter Power Requirements 5V USB Transmitter Range 15 Meters Signal Transmission Paired 433 MHz Radio Frequency Warranty Period 2 years

Flex Screen Mirror allows audiologists to view and interact with audiometric data inside the booth during pediatric VRA testing. Flex Screen Mirror In-booth access to audiometric tools Brochure Installation Manual Screen Mirror allows audiologists to view and interact with audiometric data directly inside the booth. Review completed audiograms with patients inside the booth View a video otoscope directly on a Flex VRA monitor Support counseling with on-screen annotation, drawings, and visuals Control audiometric software during testing with a wireless keyboard How It Works Demonstration of screen mirror being used on a computerized audiometer Screen Mirror works on PCs and audiometers with HDMI video out. Not sure if your device is compatible? Contact sales@flexvra.com Demonstration of screen mirror being used with a GSI Video Otoscope Screen Mirror works with most video otoscopes that act as camera devices in Windows. Not sure if your device is compatible? Contact sales@flexvra.com

Learn about VRA calibration, reinforcer placement, and how to best position visual reinforcement audiometry equipment for optimal performance. One of the most common questions in pediatric audiology is whether a VRA system needs to be calibrated. The answer depends on what the term “calibration” refers to. Audio Calibration VRA equipment itself does not generate calibrated sound. The audiometer is the device responsible for delivering calibrated signals. As long as the audiometer is calibrated according to ANSI standards, the audio portion of the VRA test remains accurate. The VRA system simply presents the visual reinforcement once the child responds. Visual Calibration There is no formal visual calibration standard in Visual Reinforcement Audiometry. However, consistency matters. Clinics should verify that: • The left and right reinforcers activate at the correct moment • The reinforcers are bright and visible from the child’s position • The timing of activation matches the audiologist’s expectations Modern software-based systems make this easier because they remove the mechanical delays found in older VRA boxes. Positioning and Setup Although VRA systems do not require calibration in the same way an audiometer does, proper setup is essential. • Reinforcers should be placed at roughly 45 degrees to the child minimum to 90 degrees maximum • The height should match eye level • The center reinforcer should help maintain attention without overpowering the side reinforcers New features like House Rules in Flex VRA allow clinics to keep the center screen simple and add consistency to the test. When to Recheck Your VRA Equipment You should review your VRA system if you notice: • Delayed activation • Dim or inconsistent displays • Loose mounts or shifted positions • Software not responding correctly These checks help maintain accurate and repeatable VRA sessions. Summary A VRA system does not require formal calibration, but proper setup, clean activation timing, and consistent visibility are essential for reliable Visual Reinforcement Audiometry. Using well designed VRA equipment ensures accurate responses and smooth pediatric hearing evaluations. Does a VRA System Need Calibration?

Learn how to prepare your child for a pediatric hearing test with simple tips that improve comfort, participation, and testing success. Preparing Your Child for a Hearing Test Top 5 Parenting Tips for a Successful Pediatric Hearing Test A pediatric hearing test can feel unfamiliar for both parents and children. This guide explains what to expect during a Visual Reinforcement Audiometry (VRA) appointment and how to help your child stay calm, engaged, and ready for a successful visit. Tip #1: Pediatric Hearing Tests Are Designed to Be Comfortable A visit to a clinic can be anxiety-inducing for both children and adults. Pediatric hearing tests, including Visual Reinforcement Audiometry (VRA) , are designed to feel more like a fun game than a medical procedure. While your child plays and responds to sounds, the audiologist gathers valuable hearing information. In most pediatric hearing tests, you also will not be separated from your child during testing. In many cases, testing can be completed with you in the room or even holding your infant or toddler on your lap. Important Parent Tip: If you are able to be with your child during the test, it's extremely important you don't participate in any way during these games. Even a head turn or gentle nudge during the test can compromise the accuracy of a result. Your job is to be a steady and uninvolved presence during the test unless the audiologist specifically asks you to intervene. Tip #2: Rested, Fed, and Relieved The length of a pediatric hearing evaluation is heavily dependent on the cooperation of the child. In order to reduce as many factors as possible that may interfere with your child’s cooperation, make sure your child is not coming into the appointment hungry, tired, or possibly needing to potty mid-way through the test. If your child has a comfort object (stuffed animal, blanket, small toy), it's also a good idea to bring it along to increase the chance of success during the hearing evaluation. Important Parent Tip: If timing of your appointment is flexible, try not to schedule during nap time. Ideally, plan for a time right after nap time with a snack right before the appointment so that they are primed to be comfortable during the visit. Tip #3: Avoid Screen Time and Overstimulation Before the Appointment Testing your child’s hearing depends heavily on engagement and attention. Pediatric audiologists use Visual Reinforcement Audiometry (VRA) , toys, games , lights, and videos to help children remain interested throughout the evaluation. To help make the transition easier, try to avoid highly stimulating screen time immediately before the appointment. Children who are focused on returning to a favorite show or device may initially have more difficulty engaging during testing. Important Parent Tip: If your child has specific shows or interests that will better engage them during the test, let your audiologist know prior to your visit. They may have a VRA system that allows them pre-load content specifically for your child so that they are as excited about the hearing test as they would be watching at home. Tip #4: Bring Your Enthusiasm Pediatric audiologists work hard to create positive reinforcement and an encouraging environment during testing. While they are experts in evaluating hearing, parents still play an important emotional role throughout the appointment. Encouragement from a trusted parent can help children feel more confident, engaged, and willing to participate during testing. The goal of the appointment is not for your child to perform every task perfectly, but to help the audiologist understand how they respond during testing. The more encouraged they feel, the more likely they are to give it their best effort. Important Parent Tip: Encouragement and coaching are different during a hearing test. Praising your child after they complete a task is very different from helping guide them toward a response during testing. Tip #5: After the Visit, Focus on the Positive Hearing evaluations for children are not always a one-time visit. Especially if a follow up visit is warranted, you want to make sure your child associates hearing tests as fun, and just as importantly, trusts that their audiologist is not a scary doctor to visit. This can make follow-up appointments even more effective as your child learns who the audiologist is, what is involved in a visit and that there is nothing to be afraid of. Your positive reinforcement of the experience after the visit can be just as valuable as the tools the audiologist utilizes during the test if a follow-up visit is required. Important Parent Tip: Even if the appointment was difficult or your child did not immediately connect with the audiologist, try to emphasize the positive parts of the experience afterward. This can help prevent anxiety or fear from carrying over into future hearing evaluations. Final Thought Pediatric hearing evaluations work best when children feel comfortable, engaged, and supported throughout the process. A little preparation before the appointment can make a major difference in helping your child have a successful experience. If you and your child would like to learn more about what to expect during a hearing evaluation, check out our Flex Dog animated introductory videos to learn more about the process in a fun and child-centric way. Flex Dog Videos

Free videos to help children prepare for hearing tests. Improve cooperation for VRA and CPA. Download and use in your clinic instantly. Knowing What To Expect Makes Hearing Tests Easier Flex Dog videos help kids understand what to expect at hearing tests so they can arrive more comfortable, confident, and ready to participate. Used in audiology clinics. Built into every Flex VRA. No Captions What Happens At A Child's Hearing Test Helps children understand exactly what will happen during a pediatric hearing test, reducing fear and improving cooperation during audiology appointments. Get Video File Want more free videos like this? Click here to give this video a Like on YouTube so we can track what content is most useful in clinics and create more of it. Captions No Captions The Listening Game (VRA) Introduces the listening game so children are ready to respond during Visual Reinforcement Audiometry (VRA) testing. Get Video File Want more free videos like this? Click here to give this video a Like on YouTube so we can track what content is most useful in clinics and create more of it. Captions No Captions Toy in the Bucket Game (CPA) Prepares children for Conditioned Play Audiometry (CPA) by showing the exact task they’ll perform during testing. Get Video File Want more free videos like this? Click here to give this video a Like on YouTube so we can track what content is most useful in clinics and create more of it. Captions No Captions Picture Game (SRT/WRS) Prepares children for pediatric speech hearing tests . Perfect for preparing children (and parents!) for audiology appointments. Get Video File Want more free videos like this? Click here to give this video a Like on YouTube so we can track what content is most useful in clinics and create more of it. Captions Why Preparing Children for Hearing Tests Matters A pediatric hearing test can be unfamiliar and sometimes overwhelming for young children. When a child doesn't know what's going to happen, it can lead to hesitation, inconsistent responses, or an incomplete test. When children know what to expect, they participate more readily, respond more consistently, and stay engaged throughout the appointment. For Visual Reinforcement Audiometry (VRA) and Conditioned Play Audiometry (CPA) especially, a child's responses directly impact the accuracy of the results. A few minutes of preparation can mean fewer delays, a smoother session, and clearer answers for everyone involved. These videos are used in audiology clinics, and built directly into Flex VRA. Download a clinic-ready poster patients can scan to watch these videos

Learn how Flex VRA was built to improve pediatric audiology testing through clinician collaboration, real-world feedback, and modern reinforcement methods. Steve Smith with his two assistant (to the) regional managers. We build solutions for the parents of the child being tested. If we provide tools for audiologists that help give those parents answers about their child’s hearing, we’ll always have a customer. Steve Smith, Founder About Flex VRA Listening to clinicians from the start Flex VRA was built to support how pediatric audiology is practiced today, not how it was practiced years ago. From the beginning, our focus has been on helping audiologists maintain attention, reduce distraction, and adapt testing environments to the needs of each child. Founded in 2018 by Steve Smith, Flex VRA began as a response to a simple question from the field: Is there a better way to control what appears on a VRA screen during testing? That question led to a prototype that allowed clinicians to tailor content and environment in real time to improve engagement and test efficiency. The positive response from audiologists shaped what Flex would become. Each request from clinicians became an opportunity to improve. Features like user-uploaded content, audiometer integration, and expanded testing modes were added in direct response to real-world use. That approach continues to guide how Flex VRA is designed today. Built through collaboration with clinicians Today, Flex VRA supports hearing tests in over 1,000 clinics. That growth has been driven by close collaboration with audiologists and a commitment to listening, adapting, and improving. Each feature added to Flex VRA reflects real-world feedback from clinicians working with pediatric patients every day. By focusing on usability, flexibility, and engagement, Flex VRA has evolved alongside the needs of the clinics it serves. Questions about Flex VRA? If you’d like to learn more or discuss how Flex VRA fits into your clinic, we’re happy to help. Contact Flex VRA

VROCA is a pediatric VRA response button designed to support consistent, child-initiated responses during visual reinforcement audiometry testing. 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 Learn how VRA compares to CPA in pediatric audiology. Better engagement 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. 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) Brochure 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. 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. 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. 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. 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, 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.

Flex Halo is a hybrid VRA reinforcer that combines video and toy stimulation in one unit. Replaces multi-unit setups. Built for pediatric audiology clinics. Where toys come to life Patent Pending First, we made VRA engaging. Now, we make it feel real. Kids are instantly drawn to it and stay engaged. Don’t take our word for it. See it in action. I used the Flex Halo system with a patient with autism where we have obtained VERY limited behavioral information and have only relied on ABRs for hearing updates. The patient conditioned to the transparent screen and we were able to obtain a speech threshold for the first time. Dr. Jenny Goehring, Au.D. Boystown Hospital The Flex Halo Effect The Flex Halo Effect A new approach to VRA Traditional VRA forces you to choose between toys, video or purchasing both. Now, you don't have to choose. Toys quickly lose their impact as children habituate quickly to the same stimulus repeatedly. Video may not provide the novelty for every child. Flex Halo combines lifelike toy and video reinforcement, so the stimulus is novel every time. Toy Video Halo Flex Halo Configurations Flex Halo isn’t an add-on. It’s a complete replacement for traditional toy and video VRA reinforcement systems. FLEXHALO-C FLEXHALO-RL FLEXHALO-RLC Point of View Demonstration Single Center Monitor 2 Remote Controls Flex PC Audiometer Integration $3,500 Right and Left Monitor 2 Remote Controls Flex PC Audiometer Integration $6,500 Right, Left, and Center Monitor 2 Remote Controls Flex PC Audiometer Integration $9,700 HYBRID Make any combination of Left, Right and Center reinforcers using the same remote control. (Maximum of 6 reinforcers) International customers: Prices shown are in USD and exclude shipping, duties, and taxes. Pricing does not include the cost of shipping, applicable taxes, and installation. Sold through authorized distributors . We believe pricing transparency saves clinicians time. You can read more about why we post prices online here. Get a Quote Brochure The Remote Two Remote Controls Included With Every Flex VRA TOY VIDEO Display videos of cartoons and live-animals on the Flex Halo VRA display Display life-like digital toys spinning inside of the Flex Halo VRA box LIGHTS ON/OFF Turn on (top button) and off (bottom button) the 360 degree LED light bar while activating VRA stimuli LIGHTS ONLY Activate the 360 degree light bar only while an activation button is pressed down. Custom content comes standard with preloaded Hey Bear Sensory content, but any content can be loaded by the end user CUSTOM VOLUME CONTROL Volume up, down, and mute control of the Flex Halo VRA. DISTRACT Use Flex Halo as a focal point to keep patients still during tympanometry, otoscopy, or OAE testing. ACTIVATORS Left (Blue), Right (Red), and Center (Green) Included With Every Flex Halo Flex PC (Computerized Audiometers) Remote Controls (2) Audiometer Integration (GSI Audiostar and Interacoustics EVO) Welcome Videos Includes built-in content to help prepare and engage pediatric patients. FREE to download here . Conditioned Play Audiometry Games Built into every Flex VRA and available for FREE to download here. Toy In The Bucket Game Toy Bubble Game The Farm Game Interactive SRT Board Watch Demo Watch Demo Watch Demo Watch Demo Optional Accessories VROCA Button A wireless and battery-free visual reinforcement operant conditioning audiometry button $800 Learn More Screen Mirror Turn Flex VRA into an internal booth monitor for counseling, play audiometry or otoscopy. $800 GSI Audiostar Pro Any computerized audiometer Learn More Specifications Display 13.3 inch Remote/Flex PC/Audiometer Integration Transmission Wireless Zoned Radio Frequency .05 Seconds (Instantaneous) Activation Latency 18 months Remote Control Battery Life Input: 100-240V 50/60Hz 1.5A MAX Output: +12V, 5A, 60W Power Specifications Dimensions 14 inch (L) x 4 inch (W) x 9.5 inch (H) Operating System Windows 10 Professional Warranty 2 Years Accessories Optional Add-Ons To Enhance Workflow

Find clear answers to common audiology questions about VRA testing, calibration, and equipment. Learn how Flex VRA supports modern pediatric audiology. Frequently asked questions Questions about the Flex VRA company Questions of Purchasing Flex VRA Questions about the Flex VRA How long has Flex VRA been in business? Flex VRA shipped it's first commercial system in October of 2018. Who owns Flex VRA? Flex VRA is an independently owned LLC based in Cedar Park, TX. While we have partnered with a number of distribution partners throughout the years to bring Flex to clinics all over the world, Flex has always been and remains a private company.

Discover how Flex VRA modernizes pediatric audiometry with flexible, software-based visual reinforcement to improve hearing assessments for infants & children. Flex VRA: A Modern Visual Reinforcement Audiometry System Overview Flex VRA is a modern visual reinforcement audiometry system used in pediatric audiology clinics to assess hearing in infants and young children through visual reinforcement. The system is designed to support reliable behavioral responses during hearing evaluations by presenting engaging visual stimuli when an auditory response is detected. What problem visual reinforcement audiometry solves Visual reinforcement audiometry is commonly used to assess hearing in children who are too young for conditioned play audiometry or standard behavioral testing. Traditional VRA systems often present challenges such as: Limited stimulus variety, which can reduce engagement over repeated trials Fixed or mechanical reinforcers that cannot adapt to different patients Rigid room layouts that restrict monitor placement or test configuration Flex VRA was developed to address these limitations while preserving the core clinical principles of VRA testing. How Flex VRA differs from traditional VRA systems Flex VRA is designed as a software-driven alternative to traditional toy-based or mechanically reinforced VRA systems. Key differences include: Visual reinforcement delivered through digital stimuli rather than fixed toys Multiple stimulus options available within a single test session Greater flexibility in system configuration and room layout Consistent stimulus presentation without mechanical wear or maintenance The goal is not to replace established VRA methodology, but to modernize how visual reinforcement is delivered in the clinic. Who uses Flex VRA Flex VRA is used by clinicians and institutions that perform pediatric hearing evaluations, including: Pediatric audiologists Children’s hospitals University audiology clinics ENT practices offering pediatric diagnostic services The system is designed to integrate into standard audiometric workflows without changing how clinicians conduct testing. Clinical considerations Flex VRA functions as a visual reinforcer and does not perform sound generation, calibration, or audiometric measurement. The system: Does not replace an audiometer Does not require independent calibration Is used alongside existing audiometric equipment This allows clinics to adopt Flex VRA without altering established testing protocols. Adaptability and workflow Flex VRA supports a wide range of patient behaviors and attention levels by allowing clinicians to vary visual reinforcement during a session. This flexibility can be especially useful for: Patients with reduced attention span Children who habituate quickly to static reinforcers Clinics that test a wide range of ages and developmental levels Optional advanced features may be used when appropriate, but the system is designed to function effectively without them. Summary Flex VRA is a modern visual reinforcement audiometry system designed to support pediatric hearing assessments through flexible, software-based visual reinforcement. By modernizing how visual stimuli are delivered, Flex VRA helps clinics maintain engagement while preserving the core principles of VRA testing. About Flex VRA Flex VRA systems are used in pediatric audiology clinics and medical centers worldwide and are distributed through established audiology suppliers . The system is designed to evolve with clinical needs while remaining compatible with standard audiometric practices.