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Flex Toy is a simple, clinic-ready VRA toy designed to maintain engagement through variation during pediatric visual reinforcement audiometry testing. Button Flex Toy configurations (R=Right L=Left C=Center) FLEXTOY-C FLEXTOY-RL FLEXTOY-RLC Point of View Demonstration Single Center Box 2 Remote Controls Flex PC Audiometer Integration Includes $1,250 Right and Left Boxes 2 Remote Controls Flex PC Audiometer Integration Includes $2,250 Right, Left, and Center Boxes 2 Remote Controls Flex PC Audiometer Integration Includes $2,950 FLEX COMBINATION SYSTEMS Make any combination of Left, Right and Center reinforcers using the same remote control. (Maximum of 6 reinforcers) Includes Go To Combo Systems Pricing does not include the cost of shipping, applicable taxes, and installation. For a full cost breakdown, please request a quote and an authorized local representative for your area will be in touch with you shortly. International customers: Prices shown are in USD and exclude shipping, duties, and taxes. Get a Quote Brochure Next Level Traditional VRA Rotating light patterns that change on each activation for increased novelty and attention Flip up front cover for easy changing of toys Dual side speakers for improved sound quality Wireless communication with remote control Audiometer integration with GSI Audiostar Pro and Interacoustics Evo included Control of the VRA from your desktop computer (Flex PC) included 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. Jack Hitchens, Au.D. Included With Every Flex Toy (No Additional Cost) Cat (Left) Dog (Center) Bus (Right) Flex PC Remote Control (2) 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 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. 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. CUSTOM

Download brochures, manuals, quick guides, and support documents from Flex VRA. Downloads Flex VRA Brochure - Product overview and specs for clinic decision makers Installation and User Manual - Guide for installers and end users Remote Control Pairing Guide- Coming Soon Integration Cable Pairing Guide (Audiostar Pro)- Coming Soon Integration Cable Pairing Guide (Interacoustics EVO)- Coming Soon VROCA Button Brochure -Product overview for clinic decision makers Installation and User Manual -Guide for installers and end users Screen Mirror Brochure Installation and User Manual -Guide for installers Flex PC Brochure Installation and User Manual PC Pairing Guide Flex Toy Brochure - Product overview and specs for clinic decision makers Installation and User Manual -Guide for installers and end users Remote Control Pairing Guide Integration Cable Pairing Guide (Audiostar Pro) Integration Cable Pairing Guide (Interacoustics EVO) Flex Mobile Brochure - Product overview and specs for clinic decision makers Installation and User Manual Remote Control Pairing Guide Flex Speaker Brochure - Product overview and specs for clinic decision makers Installation and User Manual - Guide for installers and end users Installation Video Demo - Short video demo for Flex Speaker installers Flex Window Cover Brochure - Product overview and specs for clinic decision makers Installation and User Manual Remote Control Pairing Guide

Download various Conditioned Play Audiometry apps and support tools from Flex VRA. Free CPA Games Download Flex Farm Game This application was developed for the Flex VRA but can be used on any Windows PC. This application will display various fruits on the screen that can be dragged to an animal to eat. When the task is completed, the animal will move and make a noise in response as a reward. This can be used during play audiometry so that when a child hears the sound, they can feed the animal of their choice. Download Bubble Game This application was developed for the Flex VRA but can be used on any Windows PC. This application will float bubbles on the screen and when "popped" (touched or clicked with a mouse), an animated cat will appear and music will play as a reward. Download SRT Board This application was developed for the Flex VRA but can be used on any Windows PC. This provides a visually reinforced SRT board that will move and play sound when correct selections are made by the patient. Download Flex Ball Game This application provides a "drop the ball in the bucket" game for pediatric patients to play during play audiometry. The application works both with a drag and drop mouse interface or a touch screen interface.

Discover Flex VRA — a modern Visual Reinforcement Audiometry system designed for pediatric clinics. Flexible, clinician-led, and trusted in 1000+ clinics worldwide. Flex Visual Reinforcement Audiometry Simple by design. Flexible by choice. A modern VRA system that scales from basic reinforcement to advanced testing workflows. Starting at $2,450 International customers: Prices shown are in USD and exclude shipping, duties, and taxes. Video Toy Custom Content Discover Flex VRA Flex Toy Simple VRA thoughtfully updated. Engagement through variation. Starting at $1,250 International customers: Prices shown are in USD and exclude shipping, duties, and taxes. Discover Flex Toy Flex Window Cover Visual control for sound booths. Keeps the visual environment controlled during testing. $800 International customers: Prices shown are in USD and exclude shipping, duties, and taxes. Discover Flex Cover Accurate sound where it matters. Flex Speaker A reliable speaker option commonly used in VRA testing environments. $650 International customers: Prices shown are in USD and exclude shipping, duties, and taxes. Discover Flex Speaker What's New For the Flex VRA System? Smarter hardware. More flexible setups. Expanded software tools. Expanded wireless compatibility across VRA components Improved durability and mounting options New software features including Targeted Content and House Rules See Full Details Testimonials AUDIOLOGIST, STEPHEN F. AUSTIN UNIVERSITY Nacogdoches, TX I absolutely love the Flex VRA system!!! Complete game changer. I turn the screens on before I bring the child in. It creates a better environment and keeps them distracted during otoscopy and tympanometry. Genius!! BROOKE HAMMOND, AU.D. PRIMARY CHILDREN'S HOSPITAL Salt Lake City, UT We LOVE the new Flex VRA system and the flexibility it offers to keep children interested in the task. It has definitely improved patient engagement and reliability of results. The Flex wireless system was extremely easy to install and has worked reliably.” AUDIOLOGIST, TEXAS CHILDREN'S HOSPITAL Houston, TX I LOVE this system. My nurses even commented on how modern and engaging it is compared to our older system. I'm one happy customer! CHELSEA BLANKENSHIP, AU.D., PH.D CINCINNATI CHILDREN'S HOSPITAL Cincinnati, OH We have a couple Flex VRA systems and find that they work really well with our kiddos. We really love the flexibility with the videos and have customized clips based on the child’s interest. AUDIOLOGIST, CENTER FOR HEARING AND SPEECH Houston, TX Everyone really likes it! We really like the up-to-date video clips and having the volume control. BRANDI MURPHY, AU.D., WEST TEXAS MOBILE AUDIOLOGY Lubbock, TX I have a FLEX VRA system in my mobile unit and love IT! It’s a great easy-to-use product that can maintain childrens’s attention better than any other VRA system on the market! I love using it for BOA, VRA, when obtaining OAEs, and when prepping for an ABR!

Learn how to select a reliable, flexible VRA system for pediatric audiology. Flex VRA supports integration, visual reinforcers, & seamless clinic workflows. Not all VRA systems are designed the same. As pediatric hearing evaluations have evolved, the expectations for VRA equipment have changed, as well. Clinics now look for systems that are reliable, flexible, and easy to use while supporting consistent patient responses. Here are the key factors to consider when selecting a VRA system. 1. Reliability and Timing A VRA system must respond instantly when the clinician triggers a reinforcer. Any lag or delay makes the test harder and can disrupt the child’s attention. Software driven systems tend to offer faster activation times compared to older mechanical VRA boxes. For instance, Flex VRA utilizes a paired zoned 433 MHz radio frequency wireless transmission protocol to send signal from the remote control to the reinforcer. This means that the lag time between button press to activation would be similar to that of a lag time of a wireless keyboard to your computer...instantaneous. Moreover, because each system's transmission is zoned between paired reinforcers, there is no overlap from other systems or interference from any higher frequency RF signals. 2. Quality of Visual Reinforcers Children respond best to bright, engaging, but not overstimulating content. Look for a VRA system that allows you to customize content and adjust how exciting the reinforcer should present. Features like House Rules in Flex VRA let you control how the center monitor behaves so you get clearer head turns, and more focus on the left and right reinforcers. 3. Integration With Audiology Equipment The best VRA equipment connects smoothly with your audiometer, remote, or clinic workflow. Consider whether the system supports: • Remote control activation • Audiometer integration • PC or software-based triggering Seamless integration allows clinicians to stay focused on the patient instead of the equipment. And Flex VRA includes all three of those options with every Flex VRA shipped at no extra cost . 4. Durability and Build Quality VRA equipment is used daily in pediatric settings. Look for a system designed to withstand constant use, movement between rooms, and long clinical schedules. 5. Versatility and Future Features Clinics benefit from VRA systems that grow with them. Software based systems often release updates, new reinforcers, and feature improvements that extend the life of the system without requiring new hardware. 6. Support and Service Make sure the company behind your VRA system offers reliable support. Pediatric audiology depends on smooth daily operation, so access to fast assistance matters. By evaluating these factors, clinics can choose VRA equipment that improves workflow, supports accurate Visual Reinforcement Audiometry, and creates a better experience for both the child and family. Choosing the Right VRA System for Your Clinic

Enhance VRA testing with the Flex Screen—Flex VRA's remote-controlled privacy screen for distraction-free audiology sessions. Custom sizes available. Button Brochure FLEX-WINDOWCOVER Electric rolling cover 3 ft x 3 ft Magnetic mounts Wireless remote control USB C charging cable $800 FLEX-DOORCOVER Electric rolling cover 6 ft x 18 in Magnetic mounts Wireless remote control USB C charging cable $800 Flex Cover configurations Includes Includes Operator's Side Patient Side Be heard, not seen. Visual control during pediatric testing. Battery-powered motor with wireless control Magnetic mounting for quick installation Custom sizing for individual booths

Get in touch with Flex VRA for questions on audiology equipment. Our team supports clinics worldwide with reliable, modern VRA solutions for children. Questions about Flex VRA? We’re happy to help. A member of our team will respond within one business day. Submit Thanks for submitting! 100 E. Whitestone Blvd., St. 148, #160 Cedar Park, TX 78613 512-777-0016 sales@flexvra.com Find a representative near you

Explore the Flex Mobile VRA system with wireless control, carrying case, table top mount, and seamless computer integration — designed for improved pediatric engagement. Flex Mobile VRA wherever you need it. Brochure FLEX-MOBILE A complete, ready-to-use Flex VRA kit, including: Single Center Monitor 2 Remote Controls Flex PC Carrying Case Table Top Stand $2,450 International customers: Prices shown are in USD and exclude shipping, duties, and taxes. Designed for portability A portable Flex VRA configuration for clinics, outreach programs, and shared testing environments. Zoned Wireless Remote Control Simplifed in design with increased functionality Response Time (from button press to activation): instantaneous (.5 ms) Battery: 2 AAA Batteries Battery Life: 1-1.5 years Number of Remotes that can pair to each system: 2 Number of Remotes that come with each system: 2 Dynamic SRT Pictured Words Board An SRT board that moves and has sound in response to touch! Watch Demo Diagrams Application Display diagrams of the ear for counseling or upload your own images! How it works

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.

Flex Cover is a wireless privacy screen for audiology sound booths, helping reduce visual distractions during pediatric VRA testing with simple installation and custom sizing. Button Flex Speaker $650 a pair International customers: Prices shown are in USD and exclude shipping, duties, and taxes. Installation Guide Brochure High Performance Audiometry Speakers Passive Speakers Magnetic backing for easy placement and installation Included speaker adapters for all amplified audiometers Included tape measure to ensure consistent height placement Low profile mounting (no brackets needed) 30 meters of speaker cable included Designed to fit for corner mount or flat mount Mount. Secure. Align. Wire. Connect. A clean, repeatable speaker installation every time. Flex Speaker Installation Walkthrough Compatibility Out Of The Box Taking the guess work out of audiometer connections Flex Speaker ships with the needed adapters to connect speaker wire to the GSI Audiostar Pro and Interacoustics EVO Interacoustics EVO Speaker Adapter (2 1/4" mono to terminal) GSI Audiostar Pro Speaker Adapter (5 pin DIN to terminal) Designed For Audiology Purpose-built to match Flex VRA dimensions, creating a clean, intentional sound booth environment. Integrated with Flex VRA monitor Side-profile, flush-mounted Front view, clean clinical install

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. 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. 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.

Learn about what Visual Reinforcement is and why it is so important in audologic testing. Visual Reinforcement Audiometry (VRA) What is it and how does it work? Visual Reinforcement Audiometry (VRA) is a behavioral hearing test used to evaluate hearing sensitivity in infants and young children, typically between 6 months and 2–3 years of age, by conditioning a head-turn response to sound using visual reinforcement. Rather than asking a child to respond verbally or press a button, VRA relies on a natural behavioral response. When a child hears a sound, they learn that turning toward it results in something visually interesting. Over time, that association allows clinicians to estimate hearing thresholds based on consistent responses. VRA is most often used with children between approximately 6 months and 2 to 3 years of age, although developmental level is often a more important factor than age alone. Why is VRA used in pediatric audiology ? Standard hearing tests require cooperation, instruction following, and sustained attention. For very young children, that expectation simply is not realistic. Visual Reinforcement Audiometry was developed to bridge that gap. By pairing sound with visual reinforcement, clinicians can collect meaningful hearing information during a critical window for speech and language development. For many children, VRA provides the first reliable behavioral data in the diagnostic process. How Visual Reinforcement Audiometry Works At its core, VRA is a conditioning task. A sound is presented, typically through speakers or earphones. When the child responds appropriately, a visual reinforcer is activated. Over repeated trials, the child learns that responding to sound leads to a visual reward. From there, the clinician can adjust stimulus levels and frequencies to estimate hearing sensitivity. VRA being performed at the University of North Carolina A Typical VRA Session includes: Presentation of calibrated auditory stimuli Conditioning the child to associate sound with visual reinforcement Observing head turns or eye movements toward the sound source Reinforcing correct responses Gradually reducing stimulus levels to identify response thresholds The process is flexible and adapts to the child’s attention span and engagement on a given day. Types of VRA Testing Sound-field VRA Sound-field testing uses speakers positioned to the left and right of the child. This approach measures the response of the better-hearing ear and is commonly used early in the evaluation process. Ear-Specific VRA When a child tolerates earphones or insert phones, ear-specific information can be obtained. This allows clinicians to evaluate each ear independently and is preferred whenever possible. Below is a real-world example of visual reinforcement audiometry performed in a pediatric clinic. Equipment used in Visual Reinforcement Audiometry Visual reinforcement may take different forms: Animated or video-based displays Mechanical or illuminated toys Modern VRA systems often allow clinicians to choose or adjust reinforcement types based on the child’s age, preferences, or attention level. A VRA setup typically includes: An audiometer Speakers or earphones Visual reinforcers positioned to the left and right A control interface or remote Appropriate cabling and accessories Many newer systems use software-based control, allowing clinicians to customize how reinforcement behaves during a session rather than relying on fixed hardware responses. Does VRA Require Calibration? Yes and no. The actual VRA reinforcers do not require any formal calibration because they are not putting out any kind of calibrated stimuli utilized for testing hearing threshold. They are simply the reward stimulus for after the patient has heard oand recognized a calibrated stimuli from the audiometer. It is important to remember that although the VRA does not require acoustic calibration, consistent placement and predictable behavior are important to reliable testing. With that said, in order to properly perform VRA testing, a calibrated audiometer is required to ensure accurate threshold detection. Benefits of Visual Reinforcement Audiometery VRA allows clinicians to: Obtain behavioral hearing information in very young children Perform testing in a non-invasive, child-friendly way Estimate frequency-specific thresholds Adapt testing strategies based on engagement and development For many pediatric patients, VRA represents the most practical balance between accuracy and cooperation. Limitations to keep in mind Like all behavioral tests, VRA has limitations. Results depend on the child’s attention, motivation, and conditioning. Sound-field testing does not provide ear-specific data, and fatigue or loss of interest can limit session length. For these reasons, clinicians often combine VRA with other test methods using combinations systems and emphasize flexible system design. For patients who struggle with traditional visual reinforcement audiometry, VROCA testing offers an operant, visually reinforced alternative. When VRA is the preferred approach Visual Reinforcement Audiometry is typically used when: A child is too young for conditioned play audiometry Behavioral observation alone is insufficient Behavioral data is needed to cross-check objective results Ear-specific thresholds are possible but not guaranteed Professional organizations such as the American Academy of Audiology and the American Speech-Language-Hearing Association recognize VRA as a standard behavioral assessment method in pediatric audiology. Choosing a VRA System When evaluating VRA equipment, clinicians often look beyond basic functionality. Considerations commonly include: Ease of setup and room integration Flexibility of reinforcement options Compatibility with existing audiometers Consistency and reliability during testing Ability to adapt to different patient behaviors Systems that allow customization during the session can reduce frustration and improve efficiency for both clinicians and families. In Summary Visual Reinforcement Audiometry plays a critical role in pediatric hearing assessment. By pairing sound with visual reinforcement, VRA allows clinicians to collect meaningful behavioral data during early stages of development when traditional testing is not possible. As VRA technology continues to evolve, modern systems increasingly focus on flexibility, adaptability, and clinician control, all with the goal of improving test reliability and the overall experience for children and parents alike. FAQ Review What age is visual reinforcement audiometry used for? Visual reinforcement audiometry is typically used for infants and young children between approximately 6 months and 2.5 years of age. It is most effective once a child is developmentally able to localize sound and turn their head toward a visual stimulus. The exact age range may vary depending on the child’s developmental level and attention skills. How does visual reinforcement audiometry work? During visual reinforcement audiometry, a child is conditioned to turn toward a visual stimulus, such as a lighted display or animated image, when a sound is presented. When the child correctly responds to the sound, the visual reinforcement is activated as a reward. Clinicians observe these head-turn responses to determine hearing sensitivity across frequencies and ears. Is visual reinforcement audiometry reliable? Yes, visual reinforcement audiometry is considered a reliable and widely accepted behavioral hearing test when performed correctly. Reliability depends on factors such as patient engagement, clinician experience, and proper test setup. VRA is commonly used in pediatric audiology as part of comprehensive hearing assessment. How long does a VRA hearing test take? A typical visual reinforcement audiometry session lasts 15 to 30 minutes, depending on the child’s cooperation and the information being gathered. Testing may be shorter or longer based on attention span, age, and whether additional assessments are needed. Breaks are often incorporated to maintain engagement. What is the difference between VRA and play audiometry? Visual reinforcement audiometry is generally used for younger children and relies on head-turn responses reinforced by visual stimuli. Play audiometry is used for older toddlers and preschool-aged children who can perform a task, such as placing a block in a bucket, when they hear a sound. Both are behavioral tests, but they are matched to different developmental stages.