Introducing our first-in-class Visual Reinforcement Audiometry Reward System

Our Paediatric VRA puppet towers and our VRA Video system is truly unique in that one long range 2.4 GHz wireless controller controls both the puppets and the video Visual Reinforcement Audiometry Rewards. The same reward button activates either the mechanical puppets or the video. Our systems are in use in single or two room set-ups up and down the country.


  • Videos are cataloged by category and randomised within each category so that if a patient likes  “Baby Shark” or “Tractors”, only those videos will play.
  • There is a simple to use interface for uploading additional videos.
  • Colour LED lighting keeps things varied and fresh and a multitude of colours  can be selected or randomised to fade in or flash.


We can customise your VRA tower to your room.


Our VRA systems are in use in world-renowned Paediatric Audiology centers across the UK.


Design of the VRA Reward System

The Paediatric Visual Reinforcement Audiometry (VRA) Reward System consists of two cabinets; each giving a choice of three puppets. The audiologist can activate all of the puppets independently using the intuitive remote-control. The remote-control allows the user to choose which of the puppets and which of the towers to activate. Until the user chooses to activate the puppets, they remain hidden behind black tinted Perspex sheets.


The system also has a screen on top of both the cabinets. When needed, the user can activate the screen to play a video of their choice using the remote-control. In video-mode, the user can still select which side of the patient to play the video from. This additional mode can be used to increase the number of options the user has when testing a child that does not engage well with the puppets.


Paediatric VRA Reward System Video-mode Screen manufactured by Audiologist Limited

Paediatric VRA 3-Tier Puppet Tower Reward System manufactured by Audiologist Limited

Our Towers:

gosh 1
gosh 2
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Why use the Audiologist Limited VRA Systems?

There are numerous advantages that the Audiologist Limited VRA Reward System has over those produces by other companies:

    • Remote Control: The Audiologist Limited VRA System does not require any wired connection between the controller and the Towers and can therefore be used in two separate rooms. The physical presence of the audiologist in the testing room can sometimes unintentionally guide or influence the child’s behavior or responses. With wireless control, the audiologist can maintain a more objective and standardized testing environment, reducing the potential for inadvertent cues. Our first-in-class, patent-pending, 2.4 GHz all-in-one control for video and VRA has been in use across hospitals in the UK since 2019.
    • Intuitive Controller: The VRA System is controlled by a single controller. The controller can toggle between Puppet and Video mode at the press of a button, making it a simple, efficient and user-friendly controller. The toggle ability of the controller allows audiologists to easily switch between different modes of testing, allowing the testing process to be customisable at a moments notice.
    • Choice of Toys: Our VRA System can integrate modern toys as the puppets used for the tower. Among the examples of the toys used to date are; Cocomelon, Peppa Pig, Olaf and Mickey Mouse. By allowing the toys to be up to date, the VRA system can be used to greater success than when using toys unfamiliar to the child being tested
    • Customisation of Towers: We can alter how the towers look based on the request of the customer. If limited on space in the testing facility, the customer can order a single tower or a shorter tower. Additionally, the tower is fitted with LED strip light, the colour of these lights can be changed by the audiologist at any point.
    • Bespoke System: Buyers can choose to purchase our VRA System as a pair of towers with the screen. Alternatively, they can buy each component independently to suit their specific needs.


Why Use Virtual Reinforcement Audiometry?

Paediatric Visual Reinforcement Audiometry (VRA) Reward Systems act as a solution to the difficulties that clinical paediatric audiologists experienced when attempting to test the hearing of children with a limited attention span. VRA systems consist of cabinets, each of which contains puppets. The audiologist plays a sound while illuminating and animating the puppets. The audiologist uses the puppets as a reward for the children who react to the sound during testing, learning to associate the sound controlled by the audiometer with the activation of the puppets in the cabinets. The system also has a screen on top of both the cabinets. When needed, the user can activate the screen to play a video of their choice using the remote-control.


Audiologists can customize the visual stimuli to suit the child’s preferences and interests, making the testing process more enjoyable. This degree of personalisation enhances the child’s cooperation, leading to improved accuracy in the evaluation of their hearing abilities.


Additionally, VRA systems facilitate parental involvement in the testing process. Parents can observe their child’s responses and witness the relationship between auditory stimuli and visual reinforcement. This involvement not only provides reassurance to parents but also helps them understand the child’s hearing status and actively participate in their overall auditory development.


VRA has revolutionized pediatric audiology, providing an engaging and effective method for assessing the hearing ability of young children. VRA systems capture attention, offer objective measurements, and promote parental involvement for optimal hearing outcomes. They play a pivotal role in early identification and intervention in children.


Users have found that children tend to cooperate for longer, interacting and responding more when a VRA system is used. This makes audiological testing easier to carry out especially in patients who have a limited attention span. The system has proved particularly effective in obtaining accurate aided thresholds in hearing impaired children.



For enquiries about our VRA Reward Systems, view our Contact Information