1 Automated Audiometry from the NIH Toolbox (AANT)

Attachment 1
Automated Audiometry for the NIH Toolbox (AANT)

OMB: 0925-XXXX
Expiration Date: XX/XX/XXXX
Name of test: Automated Audiometry for the NIH Toolbox (AANT)1
Estimated time burden: 7 minutes
Number of items: Five hearing frequencies will be tested
Child (3-7): Instruction Script for AANT (to be read by the examiner):
We are going to do an activity with whistles. For this activity, you get to wear these headphones. Once
you put these on, the computer will explain the activity. Your job is to listen carefully and to follow the
instructions. Let me show you how to choose the buttons. [Demonstrate button selection]. You will hear a
voice that will help you get started and show you how to do the exercise. I am going to put the
headphones on you now and then we can get started.”
If the child has difficulty using the mouse, he/she may point and the examiner may operate the mouse
and/or keyboard. The examiner should say something like the following: “You can point to your
choice and then I will enter your choice.” For children with motor problems, they can respond by
saying “Yes” or “No” and the examiner can say “You can say ‘Yes’ if you heard a whistle and ‘No’
if you did not hear a whistle.”
Child: Automated instructions for AANT (Graphics on the monitor are synchronized with recorded
instructions). This is the list of possible statements presented by the computer.
“Hello! We are going to do a whistle activity. First let’s see if you can hear me OK.”
“Choose the big ear if you can hear me OK.”
“Choose the little ear if I’m talking too softly. Choose the big ear or little ear now.”
“Choose the big or little ear now.”
“Could you hear and understand the person talking?”
“OK, be sure to choose the big ear if you hear the sound. Choose the big ear now.”
“OK, Let’s see if you can hear me at a louder level. Choose the little ear now.”

Public reporting burden for this collection of information is estimated to average 2 1/2 hours per response, including the time for
reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the
collection of information. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of
information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other
aspect of this collection of information, including suggestions for reducing this burden to: NIH, Project Clearance Branch, 6705
Rockledge Drive, MSC 7974, Bethesda, MD 20892-7974, ATTN: PRA (0925-xxxx*) EXP: (xx/xxxx). Do not return the completed
form to this address.

“Good Listening. We want to see if you can hear different whistles like this one.”
“Some whistles will be easy to hear and some whistles will be hard to hear. Sometimes there will be no
sound at all. When it is time to listen for a whistle, you’ll see me with the headphones on. [the
examiner should point to the icon showing the smiley face with the earphones.]
“Here is a quiet rabbit. He is not making any sound at all.”
“Here is a bird who makes whistle sounds.”
“If you hear a whistle, choose the bird. If you don’t hear any whistle at all, choose the rabbit.”
“Let’s try one…”
“Choose the bird if you heard a whistle. Choose the rabbit if you did not hear a whistle.”
“Choose the bird if you heard a whistle. Choose the rabbit if didn’t hear a whistle.”

“OK, we’ll try another in a minute.”
“Great. Now we are ready to continue!”
“Some whistles will be in this ear.”
“Some whistles will be in the other ear. Choose the bird if you hear a whistle in either ear. Choose the
rabbit if you do not hear a whistle.”
“Let’s practice again. Listen carefully for a whistle.”

OMB: 0925-XXXX
Expiration Date: XX/XX/XXXX
“Choose the bird if you heard a whistle. Choose the rabbit if you did not hear a whistle.”
“Oops. That time the bird whistled and you chose the rabbit. Let’s try that again.”
“Great. Let’s try some more!”
“Press the bird if you heard a whistle. Press the rabbit if you did not hear a whistle.”
“Oops. That time it was quiet and you chose the bird. Remember: listen carefully. Press the bird if you
hear a whistle. Choose the rabbit if it is quiet.”
“Great! Now let’s get started with the whistle activity.”
“The hearing activity has finished. Now you are ready for the next activity.”
Press or choose” is used throughout as a generic term prompting a manual response via mouse click. If the
examiner is responding for the child, “Say” can be used for verbal responses or “Point” for manual responses.2
If examiner determines that the child cannot reliably respond using the mouse, the examiner should switch to
the verbal response mode in which the child responds verbally and the examiner enters the response on the
child’s behalf with the examiner clicking the mouse according to the child’s verbal responses.

OMB: 0925-XXXX
Expiration Date: XX/XX/XXXX

Name of test: Automated Audiometry for the NIH Toolbox (AANT)3
Estimated time burden: 7 minutes
Number of items: Five hearing frequencies will be tested
Adult (8-85): Instruction Script for AANT (to be read by the examiner):
It is expected that the participant will use the mouse to indicate his or her responses.
The examiner says: “Now I will ask you to wear these headphones. If you are wearing hearing aids, I will
ask you to remove them for the hearing test. Once the headphones are on, we will begin testing your
hearing. I will ask you to choose your response with the mouse. The computer will give you the
instructions. I will put the headphones on you now and we can get started with the instructions.”
If a participant has difficulty using the mouse or keyboard, he/she may point and the examiner may
choose the response. The examiner should say something like the following to the participant: “You
can point to your choice and then I will enter your choice.” For participants with motor difficulties,
verbal response mode will be used in which the participant can say Yes when a tone is heard, and No
when a tone is not heard.
Adult: Automated instructions for AANT (Note: written instructions will appear on the monitor and will
be synchronized with recorded instructions). This is the list of possible statements presented by the
computer.
“Welcome to the hearing assessment.”
“Choose LOUDER if this sound is too soft.”
“Choose OK if this is loud enough.”

Public reporting burden for this collection of information is estimated to average 2 1/2 hours per response, including the time for
reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the
collection of information. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of
information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other
aspect of this collection of information, including suggestions for reducing this burden to: NIH, Project Clearance Branch, 6705
Rockledge Drive, MSC 7974, Bethesda, MD 20892-7974, ATTN: PRA (0925-xxxx*) EXP: (xx/xxxx). Do not return the completed
form to this address.

OMB: 0925-XXXX
Expiration Date: XX/XX/XXXX
“Could you hear and understand the person talking?”
“OK, as we go forward, be sure to choose OK if you hear the sound. Choose OK now.”
“OK, Let’s see if you can hear it at a louder level. Choose LOUDER now.”
“Good. Let’s review the instructions.”
“When you see and hear the “LISTEN NOW” prompt, listen carefully. You may hear a beep like this one.”
“Listen Now”
“Some beeps will be very soft.”
“After the Listen Now prompt, choose YES if you hear a beep. Choose NO if you do not hear a beep.”
“Let’s practice one now.”
“Did you hear a beep?” “YES” “NO”
“You responded NO when a tone was presented. Let’s try again.”
“Great. Now we are ready to continue.”
“The beep can be in either ear.”
“Sometimes there won’t be any beep at all. If you choose “YES” and no beep was played, you will get a
warning message like this:”
“You chose “YES” when no beep was played. Listen Carefully. Choose “YES” only when you hear a beep.”
“Did you understand the instructions? Choose “YES” or “NO””

OMB: 0925-XXXX
Expiration Date: XX/XX/XXXX
“Good. Let’s get started with the hearing assessment.”
“OK, let’s go through it again.”
“The hearing assessment has finished. Now you are ready for the next assessment.”
1

Note: The term “Choose” is used throughout as a generic term prompting a manual response. If the examiner
is providing the computer input, the term “Choose” should be replaced by “Say” and the participant is asked to
respond verbally.4