Serious Gaming Meets Audiology: Developing a Video Game for Auditory Testing

The primary objective of this research is to enhance the ecological validity of clinical hearing assessments by integrating them into a serious game environment. Traditional speech reception threshold tests, while clinically precise, often lack the contextual complexity of real-world listening environments. By developing a narrative-driven video game titled De Weg Naar Boven, the study aims to bridge the gap between controlled laboratory diagnostics and the auditory challenges encountered in daily life, such as ambient noise and visual distractions.

The game features a hiking simulation where participants navigate a virtual mountain and use an in-game walkie-talkie to repeat validated, clinically approved sentences. The auditory stimuli are masked with realistic background noise, such as wind and rustling leaves, to simulate authentic listening conditions. The development process utilized a low-poly aesthetic to ensure accessibility for a broad demographic, including older adults, and incorporated generative AI tools for asset creation. The game maintains the integrity of established clinical metrics while providing a more immersive and engaging experience for the user.

A pilot study involving twelve participants, with an average age of 37, evaluated the game through observations, interviews, and the User Engagement Scale Short Form. Results indicate high levels of aesthetic appeal and usability, with participants successfully completing the auditory tasks. While the game effectively increases engagement, it requires 15 to 20 minutes to complete, which is three to four times longer than standard clinical tests. Future development will focus on refining narrative clarity and validating the tool with individuals specifically diagnosed with hearing loss to confirm its clinical efficacy. The findings suggest that serious games offer a viable, engaging framework for modernizing diagnostic procedures in audiology and beyond.