Sleeping Baby Home Hearing Screen Instructions for Parents

Home Instructions for the Sleeping Baby Home Hearing Screen (SBHHS)

Click here for a copy of the "Sleeping Baby Home Hearing Screen Score Sheet"

Click here to watch the video of a mother screening her baby

General Instructions

  • The baby is placed in his/her crib.
  • Nursery noise must be less than 50 dB (the meter will indicate the ambient noise in the room).
  • The test is performed with the baby asleep for no more than 5 minutes.
  • A digital Sound Level Meter is turned on to the 60 dB setting on the range dial (meter weighting should be set at "C" and response set to "fast").
  • The sound level meter's microphone is placed 2 inches away from the baby's ear (the sound level meter does not generate any sound, its purpose is to measure the level of the mother's voice to indicate to her visually that she is providing the Ling sounds at a 60 dB level (normal speech level).
  • The mother stands at an arms length to the baby. While watching the sound level meter, the mother says the Ling sounds and adjusts the level of her voice to 60 dB SPL. Each Ling sound is tested 3 times.
  • The baby is observed for awakening and movement. If the baby becomes fussy, the test is performed at another time.
  • The baby's responses are written on the Sleeping Baby Home Hearing Screen Score Sheet

Getting Started with the Sleeping Baby Hearing Screen

  1. During the first year or two, your baby is held in your arms with your mouth a few inches from the baby's ear. This means that your 60 dB conversational level is being heard by your baby at 70 dB. This is analogous to an FM system where the microphone is close to the speaker's mouth, and the sound is transmitted to a hearing aid receiver in the baby's ear at increased loudness.
  2. Now set the Range Dial to 80 and then to 90. Your will note the meter reads LO at this level of sound settings. This shows that a hearing loss of 80 or 90 db does not allow conversational sound to be heard. This is the reason for a hearing aid or cochlear implant.

Step by Step Instructions

Start by reviewing the SBHHS Instructions for the digital Sound Level Meter that you were shown in your doctor's office. The photo to the right is the Radio Shack Digital Sound Level Meter, Model 33-2055 | Catalog # 33-2055. The meter is turned on and indicating 54 dB SPL with the range dial set at 60 dB.

  1. With the "Range" dial set to 60, count just loud enough to have the dots move partially across the screen.
  2. Now set the range dial to 70 and speak loud enough to move the dots across the dial.
  3. Now set the range dial to 80 and then 90 and note how loud you must shout to move the dots.
  4. While sitting across the room listening to the news, set the TV to a comfortable listening level. Hold the sound level meter in your hand with the Range Dial set to 60. You will see the dots move from -10 past 0 and over toward +10 as they did while you were counting.
  5. Set the Range Dial to 70 and now LO, 50's and 60's numbers appear, but the dots rarely reach the 0-60 dB level.
  6. Gradually move closer to the TV until the dB numbers and dots appear like the 60 dB range. This shows that sound Getting gets louder the closer you are to the source.

The Five Sounds

Click here for a copy of the "Sleeping Baby Home Hearing Screen Score Sheet".

There are 5 sounds that mother makes to observe the babies arousal to speech. These are called the Ling Sounds that contain most of the sounds (phonemes) of speech. Practice making these sounds.

The Ling Sounds are:

  • /a/ Vowel AH as in Art, hOt, Odd
  • /u/ vowel OO as in whO, mOO
  • /i/ vowel EE as in EAse, bEE, EAst, bEEt
  • /s/ consonant SS as in So, See, makeS, upSet
  • /sh/ consonant SH as in Ship, She, Shoe

While holding the Sound Level Meter that is set to 60 at arms length, practice making each sound for 5 seconds while watching the dots below the sound level screen. Control the level of your voice so the dots pass the 0 mark but rarely hit the +10 mark and look about the same as they did while you were listening to TV at conversational level. When you have learned to consistently do this with each Ling sound, you are ready to test your babies hearing.

  1. Now place the Sound Level Meter that is set on 60 on your baby's crib. Eliminate extraneous noises in the room such as TV or air conditioning. If the room is quiet enough for infant hearing testing the screen should read LO or only occasionally read 50 indicating that the room noise level is 50 dB or below.
  2. Place your baby on his/her back in the crib with no covers on so you can see your baby's movements. Place the Sound Level Meter microphone about 2 inches from your baby's ear. Watch closely to see when your baby is just going to sleep. If your baby has been asleep for longer than 5 minutes, the sleep becomes much deeper, and your baby will not react to sound.
  3. Make the first sound "AH" for 5 seconds while watching the dots on the meter to see that the sound is in the 60 dB range.
  4. For the next 10 to 15 seconds watch for any reaction to the sound.
  5. The reactions are:
    a definite eye blink,
    a slight shudder of the whole body,
    briefly opening eyes,
    marked movement of arms and legs or a combination of any of these.
    If there is a reaction, let your baby fall back asleep for 20 or 30 seconds and proceed to the other Ling Sound.
  6. If no reaction to a sound advance the Range dial to 70 and repeat the sound at a slightly louder voice to keep the Range Dial in the 20 dB range. If still no reaction, advance the Range Dial to 80 and speak the sounds at a much louder voice. If still no reaction, set the Range Dial to 90 and yell loud enough to keep the Range Dial in the 20 dB range. At each reaction level, mark an "X" in the appropriate box of the score sheet, or if no reaction at any level of loudness, mark that box "NR" for No Response..
  7. Now repeat the hearing screen with the remaining Ling sounds.

You may not be able to test all the sounds before your baby becomes fussy. If so, continue the testing at another nap time. During the next 2 weeks, repeat each sound 2 more times.

Results

  • If the baby arouses to the Ling sounds at 60-70 dB, then the baby probably has normal hearing, in at least one ear. Remember that all screening tests, especially behavioral tests, may have both false positives and false negative results for many reasons. 
  • Because hearing loss can develop during the first few years of life, the test should be repeated at 3 months, 6 months, and 12 months of life.
  • If the baby is only aroused at 80-90 dB or not at all, consistently, the baby may have a hearing loss and needs to be referred to a hearing specialist, called an Otologist, who has special expertise in diagnosing and treating children with hearing impairments. Additional objective audiometric tests such as auditory response testing (ABR), otoacoustic emission testing (OAE), and stapedial reflex testing will need to be done.
  • Click here to read the article "Our Baby is Hearing Impaired: What Do We Do? Where Do We Start?"

To learn more about the Sleeping Baby Home Hearing Screen, please contact our office at 336-273-9932 and ask to speak to one of our Audiologists.