Sleeping Baby Hearing Test (SBHT) - a Home Hearing Screen
Instructions for Parents

Instructions for the Sleeping Baby Hearing Test - a Home Hearing Screen

Click here for a copy of the "Sleeping Baby Home Hearing Screen Score Sheet" - you may download and print this paper sheet or use the database included in the SBHT app to log test results.

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 (use the app's sound level meter located on the "Perform the Test" screen to measure the ambient noise in the room).
  • The test is performed with the baby asleep for no more than 5 minutes.
  • Turn on the app's digital Sound Level Meter using the green toggle button. The numbers will change as the sound level in the room changes.
  • Place your iPhone, iTouch or iPad 2 inches away from your 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 Ling Sounds are provided on the screen with the sound level meter.
  • The baby is observed for awakening and movement (arousal). If the baby becomes fussy, the test is performed at another time. Different types of arousals are summarized in app on the "Instructions" scrreen, paragraph 6.
  • The baby's responses are then logged in the database provided on the app's "Enter test results" screen.

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.

Step by Step Instructions

Start by reviewing the SBHT Instructions included in the app.

The Five Sounds

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 your smartphone or mobile device, boot the app and press the "Perform the Test" button on the Home Screen. Press the green button to toggle "ON" the sound level meter. The numbers will change as the meter measures the sound level in the room.

Practice making each sound for 5 seconds while watching the digital read-out on the sound level screen. Control the level of your voice to keep the numbers between 60-70 dB. When you have learned to consistently do this with each Ling Sound, you are ready to test your babies hearing.

  1. Now place your smartphone or mobile device with the sound meter turned on next to your baby's ear 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 meter should read 50 dB or less.
  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 smartphone or mobile device 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. Perform the test within 5 minutes of your baby falling asleep.
  3. Make the first sound "AH" for 5 seconds while watching the numbers on the meter to see that the sound is in the 60 - 70 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 Sounds.
  6. If your baby does not arouse and does not demonstrate a reaction to a sound increase the loudness of your voice to between 70-80 dB. If no response, increase the loudness of your voice to 80-90 dB. If your baby does not arouse repeatedly at between 80-90 dB, log the result in the database as "Refer" and schedule an appointment with your baby's doctor.
  7. Repeat the hearing screen with the remaining Ling Sounds.
  8. Use the app's databsse to log the reults. Input the date/time, "Pass" if your baby aroused. "Refer" if your baby did not arouse, and (-HA) if hearing aids were not being worn during the test or (+HA) if yorur baby was wearing hearing aids during the test.

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 and 6 months.
  • 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 Hearing Test - a Home Hearing Screen, please contact our office at 336-273-9932 and ask to speak to one of our Audiologists.