Ear Center: Resources for the Sleeping Baby Hearing Test Screen

Test Norms - Scientific Rationale

In August 2009, Dr. William F. House sent out a questionnaire to the William House Cochlear Implant Study Group (WHCI) and received eleven (11) responses. These eleven centers had performed 365 cochlear implants on children who were less than age two (2). Six (6) centers were private practice. Five (5) were University based.

The Sleeping Baby Hearing Test - a Home Hearing Screen was normed on twenty-seven (27) normally hearing infants less than age 12 months by Goodman and McPherson.

The Sleeping Baby Hearing Test Screen was performed by a mother in her home, and the infants were also tested with Transient Otoacoustic Emissions (TOAEs). Twenty seven (27) of the children were shown to have normal hearing by the SBHT.

Twenty six (26) of the children were shown to have normal hearing by the TOAE screen. One 11 month old infant could not be tested with the TOAE because of excessive movement. Since this child was shown to have normal hearing by the SBHT screen, this would indicate a slight advantage of the screen over the most commonly used infant screen.

Click here to read "An Effective Protocol for the Sleeping Baby Hearing Screen" by Shawn S. Goodman.

This is a good start, but there is a problem!

The Joint Committee on Infant Hearing of the Pediatric Academy in 2007 reported that:

"When a newborn fails to pass the hospital screen two times, the screening results are conveyed to the parents and pediatrician. The birth hospital reports the failure to the State Early Hearing Detection and Intervention Coordinator whose job is to be sure (that) all hearing impaired infants are followed-up. The Coordinator recommends that the parents see an audiologist for re-screening and comprehensive evaluation with TOAE and ABR".

The Problem

"Despite the fact that in the United States approximately 95% of newborn infants have their hearing screened, half of newborn infants, who do not pass the initial screening, fail to have appropriate follow up, and if there is a hearing loss, to initiate appropriate early intervention services".

The National Institute for Deafness and Communication Disorders reports:

"The principal reason parents do not return for re-screening is there aren't enough people or resources available to handle the screening and follow-up process".

During the past 10 years, the Pediatric Joint Committee on Infant Hearing has made a large effort to relieve the shortage of pediatric audiologists by establishing additional audiology training centers. The lack of success of this effort is shown by no change during the past 10 years in the 50% follow-up rate of newborns who have failed the hospital screen.

Early detection of sensorineural hearing loss and deafness in children is critical as early detection leads to early intervention with hearing aids and cochlear implants. It is well known that early intervention leads to better opportunities for speech and language development and intellectual development.

 

One Solution

It is clear that the present follow-up of newborn hearing screen failures is not working. Therefore, Dr. House has proposed:

  • bypassing the Early Hearing Detection and Intervention Coordinator
  • initiating follow-up in pediatric offices
  • referral of failures to otologic practices and universities that are performing cochlear implants.

To accomplish this, Dr. House has developed the "Sleeping Baby Hearing Test - a Home Hearing Screen". The concept is:

  • that a normal fetus sleeping in-utero during the last 4 months of the pregnancy will awaken,
  • then move and kick when hearing their mother's voice
  • during the first year after birth, this awakening reflex persists quite strongly.

In her home, the sounds that the mother uses to initiate an arousal reaction in her lightly sleeping baby are the "Ling Sounds" that contain the phoneme sounds of speech. Ordinary conversational sound intensity when listening to a speaker that is at an arms length away, averages 60 dB SPL.

The Sleeping Baby Hearing Test - a Home Hearing screen was normed on twenty-seven (27) normally hearing infants less than age 12 months by Goodman and McPherson.

The Sleeping Baby Hearing Test - a Home Hearing Screen was performed by a mother in her home, and the infants were also tested with Transient Otoacoustic Emissions (TOAEs). Twenty seven (27) of the children were shown to have normal hearing by the SBHT. Twenty six (26) of the children were shown to have normal hearing by the TOAE screen. One 11 month old infant could not be tested with the TOAE because of excessive movement. Since this child was shown to have normal hearing by the SBHT, this would indicate a slight advantage of the screen over the most commonly used infant screen.

Paper by Shawn S. Goodman, "An Effective Protocol for the Sleeping Baby Hearing Screen"

Sleeping Baby Home Hearing Screen Score Sheet

Last revised July 1, 2019