How to Help Your Audiologist

by Ross Adams, M.S., CCC-SLP

Supporter of California Hands & Voices

Here’s a fun game to try at home with your toddler and preschooler. It’s an activity that will help your child’s audiologist get the most accurate results possible the next time your child has a hearing test in the audiology booth.

First, you will need to gather up 10-25 a set of objects from around the house, such as 10-25 of one of the following things:

  • Balled-up socks
  • Cotton balls
  • Cut-up pieces of sponge
  • Empty spools (of thread)
  • Erasers
  • Screw-on or pop-off lids from containers you no longer use (nothing with sharp edges!)
  • Child-size spoons
  • Wads of paper
  • Toy figures from the children’s party aisle, like “Dora,” “Spiderman,” or “Sponge Bob”
  • Conventional toys like building blocks, cars, pegs, or stacking rings

You can also make more than one set of 10-25, so the objects can be changed but the game can continue. Once your child has learned the game in a few weeks, you can play the game with one set, then change sets and play the game again. Letting your child pick which set of objects to use will also help keep his/her interest.

Next, you will need a container larger enough to hold one of your sets of objects at a time. You might find it convenient to store all the objects from one set in a zip-lock bag or other see through container, so you child can be excited about which toy is next.

Remember objects need to be:

  • Safe and non-breakable with no sharp edges
  • Small enough for the child to hold independently (but NOT small enough to be a choking hazard!)
  • Interesting to a toddler or preschooler (but not TOO interesting)
  • Something that won’t easily roll away (you’ll thank me later)

Finally, you will need something to make a sound with. If you don’t have anything handy, your voice will work just fine.

Some ideas for sound-making objects are:

  • A large pot, bowl, or heavy box and a sturdy spoon to bang on it
  • A cabinet or hallway door to knock on
  • A party horn to blow or bell to ring
  • A children’s drum or piano
  • Phone/tablet apps, such as “Noises,” “Dinner Bell,” or “Real Whistle”
  • Saying the child’s name, the phrase “put it in,” or sounds like “bah,” “boo,” “bee,” “sss,” sh,” or “mm”

The “sound” your child is listening to really isn’t that important. The “sound” just needs to be something you are fairly sure your child can hear.

Here’s what the child will need to do:

  1. Pick one object (and only one) from the set
  2. Hold it up to his/her cheek in the “listening” position
  3. Wait (that’s the tricky one) and listen for the “sound”
  4. Then drop the object in the container when the “sound” is heard

Seems simple enough, but we all know toddlers and preschoolers are not known for their ability to WAIT. That’s what you’re really practicing: the waiting and responding at the right time.

This game is called the “conditioned play response.” That means the child is being taught (or “conditioned”) to do a specific play activity (drop the object in the container) when the “sound” is heard. This is the same activity your audiologist uses in the audiology booth about the time your child turns two years old until the age of four-to-five years old. The idea is to make the activity fun, so the child will keep trying and respond again and again as the audiologist plays different tones.

In order to learn this game, at first you will have to do all the work:

  1. Hold onto your child’s hand, guide it to one of the objects, and help your child pick it up. With your other hand, pick up a second object.
  2. Hold your child’s hand (with the object) against the his/her cheek and your object against your cheek.
  3. Encourage your child to wait . . . wait . . . wait . . .
  4. Say things like, “I’m waiting” and “I don’t hear it yet.”
  5. Then make the sound and excitedly drop both your object and this child’s hand (with his/her object) into the container. Applaud enthusiastically. You both did it.

In the beginning it’s fine for your child to see you make the sound. Remember, this is not a hearing test, it’s a test-taking skill you are helping your child learn.

Over many, many opportunities to play the game, you will eventually be able to let your child pick up an object independently and place it on his/her own cheek. You may also no longer need to do the action with your child, so you can focus on making the sound in a way your child cannot see (behind the child or behind your own back). If this is hard to accomplish, don’t worry about it. Just keep trying. It’s sometimes easier in the beginning to have to “helpers”: one to walk the child through handling the object and one to make the sounds. Once your child has the idea, it’s fairly easy to play the game with your child on your own.

You want your child to take as many turns as possible in one sitting. At 18 months, a child might take only two or three turns. That’s perfect! At two years, a child might take 5-10 turns, but by three years, your child will be an old pro at this game. Your child may also want to switch roles and have you listen while s/he makes the sound. That can be fun, too, and helps you see that your child really understands the importance of waiting and responding at the right time.

It’s a thinking skill your toddler or preschooler is learning:

  1. First, I take an object and hold it in the listening position on my cheek.
  2. Next, I wait to hear the sound.
  3. Then, when I hear the sound, I drop the object in the container.

One word of advice: Don’t make your child wait too long, especially if s/he is young or new to this game. Waiting too long makes the child lose interest. As the child gets older and learns how to play the game, waiting becomes a challenging and is exciting to many older toddlers and prechoolers.