Music 2 My Ears

by Bright Eyes Enterprise, Inc.

How to use Music 2 My Ears

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For Infant Screening

Birth to 5 Months

Screening Technique
In an available quiet room
  • Let the baby lie on an examining table or in someone’s lap with whom s/he feels comfortable.
  • Fixate his/her attention on the stringed diversion ball
With the free arm
  • Hold the Bulb Horn 18-36 inches from the baby’s ear (be sure to point the horn end away from the baby’s ear)
  • As soon as the baby is quiet and watching the diversion ball, squeeze the bulb firmly once
Responses (In the early months, the only dependable is a reflexive response to loud sound)
  • A startle, jump-like response reflex immediately following the sound
  • An eye-blink, sudden constriction of the eyelids immediately following the sound
  • An arousal from sleep within two seconds of the sound, which is an eye movement accompanied by a movement of any limb
Note: the baby may cry at the initial startle.
If any of the above responses are observed, it is considered a pass.

Interpretation
One ear sufficiently passing is a pass on this screening. The intensity of the sound may not allow for differentiation between ears. Pass indicates no severe hearing loss. It does NOT ensure there is not a a mild to moderate hearing loss under 50 to 60 dB. Mark your observation on the Score Card.

One Person Screening Technique

6 Months and Above

With the baby seated on the lap with whom he/she is familiar or sitting in a highchair:
  1. Kneel or stand at a 45 degree angle from his/her front vision
  2. Engage the child’s attention with the stringed Diversion Ball about 18 inches in front of her/his eyes with your left hand.
  3. Lean over as far as you can towards the ball, as you prepare to present the first sound-maker on the right ear with your right hand. (The child may try to look back and forth from the ball to you so stay as close to the ball as possible.)
  4. Make a mental note whether the child can track the movement of the ball successfully. Present the sound makers in the following order
  5. Administer the sounds as described in the sound maker section below
  6. See interpretation and expected results below

(See tutorial videos below for more in depth instruction)

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Two Person Screening Technique

6 Months and Above

With the baby seated on the lap with whom he/she is familiar or sitting in a highchair, have person 1 sit in front of the child (at the child’s level), and person 2 stand or kneel behind the child with the sound-makers handy.

Person 1
  1. Keep the child’s eyes focused in front by holding the stringed Diversion Ball
  2. Move the diversion ball slowly around in a 160 degree arc or transfer it quietly from one hand to the other
  3. Observe the child closely to see that the child is able to track the ball visually from side to side
  4. If s/he does not, make a note of it on the Score Card comments section after the screening has concluded

Person 2
  1. Present sound-makers at a 45 degree angle from the child’s ear (according to the procedure above under One-Person Technique or on the Score Card)
  2. Make sure the child cannot see the instrument with her/his peripheral vision
  3. Make your observation as stated in the One-Person Technique and record it on the Score Card
  4. Administer the sounds as described in the sound maker section below
  5. See interpretation and expected results below
(See tutorial videos below for more in depth instruction)


Interpretation

One or Two Person Screening Techniques

  • Visual tracking of the stringed Diversion Ball should be seen if the child is to be passed for visual-motor integrity
  • A head turn toward the sound should be seen for every sound-maker on each side in order for the child to be passed for normal hearing. A “did not respond” check on the Score Card is a possible hearing failure or should be rechecked after an ample amount of time.
  • A head turn in the direction opposite to the sound is also a possible hearing failure (indicates possible monaural loss).
Expected Responses
  • At birth auditory responses are largely reflexive. In a very quiet environment, one may see an eye-blink or eye-widening response to the softer sound-makers, but these responses are not standardized. The only reliable response is a startle or eye-blink to the louder Bulb Horn.
  • At 3-4 months the infant may begin to turn her/his head toward a sound, but this response aslo is not yet reliable.
  • By 4 months the infant will begin to turn his/her head toward the sound source in a wobbly way. (4-7 months – localization to side only)
  • By 7 months there will be a direct turn toward the side. It will not be a direct localization of the sound at the lower level, however; it will only be a turn toward the side.
  • Between 7 and 9 months the infant will begin to find the sound source on the lower level, locating it directly by 8 to 9 months. The infant will not yet look directly at a sound on a higher plane (above eye level). (Localizes to side and indirectly below)
  • By the end of 13 months the infant will be able to localize sounds directly in any plane. Full maturation of the child’s auditory development has been attained. (13-16 months – localizes to side, below and indirectly above)
  • At 16 -21 months, the child localizes directly all signals to side, below and above
  • At 21-24 months, the child locates directly a sound at any angle.
  • The same responses will be seen in the 13-36 months period – localizing on all planes. Other factors begin to enter into the testing in this period and must be considered. For example, a 2-3 year old may hear the sound but will inhibit orienting response if s/he suspects the examiner is making the sound. Skill and experience must prevail with this age group

(The above expected responses are reprinted with permission from “Hearing in Children”, by J. Northern and M. Downs)


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Accurate Presentation of
Sound Makers

Diversion Ball

The Diversion Ball is not a sound-maker, but an important part of the hearing screening system
  • Used to divert the child’s attention so that s/he is unaware of the screener’s intention to present sounds for evaluation
  • Used to observe the child’s ability to track the ball visually from side to side
  • If the child becomes aware of the instruments, obviously the screening results can be compromised and should be attempted again later




Squeeze Ball

High Frequency Whistle or Wind-like Sound
Measures 35-39 dB
High Frequency Pattern of 1750-2400 Hz
  1. Make sure the room is quiet and the child’s attention is toward the stringed Diversion Ball.
  2. Hold the Squeeze Ball on the lower level out from the child’s right ear approximately 18-36 inches but hidden from view
  3. Point the squeaker hole upward placing the first and middle finger on each side of the squeaker hole, then place the thumb on the bottom of the ball and squeeze gently twice
  4. It will give off a slight whistle sound. (The harder the squeeze, the louder the sound will be)
  5. If there is no response, wait a moment and try again
  6. Make your observation
  7. Record your observation on the Score Card
  8. Move on to the next sound-maker


Chick-Ita

Low Frequency Rustling Sand-like Sound
Measures 40-42 dB
High Frequency Pattern of 200-1000 Hz
  1. Hold the Chick-ita on the upper level 18-36 inches out from the child’s right ear
  2. Shake the instrument back and forth two times gently
  3. Wait and observe the child’s response
  4. Make your observation
  5. Record your observation on the Score Card
  6. Move on to the next sound-maker





Cricket

Low Frequency Faint Clacking-like Sound
Measures 36-39 dB
High Frequency Pattern of 200-1000 Hz
  1. Hold the Cricket on the lower level 18-36 inches out from the child’s left ear
  2. Gently shake a couple of times and stop
  3. Make your observation
  4. Record your observation on the Score Card
  5. Move on to the next sound-maker






Bell

High Frequency Ringing Sound
Measures 37-40 dB
High Frequency Pattern of 5400-5800 Hz
  1. Hold the Cricket on the upper level 18-36 inches out from the child’s left ear
  2. Ring it once by shaking it back and forth two or three times using a rapid succession of “ding-a-ling-a-ling” then stop
  3. Make your observation
  4. Record your observation on the Score Card
  5. THIS SHOULD COMPLETE THE SCREENING PROCESS unless the Bulb Horn is necessary for special needs children





Bulb Horn

The Bulb Horn is used specifically for startling newborns or infants, but can be used on children with special needs as discussed on the “beyond two years” page

  1. Hold the Bulb Horn 18-36 inches out from either ear
  2. Give the bulb a swift squeeze
  3. Make your observation
  4. Record your observation on the Score Card
  5. If there is doubt, repeat this screening on the opposite side after waiting a few minutes first

You should observe a jump-like movement; an eye-blink immediately following the sound; or in older children, an immediate attempt to locate the sound source. The Bulb Horn can also be used as a double-check system screening if other results are in question.

Tutorial Videos

These amateur tutorial videos were recorded in 2011. The purpose of the videos is to show the viewer how an 18 month old toddler should locate directly on the sound when a sound-maker is presented when their response is considered normal. show how simple it is to screen a child using either a one-person technique or a two-person technique. They, however,
  • Use an earlier version of the Music 2 My Ears Hearing Screening System
  • Only simulate a screening environment.
  • Are edited from a multiple day shooting process and the subject (my granddaughter) had become familiar with the process, in addition to the fact that there were multiple people and cameras competing for her attention. Actual subjects during a real screening process may not be as friendly or playful

You can also download these videos to view off-line here.

Music 2 My Ears Hearing Screening Manual discusses the basic screening techniques necessary for accurate results.

Did you know the Music 2 My Ears Hearing Screening System can be used for children on the Autism spectrum and children older than 2?
The Autism, Special Needs, and Older Children page discusses slight deviations in these basic strategies for screening these children.


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