Hesperian Health Guides

How to check your child’s hearing

A small child sits on her mother's lap.

Try to notice the sounds your child responds to in everyday settings. This is a good, general way to learn about your child's hearing. Next, you can check to see what kinds of sounds your child may or may not hear. You can first check to see what sounds she hears that different objects make, and then what 'speech' sounds she hears when people talk.

To do this, you need:

  • a quiet place without other sounds or noise.
  • some simple equipment.
  • 2 people to help you.

First try to check the hearing of a child who is the same age as your child and whose hearing is normal. Practice until you see how a young child responds to hearing a sound.

Check for loudness and pitch of sounds

A helper holds a toy in front of a woman and small child; a tester stands behind the woman.
One helper sits in front of a parent and child. He will get the child's attention by showing her a small toy.

The other person stays 1 meter (3 feet) behind the parent, out of sight of the child. This person is the tester. He will make the sounds to each side of the child, for the child to hear. If the child turns to look at the tester, the tester should not interact with the child by smiling or looking at her.

What you will need to check hearing

In this test you will use simple sound makers made from 3 identical empty tin cans.

1. Put a piece of
wood in the
first tin can
(low-pitch sound)
2. Put a handful of large
uncooked dry beans in
the second tin can
(middle-pitch sound)
3. Put a handful of
uncooked rice in
the third tin can
(high-pitch sound)
HCWD Ch5 Page 52-2.png HCWD Ch5 Page 52-3.png HCWD Ch5 Page 52-4.png

Shake the can gently for a quiet sound. Shake it harder for a medium sound. Shake it very hard for a
loud sound. The tester should practice shaking each of the cans until he can control the loudness.

Testing the child

Helper: Calmly get the child's attention with the toy. When the child is paying attention to the toy, gently cover the toy with your other hand.

A helper faces the mother and child and covers the toy; the tester stands behind the mother and shakes a metal can.

Tester: Use the can to make the low-pitch sound. Cover the top of the tin can and shake it for about 3 to 4 seconds behind one of the child's ears. First make a quiet sound.

Helper and parent: Notice if the child responds to the sound.

Helper: If the child responds, nod your head slightly to show the tester that the child responded.

HCWD Ch5 Page 54-1.png

Tester: If the child responds to the quiet sound, mark
the chart with 1 circle and stop testing that ear with the low-pitch sound.

If the child does not respond to the quiet sound, shake the can a little harder to make a medium sound, also for about 3 to 4 seconds. Wait to see if the child responds.

If the child does respond, mark the chart with 2 circles and stop testing that ear with that sound. If the child does not respond to the medium sound, shake the can hard to make a loud sound for 3 to 4 seconds. If the child responds to the loud sound, put 3 circles in the correct box on the chart.

There will be no circle if the child did not hear the sound.

Repeat the test behind the child's other ear.

Be sure to check both ears with all three sounds —

  • the low-pitch sound (the can with wood)
  • the middle-pitch sound (the can with beans)
  • the high-pitch sound (the can with rice)

When you have finished

Look at the pattern of hearing. It may be very different for each child.

A chart with 3 sections for each ear (low pitch, middle pitch, high pitch)and different-sized marks in each section.
This child hears low pitch sounds better than high pitch ones.
The high pitch sounds have to
be louder for her to hear them.
She also hears better on her
right side than on her left.
A chart with 3 sections for each ear (low pitch, middle pitch, high pitch)and a mark in only 1 section.
This child is almost completely deaf.
He can hear no sounds in his
left ear. He can hear a little
in his right ear, but only low
pitch sounds that are loud.

HCWD Ch5 Page 54-4.png
= soft sound
HCWD Ch5 Page 54-5.png
= medium sound
HCWD Ch5 Page 54-6.png
= loud sound