Evaluating Attention vs. Hearing
Over the past few years, I have come up with a few techniques to evaluate whether a child who does not respond to their name may be having hearing issues or whether the lack of response could be due to attention.
When doing an evaluation, rather than asking the parents whether their child responds to their name, I actually have the parent call their name, once while the child is exploring and then again while the child is playing with a preferred toy.
If the response is less than 50% I give the parent a fill in the blank statement: "I know my child can hear because _______."
Usually, when attention is the culprit, a parent will come up with a few instances in their routine where the child immediately responds to the sound. For example, I have heard responses like: favorite TV show comes on; favorite song is sung; a doorbell ringing, a garage door opening…
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If a parent says it is a certain song or theme to a TV show, I can check to see if they respond during the evaluation.
For example, I remember evaluating a little girl that would not respond to her name at all, and she did not respond to a bell nor rattle sound. The parent started getting very anxious during the assessment. Then I gave her the fill in the blank statement and she stated her daughter responded immediately if she heard the Mickey Mouse theme. So I found the Mickey Mouse theme on my phone via my monthly music subscription and turned it on. The little girl immediately stopped what she was doing and walked over to me excitedly.
So this simple method of getting information from the parent about what the motivators are, and seeing what happens, is a great way to evaluate whether the child needs to learn how to respond to their name and to pay better attention to the sounds around them or whether we should be referring to an audiologist.
This little trick not only can clarify attention versus hearing deficits, but also helps in finding out what motivates a child.