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  • Writer's pictureStacy Crouse

Using The Ling 6 Sounds With Children With Hearing Loss

The Ling 6 Sound Test is a quick check of a child’s cochlear implant and/or hearing aid functioning. This simple listening routine should be completed each morning when the child puts on their hearing device(s). The tool is named after and based on the work of Daniel Ling, an audiologist and pioneer in the field of auditory-verbal therapy.

Why is the Ling 6 sound check important?

The Ling 6 test is used to inform adults (parents, teachers, therapists, etc.) of how a child's hearing devices are functioning at any given time. This is important since consistent access to speech is crucial for developing auditory and speech skills.

Just as a listening check is a low-tech way to confirm that a child is detecting speech information, it also helps identify when they are not. If a child suddenly cannot detect one or more of the Ling sounds, the adult is alerted that something could be wrong with the device. The audiologist can be notified to complete further evaluation and modifications to the device to restore the child's auditory access as soon as possible.

What are the Ling 6 sounds?

The 6 Ling sounds are:

  1. "ah" (as in talk)

  2. "oo" (as in hoop)

  3. "ee” (as in keep)

  4. “m” (as in me)

  5. ”s” (as in soup)

  6. “sh” (as in shop)

These six sounds are included because they span the range of frequencies of spoken language (250-8000 Hertz), which is highlighted in the curved shape on the audiogram below. It's important for children who are utilizing hearing devices to acquire spoken language to be able to consistently detect the spectrum of speech sounds.

Audiogram showing the speech banana and the Ling 6 sounds plotted

How is the Ling 6 sound test completed?

When completing the Ling 6 sound test, a parent/guardian, teacher, audiologist, or therapist produces one of the sounds and waits for the child to indicate that they heard it. The remaining five sounds are completed in the same manner.

Doing the Ling 6 sound check with younger children

The Ling 6 sound test looks very different at various stages of listening. For kids with brand-new devices, parents and professionals may focus on providing many opportunities to hear the Ling sounds (among others) as they guide them to learn how to respond to the Ling sounds.

With very young children, the sounds can be presented in a varied and interesting way. This is done by using more intonation (or a sing-song voice) while engaging in familiar routines and play activities. Parents and professionals often pair natural representations (toys or other objects) with the Ling sounds to teach the associations and make them more tangible.

Ling 6 sounds and associated toy objects including a monkey, airplane, cupcake, bed, train, and snake

For example, you might play with toy foods and pretend to take a bite of a cupcake before saying a prolonged "mmm" sound. Similarly, you may put a baby doll to sleep while saying, “shh.” During these activities, the child is working on detecting the sounds and attaching meaning to them.

Remember that a child may show detection of a sound in many ways. This could include turning their head, widening their eyes, looking around, stopping what they're doing (such as playing or sucking on a pacifier), raising their eyebrows, or blinking their eyes.

You can also model sound detection by showing excitement and pointing to your ear. You can also teach conditioned play responses such as dropping a toy in a bucket when the sound is detected. This new skill may be practiced in both structured and unstructured activities multiple times throughout the day.

Doing the Ling 6 sound check with older children

For older and more experienced listeners, the Ling 6 check takes just a few moments each morning. It becomes part of a child's everyday routine upon putting on their device(s). Rather than simply detecting the sounds, they are identifying them by repeating each one back.

The Ling 6 test can also be used if you suspect an issue with the cochlear implant or hearing aid's functioning. If a child suddenly isn’t able to detect and/or repeat one or more sounds during a daily check, troubleshooting and/or follow-up with an audiologist should be prioritized.

Here are a few important reminders for completing the Ling 6 sound check.

  • Ensure that the child cannot read the lips of the adult during the listening check.

  • Maintain the acoustic properties of the sound by using a conversational volume and tone of voice. Do not over-exaggerate the sound.

  • Present the sounds in a random order each time.

What are some activities for the Ling 6 sounds?

The Ling 6 sound check does not have to be dull and boring! There are lots of ways to make it a fun listening activity.

Toys and other objects

As mentioned above, lots of everyday items can be used for sound-object associations when practicing detection, discrimination, and identification of the Ling 6 sounds. This might include toy vehicles, food, and animals. Creating your own "Ling 6 sound kit" is an easy, versatile way to be consistent with practice.

You can hide the objects, pull them out of a bag, create songs about them, read books about the items, or simply play with them. Make up your own silly and fun listening games to provide multiple opportunities for the child to hear (and even say) the sounds.

Picture cards

Printable picture cards can also be used to represent the Ling sounds. You can hide something (such as a magnetic chip) under a card. When the child detects the sound, they can remove the chip with a magnet wand. You can continue using the cards to work on discrimination of the Ling sounds by providing choices and increasing the field size as a child's skills develop.

Ling Six Sound Test Printable Cards for AVT and Speech Therapy

Digital task cards work great for practicing the Ling 6 sounds on the go! This FREE Boom Card deck has audio recordings and movable images to engage the child in detecting the Ling sounds. It's perfect for teletherapy and assigning to parents to work on at home!

Ling 6 Sounds Free Detection Activity for Speech Therapy and AVT


Something as simple as a coloring page is another no-prep way to provide input or identification of the Ling sounds. This one is available for free for email subscribers and makes a great activity to give to parents to use at home.

Free Ling 6 sound coloring page

The Ling 6 sound test is a free, readily available method to quickly check the functioning of hearing devices. Establishing this important routine from an early age will help promote consistent auditory access each day.

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