What are school hearing screenings?

Screening programs are developed and used to identify individuals who are likely to have a specific condition.

• In this case, we are talking about hearing screenings!

• School-age hearing screenings are an integral tool in identifying children with hearing loss who were not identified at birth, lost to follow-up, or who developed hearing loss later.

• A hearing screening is a simple “pass” or “fail” test. 

• Its purpose is to determine if a child has normal hearing or not. 

• It consists of a series of beeps or tones, played through headphones, at the limit of normal range to see if the child is able to hear them.

• The child responds by raising their hand if the tone was heard across different pitches, and for each ear.

Purpose of a school hearing screening:

• A hearing screening can detect potential hearing loss

• The screening places a child into either a “normal hearing” group or “possible hearing loss group”

• This would lead to a recommendation for further testing to rule out presence of hearing loss

• School hearing screenings can pick up hearing losses that are missed at birth

• Newborn hearing screenings that are done at the hospital do not reliably rule out potential mild hearing losses

When should we screen?

• School districts have timelines set in place for when students will be screened: 

• Children who are entering school (Kindergarten, 1st grade in some places)

• Children in K-3 (annual evaluations at these ages)

• Children in 7th grade

• Children in 11th grade

• Children who have failed a grade

• Children with speech/language delay

• Children entering a special education program

Who Else Should We Screen?

However, there are other times outside of routine school hearing screenings when a child should have their hearing screening: 

• Concerns about hearing, speech language or learning

• Family history of delayed or late onset hearing loss

• Signs of syndromes that include hearing loss

• Craniofacial/ear abnormalities

• Persistent ear infections for more than 3 months

• Head trauma and loss of consciousness

• Ototoxic drug exposure (harmful to hearing)

•  Noise exposure

What is Considered a “Pass”?

• Each tone is presented to the child 3 times at 20 dB HL, which is the cutoff loudness level to be considered within the range of normal hearing. 

• If a child hears it at least 2 out of 3 times, he/she passes at that frequency, or pitch. 

• If the child passes at all frequencies, then the child passes the screening.

What is Considered a “Fail”?

• If a child does not respond to one or more of the tested frequencies at a level greater than 20  dB HL, it is considered a “failed” hearing screening

• The child “fails” the screening even if only one ear did not hear the tones at this level

If the Child Fails the Screening, What Happens Next?

• The child should be re-screened, either:

• On the spot

• On another date (should be within 24-48 hours after the first screening)

• Another type of screening tool may be used to compare to results from the first screening

• The child may be referred to an Ear, Nose & Throat doctor (ENT) or an Audiologist for a full hearing test

• Parents should be notified about results from the screening either by mail or over the phone

Consequences of Missed Hearing Loss:

• Impaired hearing is a primary health condition, just as impairment of any sense organ.

• Sensory deprivation results in restricted or non- development of the central auditory nervous system.

• Communicative: Compromised speech-language development.

• Social/Emotional: Family will use ineffective communication behaviors, experience frustration, and misinterpret the child’s behaviors and might experience guilt and anxiety when the hearing loss is diagnosed.

• Cognitive/Academic: Negative effects on vocational and economic potential and contributions to society.