Hearing Screenings: Procedures and
Guidelines
Purpose and Scope of Hearing Screenings
Objectives of Hearing Screenings
Hearing screenings are designed to identify individuals who may have hearing loss.
They are not diagnostic tests; rather, they serve as preliminary assessments.
The primary goal is to determine who requires a comprehensive evaluation by an
audiologist.
Hearing screenings fall within the scope of practice for Speech-Language Pathologists
(SLPs).
Procedures for screenings vary based on the age of the client, necessitating tailored
approaches.
Importance of Follow-Up
Follow-up assessments are crucial for the effectiveness of screening programs.
A failed screening does not equate to a diagnosis of hearing loss; it indicates the need
for further evaluation.
Emphasis on the importance of follow-through to ensure individuals receive necessary
interventions.
Statistics show that a significant percentage of infants and children do not follow up
after failing screenings.
Communication with parents and guardians is essential to ensure compliance with
follow-up recommendations.
Newborn Hearing Screening
Historical Context and Guidelines
The Joint Committee on Infant Hearing (JCIH) was established in 1969 to address infant
hearing loss.
, JCIH recommended universal newborn hearing screening (UNHS) in 2000, emphasizing
early detection.
The 1-3-6 guideline was introduced in 2007: screening by 1 month, diagnosis by 3
months, and intervention by 6 months.
In 2019, the guideline was updated to 1-2-3, reflecting a shift in focus on timely
evaluations.
Early Hearing Detection and Intervention (EHDI) programs have been implemented in all
states, though not all have legislative backing.
Screening Methods
Newborn screenings require objective measurements to assess hearing capabilities.
The two most common screening tests are Otoacoustic Emissions (OAE) and Automated
Auditory Brainstem Response (AABR).
OAE testing measures cochlear function but may miss retrocochlear hearing loss.
AABR testing involves electrodes measuring neural responses to sound, providing a more
reliable assessment.
Both methods have limitations, particularly in detecting mild hearing loss or low-
frequency issues.
Screening for Preschool and School-Aged Children
Behavioral Screening Procedures
Children aged 3 and older can participate in behavioral screenings using pure tone
testing.
ASHA recommends testing at 20 dB at frequencies of 1000, 2000, and 4000 Hz, with 500
Hz in quiet settings.
The screening procedure involves clear instructions and practice before testing begins.
If a child fails to respond to any frequency, they should be rescreened up to three times.
A pass/fail outcome determines the need for referral to an audiologist for further
evaluation.
Importance of Accurate Screening
The goal of screenings is not to determine thresholds but to identify potential hearing
issues.
Guidelines
Purpose and Scope of Hearing Screenings
Objectives of Hearing Screenings
Hearing screenings are designed to identify individuals who may have hearing loss.
They are not diagnostic tests; rather, they serve as preliminary assessments.
The primary goal is to determine who requires a comprehensive evaluation by an
audiologist.
Hearing screenings fall within the scope of practice for Speech-Language Pathologists
(SLPs).
Procedures for screenings vary based on the age of the client, necessitating tailored
approaches.
Importance of Follow-Up
Follow-up assessments are crucial for the effectiveness of screening programs.
A failed screening does not equate to a diagnosis of hearing loss; it indicates the need
for further evaluation.
Emphasis on the importance of follow-through to ensure individuals receive necessary
interventions.
Statistics show that a significant percentage of infants and children do not follow up
after failing screenings.
Communication with parents and guardians is essential to ensure compliance with
follow-up recommendations.
Newborn Hearing Screening
Historical Context and Guidelines
The Joint Committee on Infant Hearing (JCIH) was established in 1969 to address infant
hearing loss.
, JCIH recommended universal newborn hearing screening (UNHS) in 2000, emphasizing
early detection.
The 1-3-6 guideline was introduced in 2007: screening by 1 month, diagnosis by 3
months, and intervention by 6 months.
In 2019, the guideline was updated to 1-2-3, reflecting a shift in focus on timely
evaluations.
Early Hearing Detection and Intervention (EHDI) programs have been implemented in all
states, though not all have legislative backing.
Screening Methods
Newborn screenings require objective measurements to assess hearing capabilities.
The two most common screening tests are Otoacoustic Emissions (OAE) and Automated
Auditory Brainstem Response (AABR).
OAE testing measures cochlear function but may miss retrocochlear hearing loss.
AABR testing involves electrodes measuring neural responses to sound, providing a more
reliable assessment.
Both methods have limitations, particularly in detecting mild hearing loss or low-
frequency issues.
Screening for Preschool and School-Aged Children
Behavioral Screening Procedures
Children aged 3 and older can participate in behavioral screenings using pure tone
testing.
ASHA recommends testing at 20 dB at frequencies of 1000, 2000, and 4000 Hz, with 500
Hz in quiet settings.
The screening procedure involves clear instructions and practice before testing begins.
If a child fails to respond to any frequency, they should be rescreened up to three times.
A pass/fail outcome determines the need for referral to an audiologist for further
evaluation.
Importance of Accurate Screening
The goal of screenings is not to determine thresholds but to identify potential hearing
issues.
