Hearing Screening Training Manual - Minnesota Department of Health

Introduction
BACKGROUND AND OVERVIEW
Hearing screening with a pure tone audiometer conducted by properly trained personnel will lead
to early identification of children with hearing loss. The hearing screening process can identify
children with outer and middle ear problems as well as hearing loss caused by damage to the
inner ear. The screening program described here is intended to identify children in need of
further diagnosis and treatment.
Audience
This manual is intended for use in Child and Teen Checkups clinics, Early Childhood Screening
programs, Head Start agencies and School based programs. Pure tone audiometry is considered
the ‘gold standard’ method for screening children age 3 years and older. For screening younger
children or developmentally disabled children, play audiometry is recommended as a more
appropriate screening method. 1
Purpose
The purpose of this hearing training manual is to provide the screener with instructional
information to conduct pure tone hearing screening in the school or clinic setting. This manual is
not a substitute for training, but should be used as a post-training reference. Detailed description
of each procedure will be presented at the training workshop.
These guidelines were developed by a professional review committee made up from experts in
their field. The committee had representatives from ENT, audiology, family practice, pediatrics,
school and public health nursing, Minnesota Department of Human Services, Deaf and Hard of
Hearing Services Division and the Department of Education, Minnesota Academy for the Deaf.
Statistics of Hearing Problems
In the United States, approximately 1 of every 1,000 babies is born deaf and 3 to 5 babies are
born hard of hearing. 2 In Minnesota (MN), that may mean 4 babies are born each week with
hearing loss, or about 200 a year.
About 98% of MN newborns receive screening using electrophysiologic methods such as
Otoacoustic Emissions (OAE) and/or Automated Auditory Brainstem Response (AABR). 3
However, some newborn screening may miss hearing loss, which may be detected later due to
other reasons (see Risk Factors in this document).
How is a child affected by hearing loss?
Hearing loss can impact language acquisition, speech, psycho-social well-being and learning.
The critical time to learn and stimulate the auditory and brain pathways is during the first 6
months of age. Children with all degrees of hearing loss, who receive appropriate intervention
prior to 6 months of age, can obtain speech and language skills comparable to their hearing peers
at age 3 years. 4 Therefore, ongoing review of hearing and speech age-appropriate milestones,
risk factors and routine hearing screening is critical.
1