Healthy Hearing Program - Special Olympics

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WELCOME
What is hearing screening?
Hearing screening can be accomplished much faster than threshold hearing testing, often
in ordinary rooms that are reasonably quiet as opposed to the extreme quiet required
for threshold testing. The swiftness of screening allows large numbers of people to
be screened in a relatively short time. It is an efficient way to identify people who may
have hearing losses and therefore require referral for diagnostic audiological evaluations
under clinical conditions, and/or medical examinations for ear health issues. Most public
school systems in the United States, for example, conduct hearing screening programs
early in the school year to quickly identify children who may be experiencing listening
difficulties, and to prevent learning problems by providing follow-up diagnostic testing
and/or medical treatment. This public health model of prevention is the fundamental
concept of Healthy Hearing: screen, identify and refer.
Screening of hearing is accomplished by testing a person’s hearing for pure tones
within a prescribed test frequency range, usually 500 through 4000 Hz (ASHA, 1997).
An intensity level is set above the normal hearing threshold of 0dB, referred to as 0dB
Hearing Level (HL), and each frequency is tested at only that level. Most often 25dB HL
is selected as the screening level. If a person can hear each test tone at this HL, usually
giving the behavioral response of raising a hand, then hearing thresholds are considered
normal and that person should have no difficulty listening to the speech of others.
Evoked otoacoustic emissions (EOAE) technology is another method for screening
hearing. It is an electrophysiological method of assessing the integrity of the inner ear’s
sensory outer hair cells. Its widespread use for newborn screening is recommended
(Joint Committee on Infant Hearing, 2000; NIDCD, 1993; Norton, Gorga, Widen et
al., 2000; White, Vohr and Behrens, 1993) and it can be used with children and adults
as well (Robinette and Glattke, 2002). It measures objectively (i.e., without behavioral
indication) the response of the inner ear to calibrated sounds transmitted to it by a
probe microphone placed in the outer ear canal. The person does not need to raise a
hand to indicate hearing the tone, since the EOAE technology records/reports the
response of the inner ear sensory mechanism. The EOAE technology screening level
and test frequency range are essentially the same as for pure tone screening. Therefore,
the Pass-Refer conclusions for a person passing or not passing are the same.
How does Healthy Hearing screen/test athletes?
Athletes go to a registration desk, four screening stations, and a check-out desk. Athletes
may go to a fifth station for pure tone threshold testing, if they did not pass the pure
tone screening, and if threshold testing is available at the event. The specific procedures
at each station are described later in this manual. Athletes’ results at each station are
recorded on a specific form (described later in this manual). Most athletes require only
the first two screens.
The first screening station examines ear canals for the presence of cerumen (earwax);
the second conducts an EOAE screening of each ear. An athlete who passes the second
station’s screen goes to the Healthy Hearing check-out desk, turns in the Healthy Athlete
Screening Form, receives the Healthy Hearing Screening Summary Results Form (see
appendix), and gets an appreciation gift.