American Speech-Language-Hearing Association

Connecticut Hearing Screening Requirements for Newborns and School-Aged Children

The following information summarizes hearing screening programs for newborns and school-aged children.

The information has been collected by researching individual state statutes, regulations, policy documents, and by contacting each state. The information is reviewed on an annual basis. Please be advised that regulations and policy may change at any time, so always check with your state for the most up-to-date information.

Newborn Screening

Screening

Each institution that provides childbirth service shall include a universal newborn hearing screening program as part of its standard of care and shall establish a mechanism for compliance review.

Intervention

The guidelines state that if an infant does not pass the first hearing screen at birth, the screening will be repeated prior to discharge using the ABR method. If an infant does not pass the second hearing screen performed at the hospital, the family will be referred to an audiologist that specializes in working with infants, for diagnostic testing.

Standards/Protocols

Testing shall be by a physiologic technologies testing mechanism which employs automated or diagnostic auditory brainstem response (ABR) or otoacustic emissions (OAE), or subsequently developed or improved physiologic technologies that substantially enhance newborn hearing assessment that are recognized by the American Academy of Audiology or American Speech-Language-Hearing Association.

Tracking/Reporting

A mechanism for monitoring the institution's compliance with the newborn hearing screening program shall include, but not necessarily be limited to, the following information:

  1. name of each newborn infant;
  2. date of birth;
  3. date infant received hearing screening or documentation of parent refusal for newborn hearing screening;
  4. method of screening;
  5. results of screening;
  6. person performing screening; and
  7. to whom referral for further evaluation was made, if applicable.

School-Age Screening

Ages/Populations Screened

Hearing screening is required by at three grade levels as part of required health assessments (school physicals):

  1. Prior to entry into school,
  2. At 6th or 7th grade, and
  3. At 10th or 11th grade. This may be done by the child's health care provider or through the school's mass screening programs.

Audiometric screening is required to occur annually in kindergarten through 3rd grade, during 5th grade, and during 8th grade.

Who Can Screen

School nurses, registered nurses, speech pathologists, audiologists, trained aides to school nurses, licensed practical nurses, and trained volunteers may perform audiometric screening.

Training for Screeners

All persons who conduct audiometric screening shall have completed six hours of training in this area including practice supervised by a properly trained school nurse, speech pathologist or audiologist. Children under age six or handicapped students shall be screened by persons with specific training and experience in screening children in these categories.

Type of Testing

Pure tone stimuli should be presented to each ear at the following frequencies and intensities, only if ambient noise levels are appropriate. 
    Frequency     Intensity
    1000 Hz        20 dB HL 
    2000 Hz        20 dB HL 
    4000 Hz        25 dB HL

Tympanometric screening is not mandated. Since middle ear disease is not common after age 7, it is not cost effective to conduct mass tympanometric screening of children after this age. However, as noted in the introduction to these guidelines, tymanometric screening is recommended for certain at-risk populations. In addition, it should be considered when a child fails the audiometric screening twice.

Equipment Standards

Audiometers used in the screening program to meet the current American National Standards Institute (ANSI) specifications for audiometers. The most recent standard is ANSI S3.6-1996. The statute further requires that the audiometers be assessed at least annually for adequate calibration and that a statement showing the date and results of the last calibration be kept with each audiometer. In addition to the mandated calibration, each audiometer should also be subject to visual, listening and biologic checks prior to each screening session.

Equipment used for tympanometry should be capable of assessing physical volume of the external auditory canal, middle ear pressure, static compliance or admittance, gradient or analysis of tympanogram width. Examiners doing the screening should be familiar with their equipment's standard for normal or abnormal static admittance or compliance.

Follow-up Protocols & Documentation

The superintendent of schools shall give written notice to the parent or guardian of each pupil found to have any impairment or defect of hearing, with a brief statement describing such impairment or defect.

Resources

For further information on hearing screening requirements, visit these websites:

Questions regarding state advocacy issues? Call ASHA at 800-498-2071 and ask for the State Advocacy Team.

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