American Speech-Language-Hearing Association

Delaware 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 hospital shall establish a Universal Newborn Hearing Screening (UNHS) program. Each UNHS program shall provide a hearing screening test for every newborn born in the hospital, for identification of hearing loss, regardless of whether or not the newborn has known risk factors suggesting hearing loss.

Intervention

Each program shall inform the newborn's or infant's parents and primary care physician, if one is designated, of the results of the hearing screening test, or if the newborn or infant was not successfully tested. Whenever possible, such notification shall occur prior to discharge; if this is not possible, notification shall occur no later than 10 days following the date of testing. Notification shall include information regarding appropriate follow-up for a screening failure or a missed screening, and referral information for confirmatory testing. If a hearing screening test indicates the possibility of a significant hearing loss, the hospital shall ensure that the physician or other person attending the newborn or infant is made aware of the community resources available for confirmatory testing and process of referral to early intervention services.

Audiologists shall report all results of newborn, infant, and child hearing screenings and/or testing to the state Early Hearing Detection and Intervention (EHDI) program at the Division of Public Health. Reporting of results must be the same day as testing if at all possible. If this is not possible, results must be reported no later than 10 days following the testing date. Notification shall include information regarding appropriate follow-up for a screening failure or a missed screening, and referral information for confirmatory testing if not already completed.

Families shall be provided with unbiased information in a family-centered, culturally-competent manner and offered the full range of early intervention services and treatment options available for hearing loss. Opportunities for early intervention shall be consistent with the child's needs, family's goals, and preferences, and be provided in a seamless, unambiguous manner to ensure informed transitions through services.

Appropriate early intervention opportunities may include information regarding amplification options, such as hearing aids or cochlear implants, aural habilitation and communication options (manual language, spoken language, total communication), and family support.

Standards/Protocols

Each program shall also

  1. Develop screening protocols and select screening method or methods designed to detect newborns and infants with a significant hearing loss.
  2. Each program shall provide for appropriate training and monitoring of the performance of individuals responsible for performing hearing screening tests. These individuals shall be trained properly in:
    1. The performance of the tests,
    2. The risks of the tests, including psychological stress for the parent or parents,
    3. Infection control practices, and
    4. The general care and handling of newborns and infants in hospital settings.
    5. Perform the hearing testing prior to the newborn's discharge; provided, however, that if the newborn is expected to remain in the hospital for a prolonged period, testing shall be performed prior to the date on which the child attains the age of three months.
  3. Develop and implement procedures for documenting the results of all hearing screening tests, and scheduling of follow-up appointments to help reduce loss to follow-up.
  4. Collect performance data specified by the Division of Public Health to ensure that each UNHS program is in compliance with this section, including the number of infants born, the proportion of all infants screened, the referral rate, the follow-up rate, the false-positive rate, and the false-negative rate.

Tracking/Reporting

To facilitate the reporting, tracking, and monitoring of newborns, infants, and children who have or are suspected to have hearing loss, a state EHDI surveillance and tracking system shall be enhanced to track, monitor, and refer newborns, infants, and children through diagnostic and early intervention. The system shall be utilized by qualified professionals involved in the detection, treatment, diagnosis, and/or referral of newborns, infants, or children with or suspected of having hearing loss. The reporting requirements shall be designed to be as simple as possible and easily completed by nonprofessional persons when necessary.

School-Age Screening

Ages/Populations Screened

Each public school student in kindergarten and in grades 2, 4, 7 and grades 9 or 10 shall receive a hearing screening by January 15 of each school year.

Screening shall also be provided to new enterers, students referred by a teacher or an administrator, and students considered for special education.

Who Can Screen

A school nurse

Training for Screeners

Training for screeners is not addressed by laws/regulations.

Type of Testing

Type of testing is not addressed by laws/regulations.

Equipment Standards

Equipment standards are not addressed by laws/regulations.

Follow-up Protocols & Documentation

The school nurse shall record the results on the Delaware School Health Record Form and shall notify the parent, guardian or Relative Caregiver or the student if 18 years or older, or an unaccompanied homeless youth if the student has a suspected problem.

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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