Indiana 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.
All newborns and infants born in the state of Indiana shall be screened for hearing impairment.
Prior to the hearing screening of a newborn or infant, the screening facility shall provide information explaining the importance of newborn hearing screening and follow-up in writing to the newborn or infant's parents.
Educational materials, including a hearing screening certificate, shall be provided to the newborn or infant's parent by the screening facility.
If a newborn or infant does not pass his or her newborn screening and rescreening, the birthing center or hospital shall contact an approved diagnostic audiology Level 1 facility to schedule an appointment for an outpatient diagnostic hearing test. The birthing center or hospital shall provide the location, date, and time of the appointment to the infant or newborn's parent, health care provider, and the state department's (the department) early hearing detection and intervention (EHDI) program.
If a newborn or infant passes the newborn hearing screening, but has risk indicators for late-onset or progressive hearing loss, the hospital shall do the following:
- Inform the newborn or infant's parent in writing of the risk indicator.
- Provide written documentation of language and hearing milestones.
- Recommend a follow-up test at an approved diagnostic audiology Level 1 facility to be done when the infant is between nine and twelve months of age.
This information shall also be provided in writing to the newborn or infant's health care provider and to the department's EHDI program via the reporting method and format specified by the department's EHDI program.
Each screening facility shall calibrate the screening equipment annually or according to the manufacturer's guidelines. Each screening facility shall provide a copy of the manufacturer's guidelines to the department upon request.
The responsible physician, midwife, birthing center, or hospital shall conduct a hearing screening of the newborn or infant's ears via the recommended method or methods as accepted by the department. Hearing screening shall mean a test to detect hearing thresholds of 30 decibels (dB) or greater in the speech frequency range of each ear.
For newborns or infants who do not pass the initial newborn hearing screening, hearing should be rescreened one additional time in both ears (regardless of previous screening results) prior to and as close to discharge as possible (for a total of two hearing screenings). Preterm infants or newborns (born prior to 35 weeks gestational age) who do not pass the initial newborn hearing screening should be rescreened one additional time in both ears (regardless of previous screening results) prior to and as close as possible to discharge (for a total of two hearing screenings).
Hearing screening results shall be provided in writing to the newborn or infant's parent prior to discharge. Each screening facility shall report newborn hearing screening results to the newborn or infant's health care provider and to the department.
Hearing screening results for every newborn, infant, or child that receives a screen shall be provided to the department's EHDI program in the format, media, and time specified by the department's EHDI program.
The birthing center or hospital shall report all screening exceptions within five business days, including the following:
- Newborns or infants who are not screened due to equipment or hospital error.
- Newborns or infants who do not pass the initial newborn hearing screening and one additional rescreen prior to discharge (for a total of two hearing screenings).
- Newborns or infants at risk for late-onset hearing loss.
If a newborn or infant is not successfully screened or did not receive a newborn hearing screening prior to discharge, the birthing center or hospital shall report these results as follows:
- To the newborn or infant's parent orally and in writing.
- To the newborn or infant's health care provider and the department's EHDI program.
Each birthing center or hospital shall complete and submit to the department's EHDI program a monthly summary report (MSR) by the fifteenth day of the following month. MSR data shall be submitted in the format and media specified by the department's EHDI program.
Diagnostic audiology Level 1 facilities shall report results of diagnostic audiological evaluations as follows:
- Results shall be reported for each ear separately.
- Assessment results shall be reported to the department's EHDI program, regardless of audiological findings.
- Results shall include a statement of the severity and type of hearing loss identified.
- Results shall be reported within five business days following the assessment.
Each screening facility shall make available the following items to the department's EHDI program in the reporting method and format specified by the department:
- The name of the current person at the screening facility designated as the point of contact.
- The type of hearing screening equipment utilized.
- Equipment calibration records.
- Whether the hearing screening program at that screening facility is conducted by screening facility personnel or is contracted to an outside entity.
- Hearing screening protocols.
- Test procedure or procedures used by the screening facility's universal newborn hearing screening program.
- Pass criteria that minimally meet guidelines established by the department's EHDI program.
- A description of the screening facility quality assurance/quality improvement program.
Indiana State Department of Health, Early Hearing Detection and Intervention Program
- Students in grades 1, 4, 7, and 10.
- A student who has transferred into the school corporation.
- A student who is suspected of having hearing defects.
Who Can Screen
A governing body may appoint the technicians and assistants necessary to perform the testing.
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 are not addressed by laws/regulations.
Follow-up Protocols and Documentation
Records of all tests shall be made and continuously maintained by the school corporation to provide information that may assist in diagnosing and treating any student's auditory abnormality. However, diagnosis and treatment shall be performed only on recommendation of an Indiana physician who has examined the student.
Whenever the test required discloses that the hearing of a student is impaired and the student cannot be taught advantageously in regular classes, the governing body of the school corporation shall provide appropriate remedial measures and correctional devices. The governing body shall advise the student's parent of the proper medical care, attention, and treatment needed. The governing body shall provide approved mechanical auditory devices and prescribe courses in lip reading by qualified, competent, and approved instructors. The state superintendent and the director of the rehabilitation services bureau of the division of disability, aging, and rehabilitative services shall:
- cooperate with school corporations to provide assistance; and
- provide advice and information to assist school corporations in compliance
Indiana Department of Education, School Health Services
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.