American Speech-Language-Hearing Association

Ohio 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 and freestanding birthing center required to conduct a hearing screening on a newborn or infant shall, before discharge, conduct a hearing screening on each ear of every newborn or infant born in, admitted to or transferred into a hospital or freestanding birthing center through the use of a physiologic test. The hospital and freestanding birthing center shall conduct a second screening on newborn or infant, if the first screening in either ear was a non-pass.

Intervention

Each hospital and each freestanding birthing center shall communicate written results of the newborn or infant's hearing screening to the parent, guardian, or custodian prior to discharge to include:

  1. Results of the hearing screening for each ear; and
  2. Type of hearing screening; and
  3. Risk factors for hearing loss, if any.

Each hospital and each freestanding birthing center shall provide the parent, guardian or custodian of a newborn or infant that did not pass the hearing screening or did not receive a hearing screening with the following prior to discharge:

  1. A referral to audiologist for hearing evaluation; and
  2. Assistance in scheduling an appointment for hearing evaluation before discharge; and
  3. Information on the importance of making and keeping an appointment for a hearing evaluation; and
  4. A list of audiology facilities where newborn hearing screenings and evaluations are conducted within a 60 mile radius of the family's home.

Each hospital and each freestanding birthing center shall provide the parent, guardian, or custodian of every newborn with printed information provided by the department prior to discharge including obtaining the signature of the parent, guardian, or custodian indicating receipt of the information.

Standards/Protocols

The equipment used for screening shall be capable of giving reliable results, maintained in good working order, and calibrated annually per manufacturer's guidelines.

Tracking/Reporting

Each hospital and each freestanding birthing center shall communicate the results of the hearing screening for every newborn or infant to the attending physician, certified nurse-midwife, certified nurse practitioner, primary care physician, or designated medical home to include:

  1. Results of the hearing screening for each ear;
  2. Type of hearing screening; and
  3. Risk factors for hearing loss, if any.

Each hospital and each freestanding birthing center shall report the following categories of infants to the attending physician, certified nurse midwife, certified nurse practitioner, primary care physician, or designated medical home within 48 hours of discharge for:

  1. Infants who did not pass a hearing screening; and
  2. Infants who were discharged from the facility without a hearing screening.

School-Age Screening

Ages/Populations Screened

Guidelines indicate:

  1. Preschoolers attending a school-based program shall be screened each year they are enrolled in preschool. Children who cannot be screened using approved and/or optional methods shall be referred to the primary care provider or audiologist.
  2. School-aged children shall be screened at five grade levels: kindergarten, first, third, fifth and ninth grades. Students may be tested in additional grade levels. In addition, the following school children shall be screened because they have not been screened in accordance with Ohio Department of Health guidelines:
    a. Students new to a school (and not tested within the past 12 months).
    b. Students referred by a teacher or other school personnel.
    c. Students who were referred within the past year with no documented follow-up, regardless of grade.
    d. Students absent during the previous hearing screening.
    e. Students at risk for noise exposure (e.g., band, vocational education, industrial education, automotive mechanics).
    f. Students who request a hearing screening.
    g. Students whose parents request a hearing screening.
  3. Students in special education classes will be screened at the ages that correspond to the grade levels required for all students (preschool, kindergarten, first, third, fifth and ninth grade). These children should remain in the screening program due to a higher risk of undetected hearing loss and may be candidates for optional OAE testing and tympanometry screening. If the student cannot be screened, they should be referred for a complete medical/audiological evaluation.

Who Can Screen

Guidelines indicate:

Hearing screenings for school children may be conducted by:

  1. Physicians
  2. Audiologists
  3. Audiology aides only under the supervision of an speech language pathologists
  4. Speech language pathology aides only under the supervision of a speech language pathologist
  5. Nurses
  6. Nurses may delegate hearing screening to trained unlicensed personnel in accordance with the Standards of Delegation

Training for Screeners

Guidelines indicate:

It is required that all personnel providing hearing screening have adequate instruction. Ohio Department of Health's audiologists provide hearing training for screeners. Any training obtained outside of the Ohio Department of Health must be in compliance with the requirements.

Type of Testing

Guidelines indicate:

Pure-tone Air Conduction Audiometry

Screening Criteria
  • Each child shall be screened at 1000 Hz, 2000 Hz and 4000 Hz, at 20 dB HL in the right and left ear. No other frequencies or intensities are to be used.
  • If the child responds at 20 dB HL to all three frequencies in both ears, the child passes the hearing screening.
Rescreen Criteria
  • Any child failing the first screening (who does not respond at 20 dB HL to one or more of the three frequencies in either ear) should be rescreened immediately following reinstruction and repositioning of the headphones.
  • Any child who fails both initial screenings shall be rescreened again in four to six weeks.
Referral Criteria
  • Any child who fails both the initial and second screenings shall be referred for a complete medical/audiological evaluation.
  • Any child failing the first school screening and who failed the previous year's school screening with no documented follow-up care shall be immediately referred.

Equipment Standards

Guidelines indicate:

Pure-tone Equipment
  • Pure-tone equipment shall have a variable intensity attenuator ranging from 0 dB to 80 dB.
  • Pure-tone equipment shall have a binaural headset. Hand-held pure-tone equipment, automatic pure-tone equipment and standardized speech (picture) testing equipment are not approved for use in school hearing screenings.
  • Pure tone equipment shall meet the appropriate current standards by the American National Standards Institute (ANSI).
Tympanometry Equipment
  • Tympanometric testing shall be performed utilizing a 226 Hz tone and a constant pump speed of 200 daPa/sec.
  • Tympanometric equipment shall meet the appropriate current standards by ANSI.
Other

All equipment shall be calibrated annually to the appropriate current standards by ANSI.

Follow-up Protocols & Documentation

Guidelines indicate:

The Board of Education and the Board of Health shall keep an accurate record of such tests and of measures taken to correct such hearing and visual defects. This record shall be kept on a form to be prescribed and furnished or approved by the director of health. Statistical data from such records shall be made available to official state and local health, education, and human services departments and agencies. Individual records shall be made available to such departments and agencies only in cases where there is evidence that no measures have been taken to correct defects determined by such tests, provided that such records shall be made available to school authorities where they are deemed essential in establishing special education facilities for children with hearing and visual defects.

Any information regarding any diseased condition or defect found as a result of any school medical examination shall be communicated only to the parent or guardian of such child and if in writing shall be in a sealed envelope addressed to such parent or guardian.

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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