Ohio Hearing Screening Requirements for Newborns and School-Aged Children
The following information summarizes hearing screening programs for newborns and school-aged children.
This information has been collected by researching individual state statutes, regulations and policy documents, and by contacting each state. 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.
Each hospital and each freestanding birthing center shall conduct a hearing screening on each newborn or infant born in the hospital or center unless the newborn or infant is transferred to another hospital.
Each hospital and freestanding birthing center must communicate the results of the hearing screening to the parents before discharge.
They must also have a process for providing the parent with information on where to obtain an audiologic evaluation if the newborn or infant does not pass the second hearing screening, the importance of making and keeping an appointment for a hearing evaluation, and when practical, assisting the parents in scheduling follow-up appointments before discharge; and a process for providing each parent with the printed information prepared by the director of health and obtain a signature indicating such receipt before discharge.
Each hospital and freestanding birthing center shall provide parents with a written list of providers and healthcare facilities that conduct hearing evaluations, located within a sixty-mile radius of the newborn's or infant's home address, if the address is in Ohio. This list may include the referring hospital itself, if diagnostic audiologic services are provided. If the infant's or newborn's home address is outside of Ohio, the hospital and freestanding birthing center shall report the screening results and patient-identifying information to the director.
The equipment used for screening must be capable of giving reliable results, maintained in good working order and calibrated per manufacturer's guidelines. Screening methods include, but are not limited to, automated auditory brainstem evoked response screening and otoacoustic emission screening.
If the hospital and freestanding birthing center conducts a second screening on a newborn or infant, the second screening must also be a physiological test and must be completed prior to discharge. If the first screening was an otoacoustic emission screening, the second screening method shall be an auditory brainstem response (ABR) measurement, if available.
Each hospital and each freestanding birthing center shall promptly notify the newborn's or infant's attending physician of the screening results and notify the Department of Health of the screening results for each newborn or infant screened.
Each board of health shall report to the director the number of newborns and infants not born in a hospital or freestanding birthing center whose parents, guardians or custodians received infant hearing screening information.
Each hospital or freestanding birthing center shall report to the director in a manner and format prescribed by the director, information which will allow the Department of Health to determine the following:
- The name and date of birth of each newborn or infant screened; the name, address and primary and secondary contact telephone numbers of the parent, guardian, or custodian of each newborn or infant screened; the hearing screening results for each newborn or infant screened; and for newborns or infants who did not pass the hearing screening, the name, address and telephone number of the primary care provider or facility treating the newborn or infant after discharge from the hospital;
- The number of newborns born in the hospital or freestanding birthing center and the number of newborns and infants not screened because they were transferred to another hospital;
- The number of newborns and infants whose parent, guardian, or custodian refused the hearing screening;
- The number of newborns and infants referred to the hospital or freestanding birthing center for a hearing screening and the number of those newborns and infants who received a hearing screening; and
- The number of newborns and infants who did not pass the hearing screenings conducted by the hospital or freestanding birthing center.
- 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.
- 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.
- 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
Hearing screenings for school children may be conducted by:
- Audiology aides only under the supervision of an speech language pathologists
- Speech language pathology aides only under the supervision of a speech language pathologist
- Nurses may delegate hearing screening to trained unlicensed personnel in accordance with the Standards of Delegation
Training for Screeners
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
Pure-tone Air Conduction Audiometry
- 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.
- 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.
- 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.
- 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).
- 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.
All equipment shall be calibrated annually to the appropriate current standards by ANSI.
Follow-up Protocols & Documentation
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.
The information contained herein was collected and summarized annually. For detailed information on hearing screening requirements, visit these websites:
Newborn Screening Statute: Ohio Rev. Code Ann. §3701-505
Newborn Screening Regulations: Ohio Admin. Code§3701-40
School-Age Screening Statute: Ohio Rev. Code Ann. §3313.673
Hearing Screening Guidelines and Requirements [PDF]
Questions regarding this document? Call ASHA at 800-498-2071 and ask for the State Advocacy Team.