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Tennessee 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


Every newborn infant shall be screened for hearing loss in order to prevent the consequences of unidentified hearing loss.


Intervention is not addressed by laws/regulations.


Guidelines indicate:

Currently there are two technologies available for physiologic screening of hearing in newborns: Auditory brainstem response (ABR) and otoacoustic emissions (OAE). Automated physiologic hearing screening equipment does not require interpretation by the screener and is recommended if non-audiologists conduct the screening.

Screeners should be trained by individuals with experience in newborn hearing screening techniques and practice. Training should be competency based and involve hands-on components. Screeners may include audiologists, registered nurses, or other trained technical staff. Staff should meet facility employment requirements.


All screening providers or entities shall report their screening results to the Department of Health.

The Department of Health shall refer any child who does not pass the hearing screening test to the Tennessee Early Intervention System (TEIS) of the Department of Education for follow-up.

Guidelines indicate:

The state newborn hearing screening program will notify TEIS of infants reported that did not pass the hearing screening and have not had follow-up testing completed within 6 weeks of screening.

School-Age Screening

Tennessee laws/regulations do not address school-age hearing screening, but the Department of Education has issued School Health Guidelines.

Ages/Populations Screened

Guidelines indicate:

At a minimum, all students in pre-kindergarten, kindergarten, and grades 2, 4, 6, and 8 shall receive a hearing screening once a year. Screening one year of high school is optional however whatever year of high school that is selected must be then screened year after year. At any point a student can be referred for screening per local school district protocol.

Who Can Screen

Guidelines indicate:

Volunteers may be useful during the initial sweep screening to assist with the flow of students through the screening procedure. Some volunteers may be trained to conduct the initial sweep screen. Holding a volunteer instruction session is helpful for all new volunteers, and should be scheduled close to the day of the screening. During the training session, familiarize volunteers with the audiometers, screening forms and procedures. Having volunteers who feel comfortable with the equipment increases accuracy during the screening procedure. All volunteers should be counseled regarding confidentiality issues.

Training for Screeners

Guidelines indicate:

The American Speech and Hearing Association recommends that screeners be trained by an audiologist.

Type of Testing

Guidelines indicate:

Puretone audiometric testing

Equipment Standards

Equipment standards are not addressed by laws/regulations.

Follow-up Protocols & Documentation

Guidelines indicate:

The nurse should notify the child's teacher(s) that the child has been referred for a possible hearing impairment. In addition to being alert to the possibility the child is having hearing difficulty, the school personnel are often in a position to reinforce the need to follow through on the referral. It is important to monitor the child closely; documenting the nurse and teacher concerns for the effect the suspected hearing impairment is having on the child's education. These concerns need to be communicated to the parent/guardian. Trying to establish the reason for failure to have the child examined will often uncover the need for additional resources or information.


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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