Texas 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


A birthing facility shall offer the parents of a newborn a hearing screening for the newborn for the identification of hearing loss.


Birthing facilities shall provide information regarding the results of the birth admission hearing screen to the parents, attending physician or health care provider, and to the Department of Health or the Department's designee. Individually identified information will be reported to the Department of Health upon written consent of the parents. Birthing facilities shall provide information recommended by the Department of Health to the parents regarding available follow-up services for newborns and infants with abnormal screening results.


Program certification criteria shall include the following:

  1. procedures for maintaining and reporting data electronically to the Department of Health, including assurances that confidentiality and general access to data meet state and federal guidelines
  2. obtaining parental consent (relating to confidentiality and general access to data);
  3. assuring that a sufficient number of screening staff, including managers and screeners, successfully complete training provided by the Department of Health or the Department's designee during program implementation. Staff members who complete the Department of Health's training successfully shall be considered qualified hearing screening providers, and may train other staff members at their facilities;
  4. providing hearing screening using equipment that meets Department of Health criteria, including but not limited to the following:
    1. a demonstrated ability to link electronically to the Department of Health's newborn hearing screening information system,
    2. clearance or approval for marketing for hearing screening by the Food & Drug Administration, if applicable, and
    3. capability to identify hearing loss.


Audiologists, qualified hearing screening providers, intervention specialists, educators, and others who receive referrals from programs under this chapter shall either provide the needed services or refer the children to another provider of the needed services, and with consent shall provide the following information to the Department of Health or its designee:

  1. results of follow-up care,
  2. results of audiologic testing of infants identified with hearing loss,
  3. reports on initiation of intervention services, and
  4. results of follow-up and testing on children served under the state's medical assistance program under Human Resources Code, Chapter 32, who are eligible for services and hearing aids through the Department of Health's Program for Amplification for children of Texas.

School-Age Screening

Ages/Populations Screened

All children enrolled in a facility shall be screened for vision and hearing problems in pre-kindergarten, kindergarten, first, third, fifth, and seventh grades before May 31 of each year.

Who Can Screen

Screening for vision and hearing shall be performed by:

  1. a licensed professional, or
  2. an individual trained to conduct vision or hearing screening that is certified by the Department of Health.

Training for Screeners

The basic screening tests and referral criteria shall be approved by the Department of Health and incorporated into the screener training manuals provided by the Department.

Individuals who have completed high school and who have successfully completed the Department of Health's vision or hearing screening course are eligible to be certified as screeners.

Department of Health staff or Department-approved instructors of screening shall issue a certificate to individuals who successfully complete the Department's vision or hearing screening course. Certified screeners may screen children for vision or hearing problems for a period of five years.

Persons other than licensed professionals who conduct hearing screening as authorized by Health and Safety Code, Chapter 36, shall utilize only the sweep-check and extended recheck techniques and shall refer children unable to respond reliably to these screening techniques to an appropriately licensed professional for further evaluation.

Certified screeners may utilize only individuals who have completed high school as volunteer assistants.

Individuals other than Department of Health personnel eligible to become instructors in hearing screening techniques must have experience as a screener, must have experience conducting workshops, and must have successfully completed any Department of Health-required training course.

Individuals other than Department of Health personnel who are certified as instructors may maintain their certification by successfully completing each updated continuing education course provided by the Department upon notification of its availability.

All training sessions for screeners must be approved by the Department of Health at least 15 working days prior to the training sessions.

Type of Testing

Pure-tone audiometric screening

Equipment Standards

All audiometers, audiometric testing devices, and audiometric calibration equipment shall meet the appropriate current American National Standards Institute (ANSI) standards, or the manufacturer's specifications if no ANSI standards apply, and all other applicable federal and state standard(s) and/or regulation(s) for such equipment, or as otherwise approved by the Department of Health.

Audiometers and audiometric testing devices shall be maintained in calibration to meet the required standard(s) by use of the following procedures.

  1. A biological calibration shall be performed at least once each month when the audiometer is in use.
  2. A calibration shall be performed at least annually or if the results of the biological calibration indicate:
    1. hearing level differences greater than 5 dB at any frequency,
    2. the signal is distorted, or
    3. there are attenuator or tone switch transients.
  3. An exhaustive electronic calibration shall be performed at least every five years.

Calibration records and monthly biological calibration data for audiometers or audiometric testing devices shall be maintained for inspection by the Department of Health for three years. Each individual using audiometric screening or testing equipment, as well as the equipment, must be registered with the Department of Health.

Follow-up Protocols & Documentation

A facility may comply with Vision and Hearing Screening Requirements by including a statement in the child's official facility record that the child has undergone screening tests that meet the standards and were administered by persons authorized to sign the required proof of screening. The statement shall include the child's visual acuity, sweep-check results, and any other screening results. The required proof of hearing screening may be signed by a licensed professional whose licensure qualifies him or her to evaluate hearing acuity if he or she performed the hearing examinations or personally supervised the screening tests.


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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