American Speech-Language-Hearing Association

Virginia 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

All infants shall be given a hearing screening test, regardless of whether or not the infant is at risk of hearing impairment.

Intervention

Prior to discharge, written information must be given to the parent of each infant that includes purposes and benefits of newborn hearing screening, risk indicators of hearing loss, procedures used for hearing screening, results of the hearing screening, the recommendations for further testing, where further testing can be obtained, and contact information for the Virginia EHDI program.

Notify the infant's primary medical health care provider, within two weeks of discharge after birth, the status of the hearing screening including if the infant was not tested, that includes procedures used for hearing screening, the limitations of screening procedures identified risk indicators associated with hearing loss, the results of the hearing screening, and the recommendations for further testing in writing or through an electronically secure method that meets all applicable state and federal privacy laws; the Department of Health must provide follow-up for all infants reported. Follow-up includes, but is not limited to:

  1. Communicating with the parent for those infants who failed the hearing screening, those who were not screened, and those who are at risk for progressive hearing loss in order to advise of the need for audiological services as well as to provide information on locating an approved center that provides diagnostic audiological services or a licensed audiologist;
  2. Communicating with audiologists, hospitals, birthing centers, primary care providers and others as needed to ascertain follow up status and receive results of both the audiological evaluations and the intervention referrals; and
  3. Communicating with the parent for any child found to have a hearing loss in order to provide information about hearing loss and appropriate resources, including family-to-family support and referral to the Part C program; and
  4. Communicating to the Part C program regarding any child found to have hearing loss in order to facilitate early intervention services.

Persons who provide audiological services and who determine that a child has failed to pass a hearing screening, was not successfully tested, or has a hearing loss shall:

  1. Provide the screening or evaluation results, either in writing or in an electronically secure manner, to the parent and to the child's primary medical care provider;
  2. Send a Virginia Department of Health report including screening methodology, test results, diagnosis, and recommendations to the Department, in a manner devised by the Department, which may be electronic, within two weeks of the visit;
  3. Advise the parent about and offer referral to local early intervention or education programs, including the Part C program; and
  4. Give resource information to the parent of any child who is found to have a hearing loss, including but not limited to the degrees and effects of hearing loss, communication options, amplification options, the importance of medical follow up, and agencies and organizations, including the Part C program, that provide services to children with hearing loss and their families.

Standards/Protocols

Standards and protocols are not addressed by laws/regulations.

Tracking/Reporting

Within two weeks of discharge, provide the Virginia Department of Health with information on each infant who does not pass the hearing screening including:

  1. Demographic information on infants including name, date of birth, race, ethnicity, and gender;
  2. Primary contact information including address, telephone, and relationship type;
  3. Primary provider name, address and telephone;
  4. Risk indicators identified as defined in 12VAC5-80-75;
  5. Special circumstances regarding infants as needed by the department to provide follow-up;
  6. Screening methodology used, date screened, and both right and left ear results;
  7. Screening status for pass with risk indicator, fail, unable to test, refusal, and inconclusive results;
  8. Status of infants not screened prior to discharge that includes, but may not be limited to, infants who were transferred to other facilities and parents who refused screening;
  9. Hearing rescreening information including date, type of screening methodology used, results in both left and right ears, and further recommendations within two weeks after the hospital rescreening date; and
  10. Confirmatory data on the status of all infants born in the hospital facility. The department shall receive confirmation that infants not reported as passed with risk, failed, transferred, refused testing, not tested prior to discharge, expired, or other final disposition have had a negative assessment for risk indicators and that physiological hearing screening was conducted with passing results in both ears within 30 days after birth;

Report to the Virginia Department of Health, on a yearly basis, the test procedures used by the newborn hearing screening program, the name of the program director, the name of the advising audiologist, equipment calibration records, screening protocols, and referral procedures.

School-Age Screening

Ages/Populations Screened

Guidelines indicate:

All children within 60 administrative working days of initial enrollment in a public school, shall be screened in the following areas to determine if formal assessment is indicated:

  1. Speech, voice, and language; and
  2. Vision and hearing.

Additional screening for vision and hearing should occur in grades 3, 7, and 10.

Who Can Screen

Guidelines indicate:

Speech-language pathologists and audiologists are qualified to conduct hearing screening programs. Certification programs for hearing screening are available for other personnel. Non-certified personnel responsible for the screening program should receive instruction in the proper techniques to be used.

Training for Screeners

Guidelines indicate:

Training should be conducted by a currently licensed audiologist. Personnel conducting the screening should give an explanation of the test procedure to the class as a group, and individually as needed, prior to the testing to assure that students understand the purpose and process. Individual screening is required as group screening is not valid.

Type of Testing

Guidelines indicate:

Pure tone audiometers

Tympanometry screening is recommended for all students kindergarten through third grade and all preschool-aged students in the early childhood special education programs or 4-year old programs.

Equipment Standards

Guidelines indicate:

Pure tone audiometers must meet the standards for screening audiometers established by the American National Standards Institute (ANSI). It should have the air conduction frequencies of 500, 1000, 2000, and 4000 Hertz. Proper handling of these machines is required, with at least yearly calibration, in order to ensure accurate readings.

The tympanometry equipment should comply with ANSI standards and provide information on tympanogram peak (Peak Y amplitude), width (Peak Y gradient), and volume of the external auditory canal (physical volume).

Follow-up Protocols & Documentation

Guidelines indicate:

Parents of all students who do not perform satisfactorily on a hearing screening and subsequent re-test (within two weeks) are notified by school health personnel. A repeat failure of the screening indicates that there is sufficient deviation from the norm in the results of the screening test to justify parental notification. Parents should be advised to have the child evaluated by an audiologist or by their health care provider.

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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