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.
  5. communicating with parents, physicians or health care providers, the department, and Early Childhood Intervention Services with appropriate procedures for reporting screening and follow-up results and providing information to parents regarding follow-up services;
  6. procedures for distribution by birthing facilities of standardized educational materials developed and provided by the department, as well as additional materials it may select to parents, health care providers, and physicians;
  7. performance of program services (relating to Program Performance Standards and Goals); and
  8. approved protocols for program operation.


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.

Agency Oversight

Texas Department of State Health Services, Newborn Hearing Screening Program

School-Age Screening

Ages/Populations Screened

All children enrolled in a facility shall be screened for hearing problems within 120 days of enrollment in pre-kindergarten and kindergarten. Children in first, third, fifth, and seventh grades must be screened during those grade years.

Who Can Screen

Screening for vision and hearing shall be performed by:

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

Training for Screeners

The department offers certification courses and issues certificates to those who successfully complete them. To be eligible to take the department's certification course, an individual must be a high school graduate and sign a written statement to that effect at the beginning of the course. Individuals who successfully complete the course, including passing the associated tests, will be issued a certificate by the department.

Type of Testing

Pure-tone audiometric screening. Screening results shall be recorded for each ear at less than or equal to 25 dB for 1000 Hz, 2000 Hz, and 4000 Hz.

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.

Only calibration firms shall perform periodic electronic calibrations and exhaustive electronic calibrations. Calibration firms shall provide notification to the owner of the audiometer being calibrated that the audiometer has been calibrated. The notification may be in the form of a decal or sticker affixed to the audiometer, or in hard copy documentation that must be maintained by the owner and be made readily available to the department or its representative upon request.

Each individual using audiometric screening or testing equipment, as well as the equipment, must be registered with the department.

Follow-up Protocols & Documentation

A rescreen with another sweep-check is recommended if test results indicate failure to respond to any of the three frequencies in either ear, and it should be conducted no sooner than three weeks but not more than four weeks after the initial screening.

An extended recheck may be conducted or a referral to a professional examination shall be made for all children whose test results indicate failure to respond to any of the three frequencies in either ear on the second sweep-check.

If the extended recheck results in a failure to respond to any frequency in either ear at greater than 25dB, the screener must recommend that a professional examination be immediately conducted.

Each facility shall maintain hearing screening records onsite for at least two years.

On or before June 30 of each year, each facility shall submit to the department a complete and accurate annual report on the vision and hearing screening status of its aggregate population screened during the reporting year. Facilities are required to report on the following categories: the total number screened: the number who failed; the number referred for professional examination; the number transferred out of the facility prior to the facility receiving the professional examination results; professional examination results indicating none of the disorders present which are screened for under this section; professional examination results indicating a disorder(s) which is screened for under this section; and referral for a professional examination with no indication that a professional examination was ever done.

Agency Oversight

Department of State Health Services, Vision and Hearing Screening  


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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