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State-by-State Trends in School-Age Hearing Screening

S chool-age hearing screenings (SAHS) are a secondary access point to audiologic care following universal newborn hearing screenings (UNHS). However, many U.S. states either do not require or regulate SAHS. While many countries have implemented UNHS, Watkins and Baldwin1 showed that in the United Kingdom, 3.65 of every 1,000 children have a permanent hearing impairment of any degree. The U.K. UNHS identified only 0.9/1,000 of these hearing impairments; about 51 percent of hearing impairment in these children was identified after the time frame of the UNHS. In a separate study, Weichbold, et al.,2 found that about 25 percent of the children in their study cohort developed hearing loss after the UNHS time frame. While these results give concern for the sensitivity and effectiveness of some UNHS methodologies, U.S. states have no standardized process for follow-up provided by SAHS. Similarly, though professional organizations governing audiology provide guidelines, they sometimes do not provide all of the information needed. For example, the American Academy of Audiology recommends a “pure tone sweep at 1,000, 2,000, and 4,000 Hz at 20 dB HL” for children in “grades 1, 3, 5, and either 7 or 9 at a minimum.”3 While the Speech-LanguageHearing Association (ASHA) Guidelines for Audiology Service Provision in and for Schools4 do not provide specific guidelines, their Guidelines for Audiologic Screening5 provide the same pure tone screening of 1,000, 2,000, and 4,000 Hz at 20 dB HL. In this study, we evaluated the state-by-state trends and requirements for SAHS. METHODS AND RESULTS