Hearing Screenings

Question 1

portable audiometers: transducers

Answer 1

• supra-aural headphones
• insert headphones
• bone conduction vibrators/oscillators
• speakers

Question 2

before you begin…

Answer 2

complete a listening check on the audiometer

Question 3

listening check

Answer 3

• ensure transducers are working
• everything is plugged in and set appropriately
• done prior to seeing patient

Question 4

why should you complete a listening check?

Answer 4

avoid misdiagnosis

Question 5

how do you complete a listening check?

Answer 5

turn the intensity dial to 25 dB and listen to each headphone/speaker

Question 6

conditioning

Answer 6

• young children may need to be conditioned to testing
• practice a couple of times without the headphone
• supra-aural threshold

Question 7

preparing for screening

Answer 7

• find location of screening
• ensure child is faced away from you

Question 8

find location of screening

Answer 8

• move desks/chairs into proper position close to an outlet
• complete a listening check
• be sure to bring a pen/pencil
• do not bring food or drink with you
• turn off phone

Question 9

ensure child is faced away from you

Answer 9

• give instructions prior to placing the headphones
• have the child remove glasses, hats, and large earrings (only if pinching)
• tuck hair behind the ears (do not place headphones over hair)
• place headphones on child from the front and secure the headband for proper fit

Question 10

hearing screenings in the schools

Answer 10

• Pennsylvania requires 25 dB with threshold search if no response at 25 dB
• if you are screening in a school, always follow the state’s requirements

Question 11

recording results, Pennsylvania schools

Answer 11

• when doing a hearing screening for PA schools, you will not be using an audiogram
• you will be given a form by the school district from which you are providing screenings
• the form will have boxes for results (250-500-1000-2000-4000 [8000]) for each ear
• if the child responds at 25 dB, then you will mark a + sign in the box with the corresponding frequency
• if the child does not respond at 25 dB, present again
• if they still do not respond, begin a threshold search and record the threshold

Question 12

recording results: mark “refer” when…

Answer 12

• child has a threshold of 30 dB at 2 or more frequencies
• child has a threshold of 35 dB at 1 frequency

Question 13

PA hearing screenings: pupils in…

Answer 13

• kindergarten
• special un-graded classes
• grades 1, 2, 3, 7, and 11

Question 14

screening practitioners

Answer 14

school nurse and properly trained medical technicians (SLPs)

Question 15

clinical process

Answer 15

• pure tone audiometer approved by the Department of Health
• 250, 500, 1000, 2000, and 4000 Hz
• 25 dB pass, threshold search if no response at 25 dB

Question 16

follow up

Answer 16

• refer by personal contact with parent, followed by written notification
• completion of report from physician or hearing specialist following assessment

Question 17

purpose of hearing screening

Answer 17

to detect those individuals who demonstrate a greater probability for having a disease or condition so they may be referred for further evaluation

Question 18

ASHA guidelines for preschool children: goal

Answer 18

to identify the preschool children most likely to have a peripheral hearing impairment that may interfere with communication, development, health, or future academic performance

Question 19

peripheral hearing impairment

Answer 19

impairment occurring in the ear and not in the brain

Question 20

ASHA guidelines for preschool children: who can administer?

Answer 20

• audiologists CCC-A and state licensure
• speech-language pathologists with CCC-SLP and state licensure
• support personnel under supervision of certified audiologist

Question 21

preschool children are screened…

Answer 21

• as needed, requested, or mandated, or when they have conditions that place them at risk for hearing impairment
• parent/care provider concerns
• family history
• disorders, trauma, etc.

Question 22

preschool: clinical process ASHA

Answer 22

• obtained informed parental/legal guardian permission
• condition child to motor response (hand raise, tapping, etc.)
• administer 2 conditioning trials
• headphones
• pass/refer
• acceptable modifications
• follow up

Question 23

ASHA guidelines for school-age children: goal

Answer 23

identification of school children at risk for hearing impairment that may affect adversely education, health, development, or communication

Question 24

ASHA guidelines for school-age children: who can administer?

Answer 24

• audiologists CCC-A and state licensure
• speech-language pathologists with CCC-SLP and state licensure
• support personnel under supervision of certified audiologist

Question 25

clinical indications ASHA: school-aged children are screened...

Answer 25

- on initial entry to school - annually in kindergarten through 3rd grade - annually in 7th and 11th grades - as needed, requested, or mandated

Question 26

otoacoustic emissions screening

Answer 26

- place probe in ear canal - deliver screening - room should be quiet and free of ambient noise - patient should be still and quiet - screening equipment will state "pass" or "refer" - if they did not pass, refer for an audiological work up

Question 27

tympanometry screening

Answer 27

- place probe into ear canal - client needs to be still, but room does not have to be quiet - screeners have a box on the screen - if the tymp falls within the box, it is within normal limits

Question 28

additional considerations

Answer 28

use terminology "did not pass" or "refer" instead of "fail"

Question 29

can I send the results home?

Answer 29

- if you work in a school, you may be required to send it through the school nurse - it may be the screening form or a summary letter