Hearing Screening Procedures

PURE TONE THRESHOLD SCREENING

Ages/Grades: 3 years through school age (as indicated).

Purpose: To obtain a record of the child's level of hearing prior to initial referral.

Description: Have the child listen to a series of pure tones and record the softest dB level that the child responds to at each frequency. Use only “time locked” not “random” responses

Equipment: Pure tone audiometer.

Facilities: Quiet room, free from visual distractions.

Procedure:

Set Up:

  • Seat the children so they cannot see the front of the audiometer.
  • Remove glasses, hair bands, large earrings, etc.
  • Place hair behind the ears.
  • Instruct the child to raise either hand when a tone is heard.
  • Set selector switch to Right.
  • Set HL dial to 40 dB.
  • Set frequency dial to 1000 Hz.
  • Place the earphones on child's head with the red phone on the right ear and the headband flush to the head.

Threshold Determination:

  • Screen right or better ear.
  • Present the 1000 Hz tone at 40, 20, 0 dB until there is no response.
  • At the level there is no response, increase in 5 dB increments until there is response.
  • Drop 10 dB.
  • Increase in 5 dB increments until there is a response.
  • Repeat until there are 2 responses at the same level.
  • Record threshold level.
  • Repeat the process for 2000, 4000, 8000, recheck 1000 Hz and 500 Hz in the right or better ear.
  • Repeat for the other ear.

WNL: Child's threshold is above the bold line on the audiogram (20dB at 500 Hz, 15dB at 1000, 2000, 4000 Hz).

Referral: Any threshold level on or below the bold line on the audiogram (25dB at 500 Hz, 20dB at 1000, 2000, 4000 Hz).

Exceptions: When a child has a known hearing loss that has been diagnosed as non-treatable, referral to the school audiologist should be made if there is a change of 10dB poorer at any frequency.

NOTE: For children who are difficult to screen, use play audiometry procedures