Hearing Screening Online Training Program

Administrative Considerations

Characteristics of a Good Hearing Screening Facility

Avoid area near:

  • Fans or air conditioners
  • Hall traffic (reroute if possible)
  • Playground or street traffic
  • Group activity areas, e.g., break room
  • Bathrooms
  • Lunchrooms
  • Office equipment (copying machine, paper shredder, etc.)
  • Soft drink machines
  • Refrigerators, etc

Avoid excess noise within screening area, such as:

  • Talking
  • Paper shuffling
  • Open windows
  • Ticking clock
  • Movement of desks or other furniture

Room should be uncluttered and free of visual distraction:

  • Avoid mirror or reflecting surfaces
  • Avoid facing child towards a window
  • Avoid child facing others who may give clues to correct response

Cease screening momentarily if any distracting noise occurs.

As screening is usually conducted in a clinic, try using the last room at the end of a hall or one that is away from other rooms.

C&TC Programs Environmental Noise Level Check

Most clinics do not have the equipment to take ambient noise level measurements in the areas to be used for screening. However, an environmental noise level check may be substituted. This is defined as the ability to establish that the room is quiet enough for a ‘normal’ hearing person to hear 10 dB below the screening level at all frequencies. If this level cannot be established, the area must not be used for screening. However, if 500 Hz is the only frequency affected, then it may be deleted from the screening protocol.

The screener should put on the audiometer headphones and:

At 500 Hz: 15 dB should be audible.
At 1000 Hz: 10 dB should be audible.
At 2000 Hz: 10 dB should be audible.
At 4000 Hz: 10 dB should be audible.

The Audiometer

An audiometer is a device that produces tones at set frequencies and known intensities through headphones worn by the patient. The patient is required to indicate what tones s/he can hear. The pure tone audiometer is the preferred instrument used in school and clinic hearing screening programs.

There are several different brands of audiometers; most have the following dials:

Power or On/Off Switch: Needs to be on when testing.

Frequency Dial: This dial rotates from 250 to 8000 Hz and controls the test frequency or the pitch of the tone.

Hearing Level Dial or Decibel (dB) Dial: Controls the test intensity or loudness of the tone. Normally this is a rotary dial that allows you to vary the tones presented in 5 dB steps.

Tone Presentation Bar or Stimulus Switch: Pressing this bar presents the tone to the person being tested.

MAICO MA 25 audiometer.
MAICO MA 25 audiometer reproduced with permission from MAICO.

MAICO MA 27 audiometer.
MAICO MA 27 audiometer reproduced with permission from MAICO.

GSI 17 audiometer.
GSI 17 audiometer reproduced with permission from Grason-Stadler.

The audiometer has test tones ranging from 250 to 8000 Hz (Hz refers to frequency, or cycles per second). This is the pitch of the tones that range from very low to high pitch. The tones most often used in audiometric screenings are 500, 1000, 2000, and 4000 Hz. The intensity (loudness) is expressed in decibels (dB). Thirty (30dB) is considered the level of a soft whisper at a distance of three feet. Sixty-five (65dB) is the average intensity for a normal conversation, and eighty-five (85 db) is so loud that individuals must be protected when working under such exposure for a prolonged period.

Audiometric tests record the softest level at which an individual can hear a tone. The responses are recorded on a graph called an audiogram. The headphones that come with an audiometer have been calibrated to that specific audiometer and should not be exchanged with other audiometers.

General Care

Handle the audiometer gently and avoid dropping it or rough treatment. When transporting the audiometer place it on the car seat and secure it so that it cannot fall during a sudden stop.

Avoid extreme temperatures (below freezing and above 90° F). Keep all cords free of tangles and twists. Check all electrical connections, dials, and switches for signs of problems. The earphone jacks should be occasionally removed from their plugs and wiped with an alcohol pad to improve the connection. Care must be taken to prevent moisture from getting inside the audiometer proper.

The case should be kept closed to prevent dust build-up. If the case or exposed surfaces should become dirty, soap and water is usually sufficient to clean them.


Clean routinely with cleaning agent like alcohol-free wipes. (DO NOT USE ALCOHOL BECAUSE IT MAY DRY OUT THE RUBBER CUSHIONS ON EARPHONES.) When the earphone cushions need cleaning, remove them from the headset, and clean and dry thoroughly before replacing. KEEP ALL MOISTURE AWAY FROM DIAPHRAGM (HOLE IN CENTER OF EARPHONES). Do not interchange the headphones with other audiometers.

Ensuring Proper Functioning

Mechanical and biological function checks must be done regularly on each audiometer before being used (copies of instructions and documentation forms are enclosed with each audiometer). See the following examples:

Mechanical Function Check and Mechanical Function Check Sheet

Biologic Calibration Check and Check Sheet


The clinic audiometer should receive regular maintenance checks by a professional audiometer vendor according to the manufacturer’s recommendations. Calibration includes internal cleaning and lubrication along with acoustic checks on the audiometer. The vendor will also assess the machine for any needed repairs.

The audiometer is in need of repair if:

  • Tone does not sound normal, sound is not produced when the tone lever/button is pressed, or static is heard.
  • Earphones do not remain in proper position over ears.
  • A dial or switch does not function or indicator lights do not glow.

Contact list for audiometer service, repair, and sales.

This concludes this section of the training, you may continue on to the next section, Additional Information and Resources, or return back to the Table of Contents.

If you are not planning on completing the entire web training, please fill out the evaluation form, C&TC Children's Hearing Screening Web-Based Training Evaluation.

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