Hearing Screening E-Learning Course
Child and Teen Checkups (C&TC)
As part of the 1967 Federal "War on Poverty," Congress developed the Early and Periodic Screening, Diagnosis and Treatment (EPSDT) program as a prevention component to the Medicaid program. EPSDT is the largest comprehensive and preventive health care program for Medicaid-eligible children and youth ages 0 to 21 years.
The goal of EPSDT is to remove financial barriers to health care for children and ensure access to comprehensive preventive and treatment services necessary for healthy growth and development. EPSDT is one of the Medicaid services that states are required to provide. Comprehensive and periodic screening or well-child checkups are the basis for early diagnosis and treatment of developmental and medical conditions, which is the program’s goal.
Child and Teen Checkups (C&TC) Program is Minnesota's version of EPSDT and is administered by the Department of Human Services. More than 534,218 children were eligible to receive Child and Teen Checkups in 2014 (DHS, 2015).
C&TC Recommendations and Requirements
The C&TC schedule requires a hearing risk assessment and health history, and for certain ages, hearing screening with a standardized tool, as noted on the Minnesota C&TC Schedule of Age-Related Screening Standards.
Universal Newborn Hearing Screening is required for all newborns by one month through 24 months of age using Auditory Brainstem Response (ABR) or Otoacoustic Emission (OAE) technology. If there are no results for a newborn hearing screening on file, or the child did not pass, refer to audiology for objective screening.
All children must receive risk assessment/ history for hearing concerns, including family history of childhood hearing loss, delay of language acquisition or history of such delay, and a history of recurrent otitis media. Use the hearing screening questionnaire based on risk factors identified by the Joint Committee on Infant Hearing (2007) to identify a child’s risk factors for hearing loss. Refer to audiology when a concern of risk for early or late onset hearing loss is identified.
For children age three and older, in addition to risk assessment and hearing screening, pure tone audiometry is the standard and is recommended at age 3 years and required at 4 years of age. Rescreen or refer children who do not pass pure tone audiometry, as appropriate.
Please note that as of October 1, 2017 high frequency screening was added for ages 11 and older to identify children who may have noise-induced hearing loss (NIHL).
Beginning at 11 years of age, it is required to add the 6000 Hz level to the required hearing screening.
At the 16 and 20 year checkups, perform risk assessment/ history. Perform pure tone audiometry if no objective screening occurred at the previous checkup.
At each checkup, ensure that catch-up screening is provided for any child or youth who did not receive screening at the appropriate age.
For further information on C&TC requirements and recommendations for hearing screening, please refer to the most recent C&TC Hearing Screening FACT Sheet.
Other Screening Programs
Minnesota Infant and Toddler Intervention Services (IDEA-Part C)
Part C of the federal Individuals with Disabilities Education Act (IDEA) requires that the evaluation and assessment of an infant or toddler (birth through two years of age) be based on informed clinical opinion and include an evaluation of the child’s level of functioning in a variety of identified areas, including hearing. For Minnesota specific recommendations, refer to Guidelines for Hearing Screening After the Newborn Period to Kindergarten Age.
Head Start and Early Head Start Requirements
Federal Performance Standards mandate that all children receive a standardized screening within 45 days of admission to the program.
Early Childhood Screening Requirements
Minnesota law 121A.17 requires one pure tone early childhood/preschool screening before kindergarten, preferably at 3 or 4 years of age.
School Age Screening Recommendations
MDH recommends that all children receive a hearing screening annually from kindergarten through second grade and in grades five, eight, and 11. All new, special education, and other students with the following risk factors should receive hearing screening:
- Chronic or recurrent otitis media
- Cleft palate or other craniofacial anomalies
- Family history of hearing loss in childhood
- Exposure to potentially harmful levels of noise
Note: Please answer the following questions to continue with the course.