School Hearing Screenings Are a Critical Health Check for Children

October 18, 2024

(Rockville, MD) Undetected hearing loss in school-age children can lead to academic challenges, behavioral problems, and social difficulties. Yet, many children in the United States do not have their hearing screened regularly. The American Speech-Language-Hearing Association (ASHA), in conjunction with the Educational Audiology Association (EAA), is spotlighting the importance of school hearing screenings for Educational Audiology Awareness Week, October 21-25, 2024.

Hearing Loss in School-Age Children

Almost all babies born in the United States undergo a newborn hearing screening at birth. However, even if a child passes this screening, they can develop hearing loss later. The causes vary-from ear infections and viruses to genetics to noise exposure. Roughly 15% of school-age children experience some degree of hearing loss in one or both ears, according to the U.S. Centers for Disease Control and Prevention.

"School hearing screenings are an essential tool for detecting hearing loss in children and adolescents," said Tena McNamara, AuD, CCC-A/SLP, 2024 ASHA President. "Mild hearing loss in particular isn't always obvious, but even a small degree of hearing difficulty can significantly affect a student's academic success. Generally, children don't have their hearing tested annually at well-child visits. This makes it important for everyone, from families to school personnel to regulators and legislators, to understand the need for school hearing screenings and to prioritize them."

According to EAA, unidentified hearing loss can cause an increased rate of grade failure and a greater need for educational assistance. This is in large part because over half of classroom instruction requires listening. Behaviors such as low attention, lack of motivation, inattentiveness, listening fatigue, and reduced participation may stem from unidentified or poorly addressed hearing loss.

The requirements for hearing screenings in schools vary significantly by state. Some have no requirements at all. Those states that do have such requirements can differ in the frequency of screenings, the school grades in which children are screened, the testing procedures used, the personnel who conduct the screenings, and in other ways.

Families of children who are having unexplained difficulties in school, or who notice signs of hearing loss, shouldn't wait for a periodic school hearing screening. Instead, they should ask their doctor to refer them to an audiologist for a comprehensive evaluation. The same should be done for a child who doesn't pass their school hearing screening or for a child that does pass their screening but still shows signs of hearing difficulties. Screenings are based on "pass" or "fail" criteria, which do not always identify all types of hearing loss.

Role of Educational Audiologists

Hearing screenings may be conducted by educational audiologists-but, depending on the state, such screenings also may be completed by other school personnel or trained volunteers such as parents.

Regardless of who does the screening, audiologists who work in schools provide essential services that allow the general school population-as well as students with hearing loss-to maximize their success.

These essential services include the following:

• Managing hearing technology-such as (but not limited to) hearing aids. Educational audiologists help ensure that a student's hearing technology is functioning properly and can perform maintenance and troubleshooting if needed.
• Participating in the development of individualized education plans and 504 plans. These plans detail accommodations or specialized services that address a student's communication, education, and access needs. Educational audiologists also help develop a transition plan for postsecondary education, training, or employment.
• Recommend and incorporate hearing assistive technology. Classrooms can be fitted with certain technologies, such as a classroom audio distribution system (CADS) or a sound-field frequency modulation (FM) system, where a teacher speaks into a microphone. These technologies benefit all students in the classroom. Children with hearing difficulties may require the use of personal remote microphone technology coupled to their amplification system (e.g., a hearing aid and/or cochlear implant). An educational audiologist can recommend, fit, and manage these technologies.
• Teaching and supporting a child in self-advocacy. These skills enable a child to advocate for their own needs with peers, school personnel, and other communication partners.
• Advising school personnel on effective teaching strategies. Certain strategies-such as seating a child near the front of the room, not turning your back while speaking, giving both verbal and written instructions on assignments, and using visual aids-are easy ways to help improve success for students who are hard of hearing.
• Working with teachers to make classrooms quieter. It can be difficult for all students to learn in noisy classrooms, but that can be especially so for those with hearing loss. Educational audiologists can recommend steps such as placing rugs or carpets over bare floors, turning off noisy classroom equipment when you're not using it, rearranging furniture, and placing latex-free caps on chair legs.

For more information, visit the EAA or ASHA website.

About the American Speech-Language-Hearing Association (ASHA)
ASHA is the national professional, scientific, and credentialing association for 234,000 members and affiliates who are audiologists; speech-language pathologists; speech, language, and hearing scientists; audiology and speech-language pathology assistants; and students. Audiologists specialize in preventing and assessing hearing and balance disorders as well as providing audiologic treatment, including hearing aids. Speech-language pathologists (SLPs) identify, assess, and treat speech, language, and swallowing disorders.