How to Conduct a Hearing Screening?

A typical screening protocol may consist of screening each ear at a level of 20dBHL at 500, 1000, 2000, and 4000Hz. Results are recorded as “PASS” or “REFER.” The screening must be conducted in a quiet environment.

The following is a sample screening protocol. Please refer to your state or facility guidelines for the specific guidelines of your location.

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Step 1: Preparing the child for a test
  • Put the child at ease
  • Instruct the child on the test procedure:
    “I’m going to place these headphones on your ears. You will hear some beeping sounds. Raise your hand as soon as you hear the beep, even if it is very soft.”
  • Have the child sit at an angle with his/her back to the tester, so that the child cannot see the adjustments made on the audiometer.

Step 2: Place the headphones on the child
  • Place the headphones on the child with the RED phone on the child’s RIGHT ear and the BLUE phone on the child’s LEFT ear. Make sure the headband sits snuggly on the crown of the head and the earphones are centered over both ears.

Step 3: Familiarize the child with the test procedure
  • Select RIGHT ear on the audiometer
  • Select 1000Hz with the FREQUENCY (HZ) dial or buttons
  • Select 50dBHL with the LEVEL (dB) dial or buttons
    (This level is loud enough that a child should hear the tone clearly in a quiet setting.)
  • Press the TONE/PRESENTER button 1 to 2 seconds to play the tone to the child.
  • The child should raise their hand when the tone is played. Play the tone a 2nd time to make sure they understand the task. If not, re-instruct the child and try again. If no response is obtained from the child, change to the LEFT ear to confirm unresponsiveness.

Step 4: Conduct the hearing screening

  • Once the child understands the task, continue on to the screening process:
  • Change the LEVEL to 20dBHL
  • (Remain at 1000Hz and RIGHT ear)
  • Present the tone with the TONE/PRESENTER button
  • Record whether the child responded by raising their hand.
  • Change the FREQUENCY to 2000Hz, and play the tone (at 20dB)
  • Record if the child responds.
  • Change the FREQUENCY to 4000Hz, and play the tone (at 20dB)
  • Record if the child responds
  • Change the FREQUENCY to 500Hz, and play the tone (at 20dB)
  • Record if the child responds.
  • Switch to the LEFT ear.
  • Repeat the process for the Left ear, playing each of the tones (500, 1000, 2000, 4000Hz) at 20dBHL.

When presenting tones to the child, be sure to vary the timing of the tone presentation to prevent the child from routinely raising their hand for an expected tone versus the actual tone presentation.

Step 5: Results

PASS: The screening is considered a PASS if…
  • - The child responds to all frequencies in both ears.
REFER: The child does NOT pass the screening and should be REFERRED for further testing if…
  • The child misses any of the frequencies in either ear, even if it is just one.
  • Cannot complete the screening process.