West Virginia
COUNCIL
o f Sc ho o l Nurse s
RECOMMENDATION
For
Pure Tone Hearing Screening
According to West Virginia Code §18-5-17, pure tone hearing screening is a compulsory
pre-enrollment screening for all children entering public school for the first time in this
state. An audiologist, speech pathologist or support personnel under the supervision of an
audiologist should perform this hearing screening. The length and type of supervision is
to be determined by the supervising audiologist. The Regional Education Services
Agencies (RESA) has coordinated service delivery through audiologists who have
developed “Hearing Screening Guidelines” in accordance with guidelines recommended
by the American Speech and Hearing Association (1997).
Audiometers used for screening must meet ANSI (American National Standards Institute
1996) S3.6-1996 requirements for either limited range audiometers or wide range
audiometers and must be calibrated annually (1). Any other method of testing such as
noisemakers, whispering, hand-held devices, speech stimuli, or group screening is not
recommended as appropriate procedures.
A normal pure tone hearing screening is when a child can hear at the intensity of 20dB
HL at the frequencies of 1000Hz, 2000Hz and 4000Hz, and at 25dBHL at 500Hz. A
child who does not pass at the appropriate dB should be retested a second time after
they have been re-instructed and the headset has been readjusted. (2). Referral to an
audiologist should be made if the child does not hear a 20dB tone at 1000Hz, 2000Hz,
and 4000Hz and a 25dB tone at 500Hz.
Documentation of hearing results can be either pass or refer (1). Students who do not
pass the screening and recheck must be referred to an audiologist for follow-up
evaluation. A letter communicating the results of the screening and recommendations
should be given to the parent or guardian and the student’s physician as soon as possible.
A method should be developed for tracking referrals and for encouraging follow-up as
needed. The West Virginia Education Information System (WVEIS) provides a method
for recording and tracking hearing results.
Devised: December 27, 2006
Revised: January 22, 2009
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It is the recommendation of the West Virginia Council of School Nurses that counties
shall employ either an audiologist, speech pathologist or support personnel under the
supervision of an audiologist to perform hearing screenings. An audiologist must train all
persons/school personnel who perform hearing screenings. Approximately 98% of West
Virginia children have medical insurance and should be receiving a comprehensive
physical exam (i.e. Health Check) annually with a hearing screening. The health
provider’s hearing screening results shall be valid up to one year and meet the
requirements of hearing screening, as indicated in W.Va. Code §18-5-17 and West
Virginia State Board of Education Policy.
Devised: December 27, 2006
Revised: January 22, 2009
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References
1. American National Standards Institute. (1996). Specifications for Audiometers
(ANSIS.6-1996). New York: Acoustical Society of America.
2. American Speech-Language-Hearing Association. (1997). Guidelines for
Audiologic Screening. Retrieved on May 2008 from
http://resa7.k12.wv.us/.
3. Hendershot, L.B., Chair. WV Speech, Language, and Hearing Association
Hearing Screening Task Force. (1999). Hearing Screening Guidelines.
Fairmont, WV. Retrieved on May 2008 from http://resa7.k12.wv.us/.
DISCLAIMER:
The “Recommendation” of the West Virginia Council of School Nurses (WVCOSN) is not representative of West
Virginia State Code or West Virginia State Board of Education recommendation or policy. This is a
recommendation based on consensus, evidence-based practice reviews and current research from the WVCOSN.
The WVCOSN is set forth by W.Va. Code §18-5-22.
The certified school nurse is responsible for utilizing nursing judgment and skill to determine the safest delivery of
health care on an individual case-by-case situation in the West Virginia public school setting while protecting the
welfare and health of the student. Every situation is unique and requires a collaborative team approach lead by the
certified school nurse, which includes, but not limited to, the student, parents/guardians, school administrator,
experts in the field and the student’s primary health care provider, at the local level.
Devised: December 27, 2006
Revised: January 22, 2009
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