ARIZONA T3 HOW TO TRAIN
HEARING SCREENERS
RENEWAL CURRICULUM:
REFERRAL/NOTIFICATION AND
REPORTING
T3 Referral, Notification & Reporting
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Referral/Notification and Reporting
Learning Objectives
Understand the results of hearing screening methods.
Know appropriate responses to screening outcomes.
Demonstrate principles of effectively communicating
with parents.
Understand documentation and tracking procedures.
Know how to report screening results to ADHS.
Understand the role of community resources.
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Pure Tone Screening
To pass a pure tone screening, a child must respond
to each of these four frequencies at the screening
level in both ears:
25
20
20
20
dB
dB
dB
dB
HL
HL
HL
HL
500 Hz
1000 Hz
2000 Hz
4000 Hz
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Tympanometry
To pass a three-frequency, pure tone hearing
screening with tympanometry, the child:
Responds to the pure tone screen at 1000
Hz, 2000 Hz and 4000 Hz at 20 dB in each
ear, and
Reaches a point of maximum immittance in
each ear within the range of +100 mm H2O
to -200 mm H2O in each ear.
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Otoacoustic Emissions (OAE)
To pass the otoacoustic emissions screening:
Reproducibility must be greater than 50% in each
ear; and
The response must present no less than 3 dB above
the noise floor at a minimum of three frequencies.
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Documentation Requirements
The Arizona DHS Hearing Screening Rules
contain requirements for:
referring children who do not pass the
second hearing screening test,
notifying parents, and
making reports to the agency.
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Referrals
All referrals are made to the parent/guardian
for follow-up with one or more of the following:
Audiologist
Physician
Primary care practitioner
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Referral Conditions
If a child fails 2nd pure tone and school has an audiologist,
screener may consult with the audiologist.
If one of “Four Reasons NOT to Screen” is present, refer to
primary care practitioner or physician.
If a child fails 2nd pure tone and school has no audiologist and
parents have insurance, refer to parent who will refer to
physician and/or an audiologist for further evaluation.
If a child fails the 2nd pure tone and no school audiologist and no
insurance, parents may need assistance in finding care;
discussed further in Resources section.
If a child passes pure tone and fails tympanometry, refer to
primary care physician/may be middle ear problem.
If a child passes tympanometry and fails pure tone, refer to an
audiologist/may be hearing loss.
If only pure tone or OAE are used without tympanometry, refer
to either an audiologist or health care provider.
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Good Listening Skills
Assure privacy.
Show interest in their concerns.
Be attentive.
Minimize distractions.
Welcome their questions.
Try to imagine what the parent is feeling.
Resist the temptation to quickly give advice or make judgments
beyond your expertise.
Allow parents to clarify the meaning of the screening results,
and facilitate their efforts in taking the next steps required to
evaluate the child’s hearing.
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“How Do You Say It?”
Activity
Parents want you to appreciate their concern
for their child’s health.
Parents want clear and accurate information.
Parents want you to recognize that they want
the best for their child.
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Notifications
Each of the child’s teachers
Person responsible for school’s special
education services
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Specific Program Documentation
Class Screening Results
Hearing Re-screening List
Individual Hearing Screening Results
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Diagnostic and Support Services
Private health insurance plan or HMO
Local health department
School nurse
Audiologist contracted with school district
Audiologist in private practice or on staff of hospital
or clinic
AHCCCS
KidsCare
ASDB Regional Cooperative Programs
CCRS
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Early Childhood Resources
Parent Outreach Program
Arizona Early Intervention Program
Arizona Council for the Hearing Impaired
ADHS Sensory Program
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Hearing Screening
Program Report
Enrolled at the time of the first screening
Did not have a first screening
Had a first screening
Did not pass a first screening
Had a second screening
Did not pass the second screening
Were evaluated by an audiologist
Were evaluated by a physician or primary care practitioner
Were first diagnosed as deaf or hard of hearing during the
current school year
Were diagnosed as deaf or hard of hearing during a prior school
year
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ADHS Sensory Program
Reported results help the Sensory
Program evaluate how successful our
state is in identifying children with
hearing loss and in providing timely
and appropriate educational and
medical follow-up and management.
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