In recent years, there has been a significant increase in global concern regarding hearing loss. According to the World Health Organization (WHO), 1.3 billion people worldwide are affected by hearing loss, including 34 million children. In the United States, the Centers for Disease Control and Prevention (CDC) estimates that 15% of children ages 6 to 19 have at least some degree of hearing loss in one or both ears. Additionally, studies suggest that noise-induced hearing loss (NIHL) is on the rise, with one in every six to eight middle and high school students experiencing detectable hearing loss likely due to excessive exposure to noise. This reality imposes a critical responsibility on school health teams to identify students with hearing loss through evidenced-based school hearing screening programs.
Hearing Screening Methods Explained
Currently, there are no established national guidelines for conducting hearing screenings in schools. Still, most state health or education departments have instituted specific recommendations and requirements for school-based hearing screenings. Check your state's HERE. The three most common methods for screening for hearing loss in the school setting include:
Otoacoustic Emissions (OAE) Testing
OAE testing is an effective and accessible screening tool, particularly useful for screening younger students or those with communication challenges. The noninvasive nature of the OAE screen, which evaluates the response of the cochlea's outer hair cells, identifies potential hearing loss without requiring active participation from the student. More information on OAE Testing can be found in our blog post, Hearing Screening 101: Otoacoustic Emissions Test (OAE Test).
Tympanometry
Tympanometry is focused on the health and functionality of the middle ear, namely how well the eardrum moves. It can be particularly helpful in identifying hearing issues caused by infection, fluid build-up, or Eustachian tube dysfunction. Results from tympanometry testing done in school hearing screening can provide targeted information that may accelerate diagnosis and intervention, effectively reducing the academic and social impacts of middle ear pathologies. More details on tympanometry can be found in our blog post, Hearing Screening 101: Tympanometry Test.
Pure Tone Audiometry
Pure tone audiometry is the most conventional school hearing screening tool and remains unmatched in its capacity to evaluate the entire hearing pathway and assess functional hearing. Pure tone audiometry can be affected by many factors, including environmental distractions, tester competence, and the student's developmental stage and behavior. Therefore, meticulous attention to test conditions and protocol adherence are required to ensure reliable results. More information on pure tone audiometry, including sweep-check screening versus threshold screening, can be found in our blog post, Hearing Screening 101: Pure Tone Audiometry.
The consequences of untreated hearing loss on a student's development are profound, potentially leading to delayed intellectual, social, speech, language, and academic development. It's crucial that any student with a positive screen is promptly referred to their primary care provider for further consultation and diagnostic testing. School health teams are pivotal in advocating for students and equipping parents with information about their children's ear/hearing health and associated educational and developmental risks. By embracing the complexities and opportunities of school hearing screenings, school nurses can significantly contribute to protecting and enriching the learning environment through optimal hearing health.
