We know that many providers who serve children 0-3 years of age also serve children in the 3-5 age range. For this reason, the ECHO Initiative often receives questions about how hearing screening with preschool-age children should be conducted.
Some early childhood education programs use Otoacoustic Emissions (OAE) screening with both age ranges. For children 3 years and older, pure tone audiometric screening has been the traditionally accepted method. 
It is performed by placing earphones on a child's ears, presenting a series of tones to each ear and requiring the child to provide a behavioral response (like raising a hand or dropping a block in a bucket) each time a sound is heard. Pure tone screening equipment does not produce an automated result. Instead, screeners must be trained to complete a set of steps to teach a child to provide a consistent response each time a tone is heard.
A few of the most common errors and problems in conducting pure tone screening include:
- Increasing the sound volume when screening in noisy environments.
- Inadvertently providing visual cues that prompt children to respond.
- Getting children conditioned to respond consistently.
As with any type of screening, it is critical that screeners adhere to specific procedures and a follow-up protocol. A comprehensive set of training materials for screeners is not yet available, but the ECHO Initiative has pulled together a preliminary set of pure tone screening resources that programs can use as they work with a local audiologist to improve their practices. We hope to be able to create and offer a complete set of training videos and tools in the months ahead.
It is also important to remember that pure tone screening can be particularly challenging for younger children in this age range, as well as for those who have developmental delays, physical limitations, or language barriers. For these children, it is very appropriate to conduct OAE hearing screening.
Celebrate May as Better Hearing & Speech Month by improving your hearing screening practices!
