In determining how to most effectively conduct hearing screening with preschool children, early care and education providers are advised to work with a local audiologist to determine the screening method(s) best suited to their setting and population.

Pure tone (PT) screening has been used widely to screen school-aged children for permanent hearing loss and employed on a more limited scale with preschool children.  Approximately 20% of children 3-5 years of age may not be able to complete PT screening, however, because the procedure requires them to consistently raise a hand or complete a simple task in response to sound.

Otoacoustic emissions (OAE) technology has been used extensively in hospital-based universal newborn screening efforts and has become the recommended method for screening children 0-3 years of age in early care and education settings.  Some audiologists also consider OAE screening to be the most practical methodology for lay screeners serving children 3-5 years of age. 

There are a variety of factors to consider when determining an optimal screening method for children in a specific setting.  It is therefore important for administrators and decision-makers to be aware of these factors,  to check state regulations and to consult with a local audiologist and the Health Services Advisory Committee, keeping in mind that:

• The selected procedure needs to be simple enough to be performed reliably by lay screeners;


• Screening is not diagnostic--it is intended to identify children who need further audiologic evaluation to determine whether a permanent sensory or conductive hearing loss is present;


• Neither PT nor OAE screening will identify all children with every type/degree of hearing disorder (very mild loss, auditory neuropathy spectrum disorder, central auditory processing disorder, etc.)

Be aware that if a child manifests a language delay,
or if parents or caregivers have concerns about hearing or speech, a hearing evaluation by a pediatric audiologist is critical--even if the child passes a hearing screening.  Observations of the child's behaviors and developmental progress, along with quality PT or OAE hearing screening, are all important tools to help you determine which children need further assessment and intervention.