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Should You Have Your Child’s Hearing Tested?

Routine screenings at school are normal and important

Young boy receives a hearing exam as doctor feels the backs of his ears while his mother looks on

It’s common for your child to have their hearing screened while in school, typically every other year beginning either in preschool, kindergarten or first grade, at the beginning of the school year. If a concern about hearing arises at other times, a screening may be requested as well.


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“Routine hearing screenings help identify hearing loss that may have developed since birth or not identified at birth,” says audiologist Sharon Sandridge, PhD.

A very common cause of hearing loss is due to middle ear infections that might go unidentified.

Fluid in your child’s middle ear can cause a temporary hearing loss but needs medical intervention to make sure the loss remains temporary. Another hard-to-detect hearing loss is a unilateral hearing loss — loss in only one ear. Your child might still function well because their other ear has normal hearing. But a unilateral hearing loss puts your child at risk for academic difficulty and psychosocial involvement.

Here are the next steps to take if your child has trouble hearing.

What happens if your child fails a hearing screening?

A hearing screening is just that — a screening. Don’t panic, the screening simply identifies a concern.

“We have parents stress out after their child has received a referral from a hearing screening,” Dr. Sandridge says. “These screenings only indicate that on that day, in that test environment, they did not pass the screening. Many factors in the initial screening can impact the screening results, and they may not be due to hearing loss. So just think of the next step as precautionary, a needed step to rule out a possible hearing loss.”


Common issues during school hearing screenings

The hearing screening can be administered by a school nurse, speech language pathologist or a visiting audiologist — all professionals who perform their jobs well.

1. Unfavorable screening environments. The test environment isn’t always an optimal setting. For example, screenings sometimes take place in a school gymnasium with multiple children being screened in the same area at the same time. The noise level can be a factor. In addition, gymnasiums and other non-sound-booth environments often have poor acoustics (how sound is transmitted), increased reverberation (like an echo) and high levels of ambient (background) noise levels. All of these factors can impact the screening results.

2. Improperly fitting headphones. It’s difficult to find a universal size of headphones for each child. In many cases, headphones might be too loose, making it hard for your child to hear.

3. Short attention spans. Young children won’t understand the importance of the hearing screening and can be easily distracted by friends and classmates. If they fail a screening, it could be because they simply weren’t paying enough attention to the sound prompts.

A referral on a hearing screening does not necessarily mean that a hearing loss is present. However, it does mean that it needs to be ruled out by having your child’s hearing tested.

“Following up with a comprehensive audiologic evaluation is critical. If a problem is found, appropriate management can be delivered. That could include seeing an ENT (ear, nose and throat doctor) for middle ear fluid or other options to enhance your child’s hearing,” says Dr. Sandridge.

What’s involved in a comprehensive audiologic evaluation?

If your child receives a referral notice, you’ll need to schedule with an audiologist to have their hearing tested. This evaluation will determine if your child’s hearing is within normal range or if a hearing loss exists. Your child will listen and respond to sounds — both tones and speech delivered in a controlled and calibrated (not like a noisy gym) test environment.

How to help your child prepare for the comprehensive audiologic evaluation

The following are simple steps you can take to help your child prepare for their comprehensive audiologic evaluation:

  • Talk to your child about what the test will involve. They’ll be seated in a room and asked to respond to sounds.
  • Reinforce that your child needs to pay attention and listen to the instructions closely in order to complete the testing.
  • Have your child wear a pair of headphones so they become comfortable with them on their head.

Early detection is important

The earlier a hearing loss is identified, the earlier a solution can be found. If the cause of hearing loss is due to a middle ear infection, medical intervention can address and resolve that temporary loss. If the loss is more permanent, audiologists will recommend appropriate options.


“Some hearing losses are so mild that parents are not aware of the loss. Or the hearing loss may affect only one ear and not be noticed,” says Dr. Sandridge. Yet, both of these types of hearing loss can place your child at risk for a number of academic and psychological disadvantages. So, it’s critically important that a follow-up visit is scheduled if your child is given a school referral and appropriate measures are taken as early as possible.

How to protect your child’s ears

It’s now known that if we listen to sounds that are too loud for too long, we create permanent injury to our ears — even as a child. This injury may not show up on the hearing test today, but it’ll impact your child’s hearing as they age. So, it’s best to begin practicing safe listening at a young age. A few suggestions include:

  • If your child uses ear buds or headphones at all, remind them to keep the volume at a safe level. If you can hear it at an arm’s length, the sound is too loud.
  • Have your child use hearing protection (earplugs or earmuffs) when there are loud sounds. For example, hearing protection should be used when mowing the grass or riding a motorcycle. General rule of thumb: If you have to raise your voice to be heard, the sound is probably too loud.
  • There’s a tradeoff between loudness and length of listening. The louder the sound, the less time your child should be listening. So, if your child loves to listen to their personal music device, keep the volume control at 50% and they can listen all day. If the volume is increased, their listening times should be decreased.
  • If your child ever experiences a dullness in their hearing or a ringing in their ears after a loud event — like a sporting or a musical event — the sound was too loud and injury to their ear has happened. Next time, protect their hearing.

Hearing is important!

Hearing is one of our most valuable senses. It shouldn’t be taken for granted. Hearing allows us to communicate easily and is the primarily way we learn in school. Hearing also lets us know when the bell rings for recess or that the teacher is calling your name!

And, critically important, hearing warns us when we might be in danger, like stepping in front of a car. We need to protect and preserve hearing for a life time. So, get regular hearing screenings and follow-up if your child doesn’t pass their hearing screening.


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