The Real Disruption in Audiology: States Not Requiring Hearing Screenings for Children

By Jacqueline R. Scholl, Au.D, CCC/A, PS/A

Literacy is arguably one of the most pressing concerns for the economic future of our country. Yet, because most children do not receive hearing screens beyond birth, those with auditory pathway disorders are being relegated to a life where learning at its most basic level—reading—is difficult, if not impossible.

Case in point: more than 50% of first- and second-grade students in Oklahoma public schools began the 2021-2022 school year classified as “at risk” in reading. Oklahoma is not alone. These statistics are reflective across the United States.

During a time of disruption in our profession, we are allowing our schools to mislabel our children and put them in disability categories where they don’t belong. As such, they are not receiving the intervention necessary to develop literacy skills and are destined to a life of special education, welfare, and incarceration.¹

As Audiologists, we are uniquely trained and educated to change this trajectory.

The Backstory

Most states screen hearing at birth because hearing loss is a leading birth defect. The Center for Disease Control estimates approximately 15% of children in schools have some form of hearing loss. By the time kids start school, however, Child Find considers hearing loss a “low incidence” disability.

Oklahoma’s school districts, like most states, do not have early and effective ways to screen and provide appropriate intervention for children with reading problems. As such, our children lack the support they need to build strong literacy skills. Those that are screened receive hearing screenings like those provided 50 years ago: screening four pure tones and possibly a tympanogram, which is not appropriate today.

In my initial research into Oklahoma schools, I found that:

1. Equipment has not been calibrated for many years;
2. Children do not receive a hearing screening unless requested by the parent or teacher;
3. Many children receive speech services, but have never had a hearing screening;
4. Many Head Start programs use a tympanogram as a “hearing screening”;
5. Children with auditory pathway issues may receive services for the symptoms, but rarely for the problem.

Based on these findings, it should be no surprise that hearing loss is considered a “low incidence” disability in school-aged children; no one is really looking for it.

Through the non-profit organization, Soundwrx, free hearing screenings using modern technology and a current protocol are being offered to school districts in Oklahoma. Soundwrx recently screened all preK-3rd grade students in the first school district to accept this offer. Findings were as follows:

1. 31% of children had middle ear pathology (many of those had qualified for speech services);
2. 11% are suspect of a mild or high frequency hearing loss;
3. 6% are suspect of a unilateral hearing loss;
4. 29% have a possible auditory pathway disorder;
5. 23% need to be retested in a quieter environment;
6. Foreign bodies (a bead and pencil eraser) were found in 2 children;
7. Ear tag on one (also one of the one with possible hearing loss);
8. Abnormal pinna’s on two children (also suspect of hearing loss), and
9. An undiagnosed child craniofacial anomalies with low-set ears.

Call To Action

On October 4 at 8:30 am, Dr. Nina Kraus, PhD of Northwestern, School of Communication, and I report on the state of auditory pathway disorders, including hearing loss in Oklahoma schools during an Interim House of Representatives study sponsored by Rep. Meloyde Blancett (D-Tulsa). You can watch the presentation by clicking on "Recordings," finding "Week of Oct 2, 2022", then clicking on the "Common Education [Room 4S5], Tue, Oct 4, 2022 8:30-9:30 AM".

About the author: Jacqueline Rogers Scholl, AuD, is an audiologist and founder of the Scholl Center in Tulsa, Okla. She also serves as the executive director of Soundwrx.