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ARIZONA T3 HOW TO TRAIN HEARING SCREENERS RENEWAL CURRICULUM: PRESCREENING T3 Prescreening 1 Prescreening Learning Objectives Recognize normal auditory development. Understand the importance of early identification of hearing loss. Know when and how hearing screening is conducted. Practice selecting an appropriate screening method. Be able to set up a hearing screening program. T3 Prescreening 2 Screening Programs Goal: to quickly and efficiently distinguish those children who need further evaluation from those children that probably are not having hearing difficulties significant enough to interfere with learning. T3 Prescreening 3 Early Screening in Infants Otoacoustic Emissions (OAE) Auditory Brainstem Response (ABR) or Brainstorm Auditory Evoked Response (BAER) T3 Prescreening 4 Risk Factors for Hearing Loss Birth to 28 days (Neonates) A family member with a permanent hearing loss since childhood Serious infection present during pregnancy or at birth of infant Birth weight less than 3 ½ pounds (1500 grams) Difficult birth or delivery affecting baby’s breathing Unusual appearance of head, face or ears Severe jaundice requiring a blood transfusion Infection of the brain Prolonged mechanical ventilation Characteristics related to certain syndromes Receiving drugs toxic to the ears T3 Prescreening 5 Risk Factors for Hearing Loss 29 days to 2 years Factor(s) from the previous slide Factors associated with progressive hearing loss (infection, mechanical ventilation, heredity) Parent or caregiver is concerned about hearing, speech, language or developmental delays History of head trauma History of an infectious disease associated with sensorineural hearing loss (measles, mumps) T3 Prescreening 6 Arizona Hearing Screening Rules Hearing Screening Population Screening Requirements Criteria for Passing a Hearing Screening Requirements for Performing a Second Hearing Screening Referral, Notification and Follow-Up Screener & Trainer Qualifications Equipment Standards Record Keeping Reporting Requirements T3 Prescreening 7 Required each year for students: Enrolled in preschool, kindergarten, or in grade 1, 2, 6, or 9 Enrolled in grade 3, 4, or 5, unless there is written documentation that student had a hearing screening in or after grade 2 Enrolled in grade 7 or 8, unless written documentation shows student had hearing screening in or after grade 6 Enrolled in grade 10, 11, or 12 unless there is written documentation that student had a hearing screening in or after grade 9 Receiving special education Who failed second hearing screening in prior school year T3 Prescreening 8 Screening NOT Required If: Child is 16 years or over Child’s parent objects in writing to the screening as allowed in state rules Written diagnosis or evaluation from an audiologist states that a child is deaf or hard of hearing Child has a hearing aid, an assistive listening device, or a cochlear implant T3 Prescreening 9 Four Reasons NOT to Screen 1. Fluid or drainage from the ear 2. Blood 3. Open sore 4. Foreign object in the ear canal T3 Prescreening 10 ADHS Approved Screening Methods Pure Tone Tympanometry Otoacoustic Emission (OAE) T3 Prescreening 11 Pure Tone Screening Can the child: Attend to sound? Follow directions? Give a behavioral response? T3 Prescreening 12 Pure Tone with Conditioned Play Audiometry (CPA) Requires child be able to wear headphones and learn a play activity in response to sounds Is useful with 3-5 year olds Is useful with children developmentally able to tolerate headphones and learn a repetitive task, but unable to follow complicated directions or stick with a task Is useful with older children who are developmentally delayed T3 Prescreening 13 Tympanometry Looks for fluid in middle ear Does not measure hearing Is useful with young population that has high incidence of middle ear fluid T3 Prescreening 14 Otoacoustic Emission (OAE) Is mostly used with very young or difficult to screen children For school age children, must complete pure tone screening first Looks for middle ear problems and hearing loss caused by damage to cochlea or sensorineural hearing loss Is quick T3 Prescreening 15 Selecting the appropriate screening method depends on: Age of the child Abilities of the child (developmental age) Availability of trained personnel Availability of equipment and other resources Ability of the child to follow instructions T3 Prescreening 16 Selecting a Hearing Screening Site Is it quiet? Are there enough outlets? Are noisy conditions limited? Is area adaptable to traffic flow? Adjust your environment; never adjust your equipment! T3 Prescreening 17 Preparing the Hearing Screening Site Decide on the number of stations Obtain a table, 2 chairs & screening equipment for each station Design traffic flow Designate areas for screening and waiting Obtain extension cords, 3 prong adapters, power strips & duct tape Set out necessary paperwork and pens Set out headphone cleaning supplies Have “Quick Kit” on hand T3 Prescreening 18 Quick Kit Several pairs of latex gloves Paper towels Self-closing plastic bags (e.g., Zip-loc ®) Moistened towelettes, or waterless handwashing gel Small bottle of freshly-made bleach and water solution mixed in a ratio of 1 part bleach to 10 parts of water - Keep this solution out of the reach of children! T3 Prescreening 19 Legal Considerations Liability Confidentiality Obtaining Parental Consent T3 Prescreening 20 Volunteers Role Recruiting Training T3 Prescreening 21 Equipment Must meet requirements specified in Arizona rules Maintenance and calibration are required Every audiometer must receive a comprehensive calibration once a year by a certified technician! T3 Prescreening 22 Think, Pair & Share Activity Be familiar with state rules Know your equipment is calibrated Be sure you use the right screening method for each child Screen in a quiet area Have everyone trained before the screening day Gather all necessary supplies before setting up! T3 Prescreening 23