August 2024
Hearing Screening
Question:
I am a regulated SLP member of ACSLPA working with preschool children. I understand the risks involved in proceeding with speech-language assessment and treatment intervention for children without first making sure that hearing loss is not a contributing factor.
It is not feasible for me to purchase an audiometer with all the accessories and required maintenance involved. How can I ensure that the pediatric clients I see for assessment have had or will have their hearing tested before I proceed with speech-language testing and intervention?
Answer:
You are entirely correct that potential hearing loss should be ruled out for pediatric clients prior to conducting a speech-language assessment and intervention to avoid any misdiagnosis and ineffective use of resources.
The ACSLPA Hearing Screening Guideline and Protocol – Preschool to Adult (2023) discusses the importance of determining a client’s hearing status prior to the administration of any speech-language assessment or intervention. Further, the Guideline notes that the SLP is responsible for ensuring that each child on their caseload obtains a hearing screening, preferably before or at the time of assessment, or soon after an assessment and before commencing with intervention.
Ideally, each child referred for a speech-language assessment or reassessment would be screened by the designated SLP, or by assigned personnel within the organization. This is the most convenient, efficient, and effective way to know if hearing loss is a contributing factor to the speech-language development of a client. Ready access to hearing screening/testing is considered an essential part of an SLP’s practice when providing speech-language assessments to children, regardless of their practice setting.
Recent technological advances negate the need to purchase expensive bulky equipment to provide hearing screening, software programs are now available that allow hearing screening directly from a laptop. Calibration of software is conducted online through the manufacturer.
Another option is to let parents or guardians know that the child requires a hearing test or screening prior to a speech-language assessment. Hearing testing can be accessed through a private audiology clinic or through public health services. In this scenario, the SLP must ensure testing has been completed and the results are shared. Keep in mind that the wait lists for hearing testing may be lengthy, which is another factor supporting hearing screening occurring at the time of assessment.
Because of the importance of knowing a child’s hearing status prior to completing speech-language assessments, SLPs may wish to consider delaying assessment and or any intervention until hearing status is documented.
Where necessary, regulated members should work with their program administrators and managers to advocate for client access to hearing screening, by communicating the importance of combining hearing screening with speech-language assessment, the different options for hearing screening available, and the rationale for delaying and assessment and intervention until hearing screening has been completed.
For comprehensive guidance, please refer to the Hearing Screening Guideline and Protocol, Preschool to Adult (July 2023).
If you have any questions or need further clarification, please contact ACSLPA’s SLP or Audiology Advisors through the Contact Us form.