Which patients should be screened?

Ideally, all patients should be screened periodically. Certainly, screening is important to the following patients:

Every patient who answers “yes” to any questions on the self hearing test.

Others who might be at high risk (e.g. all patients over 50 years of age or those with heart disease, excessive exposure to noise, AIDS, kidney ailments, diabetes mellitus, and ototoxic drug use).

Each year for children functioning at a developmental level of three years through grade 3 and for any high risk children including those above grade 3.

Individuals who manifest symptoms during their visit to the office.

(American Speech-Language-Hearing Association. 1997. Guidelines for Audiologic screening.)

What is the self-hearing test?

Although the self-hearing test was designed for those who are 65 years or older, it can be an effective tool for screening adults of all ages. This screening tool can be useful in corroborating information obtained through audiometric screening or observation. A “yes” response to an item is awarded 4 points, “sometimes” 2 points, and a “no” 0 points. Scores range from 0-40 with higher scores indicating greater perceived handicap. A score in excess of 10 suggests a need for referral to a hearing care provider.

1. Does a hearing problem cause you to feel embarrassed when meeting new people?

2. Does a hearing problem cause you to be frustrated when talking to members of your family?

3. Do you have difficulty hearing when someone speaks in a whisper?

4. Do you feel handicapped by a hearing problem?

5. Does a hearing problem cause you difficulty when visiting friends, relatives, or neighbors?

6. Does a hearing problem cause you difficulty at movies, the theatre, or religious services?

7. Does a hearing problem cause you to have arguments with family members?

8. Does a hearing problem cause you difficulty when listening to TV or radio?

9. Do you feel that any difficulty with your hearing limits or hampers your personal or social life?

10. Does a hearing problem cause you difficulty when in a restaurant with relatives or friends?

(Journal of the American Academy of Audiology 2:70-75,1991)

Screening audiometers: What do they do?

Screening audiometers produce a restricted range of pure tones of varying frequency and intensity. Frequency is measure in Hertz (Hz) and is perceived as pitch. Intensity is measured in decibels (dB) and is perceived as loudness.

Screening audiometers typically provide for a sweep across the frequencies important for speech (500 Hz to 4000 Hz) at a fixed intensity, usually 25 dB HL. Typically, the patient who hears all the tones has normal hearing, and a miss constitutes a fail. In other words, it’s a “yes”/”no” type of test.

For testing patients over age 65, a screener that can also test at the 40 dB HL level is advised.

Another alternative is the use of a full “threshold” test. A threshold is the faintest sound that the average listener can just hear in a quiet environment. A threshold test is used to obtain more information about hearing at each of about four to eight frequencies.