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DoDEA School Health Services Manual 2942.0 Volume 1 Revised: 2016 DRAFT
Symptoms reported by the sponsor/parent/guardian or classroom teacher that
may need further evaluation are:
•
Complaints of frequent earaches or pain in the area immediately adjacent to
the ear
•
Complaints of the ear being “stopped up”
•
Complaints of noises such as ringing or buzzing
•
Drainage from the ear, sometimes accompanied by an unpleasant odor
•
Ears dirty with heavy encrustation of dried earwax
•
Frequent colds or allergic symptoms
•
Constant mouth breathing
•
Poor balance in walking, running, leaping, and other similar activities
•
Poor or defective articulation of speech sounds
•
Misunderstanding or misinterpretation of oral communication
•
Inattention, interrupting conversation of others, being unaware that others
are talking, answering questions inappropriately, responding off topic, leaning
forward to hear, or cocking the head in an effort to hear better.
Students are screened for hearing (puretone screening) during the year of first
entry into school and every two years thereafter. Minimal requirement:
•
Once in preschool
•
At school entry in kindergarten or 1st grade (whichever is first entry)
•
Second or third grade
•
Fourth or fifth grade
•
Sixth or seventh grade
•
High school students should be screened at least once during their high
school years.
The school nurse should accept referrals from a sponsor/parent/guardian, school
staff, primary care manager/provider, or student, as well as referrals from any of the
various school teams (i.e., CSC, 504 Accommodation Team, Student Support Team).
When screening, standardize screening by always starting with the RIGHT ear.
This standardized process results in a more reliable outcome in documentation. Test
each ear separately. A screening of ‘both’ ears is unreliable as the ear with the better
acuity will dominate, thus yielding a false acuity level.
Begin screening at 20 decibels (dB) and test at the following frequencies (Hz)
500, 1000, 2000, and 4000 Hz. If the environment has extraneous noise, the intensity
can be raised to 25dB. Never increase intensity beyond 30 dB during screening process.
Referral criteria should be coordinated with the local medical treatment facility.
American Speech Language Hearing Association guidelines indicate “passing” acuity in