|(a) Screening is required, for individuals who attend
a facility, to detect hearing disorders. Hearing screening under this
subchapter must be conducted using screening methods and referral
criteria, and in compliance with other requirements, as follows.
(b) A person who is not a "licensed professional,"
as that term is defined in this subchapter, who conducts hearing screening
must be trained and certified as described in §37.27 of this
title (relating to Standards and Requirements for Screening Certification
and Instructor Training).
(c) A pure-tone audiometer shall be used to conduct
a sweep-check screen.
(d) Screening results shall be recorded for each ear
at less than or equal to 25 dB for 1000 Hz, 2000 Hz, and 4000 Hz.
(e) A rescreen with another sweep-check is recommended
if test results indicate failure to respond to any of the three frequencies
in either ear, and it should be conducted no sooner than three weeks
but not more than four weeks after the initial screening.
(f) An extended recheck may be conducted or a referral
to a professional examination shall be made for all children whose
test results indicate failure to respond to any of the three frequencies
in either ear on the second sweep-check.
(g) If the extended recheck results in a failure to
respond to any frequency in either ear at greater than 25dB, the screener
must recommend that a professional examination be immediately conducted.
(h) An extended recheck shall be conducted according
to the following procedures.
(1) Beginning with the right ear, present the tone
at 40 dB hearing level (HL) and at 1000 Hz for two to three seconds.
If no response is obtained, record "greater than 40 dB."
(2) If the child responds at 40 dB, lower the intensity
to 30 dB HL and present the tone again.
(3) Lower the HL in 10 dB increments until no response
is obtained, or until 20 dB is reached. If a response is obtained
at 20 dB, record "20 dB."
(4) If no response is obtained, increase the HL dial
in 5 dB increments until a response is obtained. Record the dB results
obtained at 1000 Hz for the right ear.
(5) Repeat steps in paragraphs (1) - (4) of this subsection
at 40 dB HL for 2000 Hz and 4000 Hz.
(6) Repeat steps in paragraphs (1) - (5) of this subsection
for the left ear.
(i) When a screener makes a referral based on the screening
results under subsection (a) of this section, that referral shall
be to a licensed professional for a professional examination, and
not to a specific individual.
(j) The requirements of this section do not apply when
the individual is already actively under medical care by an appropriate
licensed professional for one or more of the hearing problems for
which screening is done under this section. In order to claim this
exception, the individual under the scenarios described at Texas Family
Code, §32.003 or, if the individual is a minor, the individual's
parent, managing conservator or legal guardian, must submit documentation
from the licensed professional to the facility. The documentation
must be signed and dated by the licensed professional, and must affirmatively
state that the individual is under active, ongoing medical care from
the licensed professional for specific hearing problems as referenced
in this subsection.