Pathway for Hearing Screening at Well Child Visit
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0-6 Months
6 Months-3 Years
Over 3 Years
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Review Newborn Screening Results
Evaluate Risk Indicators
Routine Development Surveillance
Evaluate Risk Indicators
Screening Schedule
Baseline standards follow
the AAP guidelines.

At 4, 5, 6, 8 and 10 Years old well visits, and once between 11-14 years, once between 15-17 years, and once between 18-21 years

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Passed, No Risk Indicator(s)
Routine Developmental Surveillance

Failed, Unable to Screen or Risk Indicator(s)
Refer to Audiology
No Risk Indicator(s)
Routine Developmental
Surveillance

Risk Indicator(s)
Refer to Audiology
Screen all patients in each ear at 20 dB HL
@ 1000 Hz, 2000 Hz, 4000 Hz
For patients 11-21 years, also screen
at 20dB HL @ 6000 Hz and 8000 Hz
Screening Procedure
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PCP Ear Exam
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No Risk Indicator(s)
Screening at Next Annual Visit


Risk Indicator(s)
Refer to Audiology
No Ear-related Pathology
Refer to Audiology
Ear-related Pathology
Treat as indicated
Re-screen in office
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No Risk Indicator(s)
Screening at
Next Annual Visit
No Ear-related Pathology
Refer to Audiology
Ear-related Pathology
Refer to ENT
Posted: October 2015
Revised: February 2018
Authors: McKay, S., AuD.; Biggs, L., MD; Germiller, J., MD, PhD; Macaulay, C., RN, CSN, CEN; Peterson, J. AuD
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Community Resources
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