1. (a) Once the individual's parent or guardian has given consent for screening, hearing screenings to detect hearing disorders must be provided for individuals attending a facility. Hearing screening as described in this subchapter must meet the following requirements.

   1. (1) Use a pure-tone audiometer to perform a sweep-check screen.
   2. (2) Record the screening results for each ear at less than or equal to 25 dB for 1000 Hz, 2000 Hz, and 4000 Hz.
   3. (3) A screener must perform a second sweep-check screen if the results show that the child did not respond to any one of the three frequencies in either ear. If the child has a cold, congestion, fluid buildup in the ears, or any other condition impacting hearing, delay the second sweep-check screen. The screener must perform the rescreening no later than 31 calendar days after the initial screening.
   4. (4) A screener must either perform an optional extended recheck or refer the child for a professional examination if the child does not respond to any one of the three frequencies in either ear on the second sweep-check. The hearing screening manual lists the steps for conducting an extended recheck.
   5. (5) A screener must refer for a professional examination if the child does not respond to any one of the three frequencies in either ear at 25 dB or lower during an extended recheck. The hearing screening manual lists the steps for conducting an extended recheck.
2. (b) Otoacoustic emissions (OAE) testing may replace pure-tone audiometry only if a child has a documented disability preventing audiometer screening. OAE testing is optional and dependent on the screener's access to OAE testing equipment. The screener must use the equipment according to the manufacturer's recommendations.
3. (c) A screener who is not a provider and performs hearing screenings in facilities must be trained and certified as described in §37.27 of this subchapter (relating to Standards and Requirements for Screening Certification and Instructor Training).
4. (d) Facilities must give the child's parent, other legally responsible adult, or the individual in the scenarios described in Texas Family Code §32.003, a referral form if the child fails a second sweep-check or extended recheck screening. The referral is for further evaluation by an appropriate provider. Facilities must not refer a child to a specific person.
5. (e) Facilities, school districts, and screeners must follow all instructions in the hearing screening manual available on the Department of State Health Services (DSHS) website.

Source Note:The provisions of this §37.24 adopted to be effective August 17, 2014, 39 TexReg 6055; amended to be effective February 9, 2026, 51 TexReg 732.