Which of the following actions will most effectively control the problem of overreferral in school screening programs that use impedance/immittance measurements?

Which of the following actions will most effectively control the problem of overreferral in school screening programs that use impedance/immittance measurements?

• A. Obtaining the measurements in a professional sound-insulated room
• B. Including 500 Hz in the audiometric screening procedure
• C. Retesting immediately those who did not pass the first screening
• D. Waiting three to five weeks to retest those who did not pass the first screening

Answer: (D)

Waiting three to five weeks to retest those who did not pass the first screening is the most effective action to control overreferral in school screening programs that utilize impedance/immittance measurements. The primary goal of this approach is to allow time for any temporary conditions that may affect hearing, such as middle ear fluid or transient blockage, to resolve before retesting. Many children experience transient hearing issues that do not indicate a long-term problem; thus, immediate retesting could falsely identify a significant number of children as needing further evaluation when they might actually have normal hearing capabilities after a short period. By implementing a delay, the likelihood of misdiagnosing temporary issues as permanent ones is reduced, which subsequently helps in preventing unnecessary referrals to specialists. This strategy leads to more accurate identification of children who genuinely require intervention while minimizing the burden on families and the healthcare system that can result from excessive referrals. In contrast, actions like obtaining measurements in a sound-insulated room can enhance the reliability of the results, but it does not directly address the timing of retests. Including 500 Hz in the audiometric screening may enhance the detection of specific hearing loss types, but it doesn’t fundamentally reduce overreferrals due to transient conditions. Retesting immediately after a failed screening does

Waiting three to five weeks to retest those who did not pass the first screening is the most effective action to control overreferral in school screening programs that utilize impedance/immittance measurements. The primary goal of this approach is to allow time for any temporary conditions that may affect hearing, such as middle ear fluid or transient blockage, to resolve before retesting. Many children experience transient hearing issues that do not indicate a long-term problem; thus, immediate retesting could falsely identify a significant number of children as needing further evaluation when they might actually have normal hearing capabilities after a short period.

By implementing a delay, the likelihood of misdiagnosing temporary issues as permanent ones is reduced, which subsequently helps in preventing unnecessary referrals to specialists. This strategy leads to more accurate identification of children who genuinely require intervention while minimizing the burden on families and the healthcare system that can result from excessive referrals.

In contrast, actions like obtaining measurements in a sound-insulated room can enhance the reliability of the results, but it does not directly address the timing of retests. Including 500 Hz in the audiometric screening may enhance the detection of specific hearing loss types, but it doesn’t fundamentally reduce overreferrals due to transient conditions. Retesting immediately after a failed screening does