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To the Editor.—Ms Niskar and colleagues¹ chose to define hearing loss as an average threshold in either ear greater than 15 dB hearing level (dB HL) for either low tones (0.5, 1, and 2 kHz) or high tones (3, 4, and 6 kHz). Although this choice was not explicitly justified, the authors imply that children with hearing worse than this "need intervention at home and school to prevent hearing loss from impairing their development." They go on to urge screening using these frequencies (and presumably this intensity criterion) from elementary through high school and contrast this policy with the common policy of screening at 1, 2, and 4 kHz. As of 1985, the policy of the American Speech Language Hearing Association (ASHA) recommended using 1, 2, and 4 kHz, plus 0.5 kHz if ambient noise levels were low enough, with referral when thresholds were greater than 20 dB HL.^2-3 . . . [Full Text of this Article]

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