Reading skills, in other words, are initially and most efficiently grounded in the sense of hearing. It is because congenitally and profoundly deaf children do not possess an auditory-based linguistic system that they have such difficulty reading at grade level. Children in regular schools, and this applies to normally hearing children as well as to those with minimal hearing losses, must hear in order to learn, and the more they hear, the more they are likely to learn. They must be able to hear the comments and questions of the other children in the class. Children have enough hurdles to overcome during the learning process without the added problem of an undetected and untreated hearing loss.
Many states now mandate some sort of hearing screening program, but others make no such provision.
In some states, the authority for the hearing screening program rests with the state department of health, while in others the department of education takes on this responsibility. When a state does not require a hearing screening program, the local school authorities may or may not fill the gap. Some states mandate that kindergarten children entering school have their hearing examined, and then follow through with a hearing screening program at later times. In some locales, newly enrolled children, those with special needs, or children with known hearing losses are examined every year, while other jurisdictions have different or no such provisions at all. Some states and districts provide guidelines that incorporate specific testing procedures, including tympanometry and otoscopic examination, as well as required follow-up procedures, while others leave the details to the local authorities.