OMB C Memo

MEMORANDUM

UNITED STATES DEPARTMENT OF EDUCATION

Institute of Education Sciences
National Center for Education Statistics

To:

Shelley Martinez, OMB

From:

Gail Mulligan and Jill McCarroll, NCES

Through:

Kashka Kubzdela, NCES

Date:

August 9, 2012

Re:

Change request to the Early Childhood Longitudinal Study Kindergarten Class of
2010-11 (ECLS-K:2011) Spring First-Grade and Fall Second-Grade Data
Collections package (OMB# 1850-0750 v.10 approved 12/8/2011)

We are requesting a change to our ECLS-K:2011 Spring 1st and Fall 2nd Grade Data Collections package.
Specifically, this is a request to replace the hearing evaluation results letter for parents in the original
package with the version included in this request.
After the previously submitted letter was approved by OMB, ECLS-K:2011 study staff decided the
information provided to parents may be more clear if presented in a different format. Study staff have
worked with our hearing evaluation cosponsors and collaborators (staff at the National Center on
Deafness and Other Communication Disorders (NIDCD) and the National Institute for Occupational
Safety and Health (NIOSH)) to make the hearing evaluation results letter for parents more accessible and
reader-friendly. The revised letter still contains necessary technical terms (e.g., “audiologist”) in order to
keep the information about the results fully accurate, but has enhanced readability.
This request has no associated change in respondent burden.
Both the original hearing evaluations results letter and the requested revision are included below.

Hearing Evaluations Results Letter:
Approved Letter Included in Original OMB Package

[DATE]
PARENT’S NAME
PARENT’S ADDRESS
CITY, ST, ZIP
RE: CHILD’S NAME
Dear ,
had hearing evaluated by a trained health technician on as
part of the Early Childhood Longitudinal Study, Kindergarten Class of 2010-11 (ECLSK:2011). This letter reports the results of the evaluation.
The softest sounds a person can hear are called hearing thresholds. ’s thresholds
at the different frequencies (pitches) that were tested are reported in the table below.
Thresholds towards the left of the table are for lower-pitched sounds and thresholds toward
the right are for higher-pitched sounds. Smaller thresholds mean quieter sounds, and therefore
indicate better hearing. Values of 20 decibels (dB) or less are considered normal hearing in
children.
Hearing Thresholds by Ear and Frequency (Pitch)

1000

Frequency (Hz)
2000
3000

4000

6000

8000

Right Ear (dB HL)
Left Ear (dB HL)
Print legend only if “***” or “NRS”
appears in table

* * * = threshold not tested
NRS = no response at limits of equipment

[IF RESULTS ARE THE SAME IN BOTH EARS]Results ’s hearing is within normal limits in both ears” or “could not be
obtained for several of the sounds we tested in either ear”>. [IF RESULTS ARE
DIFFERENT IN EACH EAR]Results ’s hearing is within normal limits” or “could not be obtained for several of the sounds we
tested”> in right ear and ’s
hearing is within normal limits” or “could not be obtained for several of the sounds we
tested”> in left ear. [IF INSUFFICIENT THRESHOLDS IN EITHER EAR]
Failure to obtain results typically happens because there was not enough time for the entire
evaluation or the room was too noisy to complete the evaluation.
[PHYSICIAN’S REFERRAL A – printed for children with hearing loss in either ear]
The hearing test we conducted for the ECLS-K:2011 can identify possible hearing problems
but cannot determine the cause of those problems. Please note that testing conditions in your
child’s school may have affected the results, and that the results of our evaluation do not
replace those that you would receive during a full hearing examination by a medical
professional. If you have not already done so, we recommend that you see your child’s doctor
or other health professional regarding a hearing evaluation. You may wish to take this letter to
the doctor or other health professional.
[PHYSICIAN’S REFERRAL B – printed for children with insufficient thresholds to calculate
results in either ear, unless PHYSICIAN’S REFERRAL A is printed]

Please note that testing conditions in your child’s school may have affected the results, and that
the results of our evaluation do not replace those that you would receive during a full hearing
examination by a medical professional. If you have any concerns about your child’s hearing, we
recommend that you see doctor or other health professional regarding a hearing
evaluation.
If you or your health care provider have questions about ’s hearing test, please
contact Christa Themann, MA, CCC-A, the certified audiologist supervising the ECLS-K:2011
hearing component, at 513-533-8485 or [email protected].
If you would like further information on hearing loss and its effects, prevention,
treatment, or rehabilitation, please contact the National Institute on Deafness and Other
Communication Disorders (NIDCD) at 800-241-1044 or visit them on the web at
www.nidcd.nih.gov. NIDCD is the sponsor of the hearing evaluations included in the
ECLS-K:2011

INSTRUCTIONS FOR FILLS FOR HEARING RESULTS LETTER
1. Insert audiometric thresholds into the appropriate cells in the table.
a) If there was no response at the limit of the audiometer for a particular frequency, insert “NRS”
into that cell and print the NRS legend below the table.
b) If a threshold could not be obtained, insert “

” into that cell and print the “

” legend below
the table.
c) If a threshold is less than or equal to the minimum testable threshold reported by the noise
monitoring system for that threshold, insert “

” into that cell and print the “

” legend
below the table.

2.

Insert appropriate text into results letter.
a) If hearing is normal for a given ear, insert “indicate that ’s hearing in within
normal limits” in the RESULTS paragraph.
b) If hearing is not completely within normal limits for a given ear, insert the text from the
audiometry results table given below. Print the PHYSICIAN’S REFERRAL A paragraph
following the RESULTS paragraph.
c) If there are insufficient thresholds to provide results for a given ear, insert “could not be
obtained at all frequencies” in RESULTS paragraph and add the INSUFFICIENT
THRESHOLDS sentence at the end of the RESULTS paragraph. Print the PHYSICIAN’S
REFERRAL B paragraph following the RESULTS paragraph, unless the PHYSICIAN’s
REFERRAL A paragraph will be printed as indicated in (b) above.

If any threshold exceeds 20 dB HL in a given ear, calculate the average threshold for the
frequencies 1000, 2000, 3000, and 4000 Hz. Based on this pure tone average, results are
provided in the table below:
PTA: PURE TONE AVERAGE (1000, 2000, 3000, 4000 HZ)
PTA < 20

indicate a slight
hearing loss, which
would probably not
cause
much difficulty,

20 ” PTA < 35

indicate a mild
hearing loss, which
may cause to miss some
speech sounds,

35 ” PTA < 50

indicate a moderate
hearing loss, which
can cause to have
difficulty hearing
speech,

50 ” PTA

indicate a serious
hearing loss, which can
cause to
have significant
trouble hearing speech
and other sounds,

NOTE: If a threshold is given as NRS (no response), use the following values as the
threshold in calculating the frequency average:
1000-6000 Hz: 105 dB
8000 Hz: 85 dB
NOTE: If results are the same in both ears, the results can be reported together, as indicated in
the letter.

Hearing Evaluations Results Letter:
Requested Revision

ECLS-K:2011 HEARING EVALUATION REPORT

STUDENT NAME:
DATE OF HEARING EVALUATION:

The Early Childhood Longitudinal Study – Kindergarten Class of 2010-11 (ECLS-K:2011)
conducted hearing evaluations on some children this fall. received this
hearing check at school on .
[RESULTS A – for children with sufficient thresholds to produce a summary report]
Results of the hearing check ’s hearing
is within the expected range, meaning that was able to hear sounds that
children with normal hearing can hear”>. Details about ’s hearing check are
provided on the attached page. Please note that we may not have been able to check all of the
sounds during ’s evaluation. If some sounds were not checked, it is likely
because there was not enough time or the room was too noisy to complete the entire
evaluation.
[RESULTS B – for children with insufficient thresholds to produce a summary report]
Unfortunately, we cannot summarize the results of ’s hearing check because we
were not able to obtain results for enough sounds to draw conclusions about ’s
hearing. This likely happened because there was not enough time or the room was too noisy to
complete the evaluation. Details about results we could obtain are provided on the attached page.
[PHYSICIAN’S REFERRAL TEXT A – for children with any threshold > 15 dB HL]
The ECLS-K:2011 hearing evaluation can identify possible hearing problems but cannot
determine the cause of those problems. While our study staff attempted to do the hearing
check in a quiet location, the testing conditions in the school may have affected the results.
This evaluation does not replace a full hearing examination by a medical professional. If you
have not already done so, we recommend that you talk to your child’s doctor or other health
professional about scheduling a complete hearing evaluation. You may wish to take this report
with you to the doctor or other health professional.
[PHYSICIAN’S REFERRAL B –for all other children]
While our study staff attempted to do the hearing check in a quiet location, the testing conditions
in the school may have affected the results. This hearing check does not replace a full hearing
examination by a medical professional. Please talk to your child’s doctor or other health
professional about a complete hearing evaluation if you have any concerns about ’s hearing.
The ECLS-K:2011 hearing evaluations were overseen by certified audiologists at the Centers
for Disease Control and Prevention (CDC). If you have any questions about this hearing
evaluation, please contact the ECLS-K:2011 audiology team at 513-533-8485 or
[email protected].
The National Institute on Deafness and Other Communication Disorders (NIDCD)
sponsored the hearing evaluations included in the ECLS-K:2011. The NIDCD is part of
the National Institutes of Health, the nation's medical research agency. For further
information on hearing loss and its effects, prevention, treatment, or rehabilitation, please
contact the NIDCD at 800-241-1044 or visit www.nidcd.nih.gov.

ECLS-K:2011 HEARING EVALUATION REPORT (continued)

STUDENT NAME:
DATE OF HEARING EVALUATION:

Detailed Report
The softest sounds a person can hear are called thresholds. The ECLS-K:2011 hearing
evaluation checked thresholds at several different pitches, measured in Hertz. Some of the
sounds had a lower pitch (such as 2000 Hertz, about the pitch of a watch ticking), and some of
the sounds had a higher pitch (such as 8000 Hertz, about the pitch of birds chirping).
Thresholds are measured in decibels. The threshold tells how loud each sound had to be for
to be able to hear it. When thresholds are smaller, that means your child can
hear quieter sounds, which indicates better hearing. Threshold values that are more than 15
decibels (about as loud as a breeze blowing through the leaves of a tree) indicate possible
hearing difficulty in children.
’s results are shown in the table below. Thresholds towards the left of the
table (for example, 2000 Hertz) indicate how well your child can hear lower-pitched sounds
and thresholds toward the right (for example, 8000 Hertz) indicate how well your child can
hear higher-pitched sounds. Thresholds in bold indicate hearing levels that are higher than
what is expected for children and may need further evaluation.

’s Thresholds by Ear and Pitch
Pitch of Tested Sound (Hertz)
(lower)

1000

2000

3000

4000

6000

8000

(higher)

Right Ear Threshold

(decibels)

Left Ear Thresholds

(decibels)

[Include shaded columns in table only if any thresholds exist for at least one of the shaded cells.]
[Print the following legends only if the code explained by them appears in the table.]
* * * = It was too noisy or there was not enough time to test this sound.
NRS = No Response. Your child did not indicate he or she could hear this sound even when it was
very loud.

Early Childhood Longitudinal Study: Kindergarten Class of 2010-2011
nd
Fall 2 Grade Hearing Results Letter: Programming Instructions

FINAL: 08/06/2012

1. Insert child’s first and last names and test date in appropriate fields in the header and report.

2. Determine if sufficient thresholds are available to report summary results.
a) Check each ear for sufficient thresholds to calculate a threshold average.
Available thresholds are defined as one of the following:
i. A threshold greater than its corresponding minimum testable threshold reported by
the noise monitoring system
ii. An NRS (no response) threshold
b) For each ear in which two or more thresholds are available among the frequencies 1000,
2000, 3000, and 4000 Hz, calculate the threshold average of the available thresholds at
those frequencies.
NOTE: Use the 105 dB for NRS thresholds when calculating the frequency average:
c) If a threshold average can be calculated for at least one ear, a results summary will be
reported. Follow the instructions provided in #3, below
d) If a threshold average cannot be calculated for either ear, a results summary will not be
reported. Follow the instructions provided in #4 below.

3.

RESULTS A – for children with sufficient thresholds to produce a summary report.
Insert appropriate results text into the RESULTS A paragraph of the evaluation report.
a) If all available thresholds (at any tested frequency) are 15 dB HL in both ears, insert “show
that ’s hearing in within normal limits” in the RESULTS A paragraph.
b) If any available threshold (at any tested frequency) is > 15 dB HL in either ear, insert the text
from the audiometry results table given below in the RESULTS A paragraph. If sufficient
thresholds are available to calculate a frequency average for both ears, use the poorer (i.e.,
larger) threshold average to select the appropriate text.

PTA: PURE TONE AVERAGE (1000, 2000, 3000, 4000 HZ)
PTA < 20

20 ≤ PTA < 35

35 ≤ PTA < 50

50 ≤ PTA

show a slight
hearing loss which
would probably not
cause much
difficulty,

show a hearing loss
which may cause
to
miss some speech
sounds,

show a hearing loss
which could cause
to
have difficulty hearing
speech,

show a hearing loss
which could cause
to
have significant
trouble hearing speech
and other sounds,

4.

RESULTS B – for children with insufficient thresholds to produce a summary report.
Insert the RESULTS B paragraph of the evaluation report.

5.

Print the appropriate PHYSICIAN’S REFERRAL text in the evaluation report.
a) If any available threshold (at any tested frequency) is > 15 dB HL in either ear, print
PHYSICIAN’S REFERRAL TEXT A.
b) For all other children, print PHYSICIAN’S REFERRAL TEXT B.

6. Print the Hearing Thresholds table in the detailed evaluation report.
a) If at least one threshold exists at 1000, 3000, or 6000 Hz in either ear, print the larger results
table in report, as shown below:
’s Thresholds by Ear and Pitch
Pitch of Tested Sound (Hertz)
(lower)

1000

2000

3000

4000

6000

8000

(higher)

Right Ear Thresholds

(decibels)

Left Ear Thresholds

(decibels)

b) If no thresholds exist at 1000, 3000, or 6000 Hz in either ear, print the shorter results table in
the report, as shown below:
’s Thresholds by Ear and Pitch
Pitch of Tested Sound (Hertz)
(lower)

2000

4000

8000

(higher)

Right Ear Thresholds

(decibels)

Left Ear Thresholds

(decibels)

c) Insert audiometric thresholds into the appropriate cells in the table.
i. If there was no response at the limit of the audiometer for a particular frequency,
insert “NRS” into that cell and print the NRS legend below the table.
ii. If a threshold could not be obtained, insert “” into that cell and print the “”
legend below the table.
iii. If a threshold is less than or equal to the minimum testable threshold reported by the
noise monitoring system for that threshold, insert “” into that cell and print the
“” legend below the table.