Teaching · Speech & Language

Rule out the ears before you test the words.

Record every hearing screening the family or the file shows, ear by ear, along with ear infections, tubes and what the family notices at home. The intake gives the latest result for each ear, flags a referred ear with no later pass, and lists the health facts the speech-language pathologist should know.

Start an intakeWhat you get
$12one-time · every device you sign in on
Buy · $12

Included with Caveat Classroom and Whole-school licenses. Or get it in the Speech & Language toolkit, $79 for 72 items.

The intake form

One intake per student, keyed by initials or a code. Health details stay in this browser. The example is made up.

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What you get

Teaching · Speech & Language$12 · included with Classroom and Whole-school licenses

What you finish with
A medical and hearing history for each student: early health, ear infections and tubes, what the family notices at home, every hearing screening with the right and left ear results, health conditions that matter for communication, medicines, vision and the other providers involved. The summary gives each ear’s latest result and a follow-up list.
Who it is for
School speech-language pathologists, school nurses and special education case managers gathering health history before a speech-language screening or evaluation.
Format
Browser form for an interview or for records review. Several saved intakes; printed with the summary or as a blank interview form; CSV of every intake; export and import a file.
Access
$12 one-time, yours on every device you sign in on; the tool opens once you are signed in with it. Included with Caveat Classroom and Whole-school licenses. Also in the Speech & Language toolkit ($79) and the Teaching Suite pass ($199), and 1 more bundle. Everything you type stays in this browser; nothing is sent to Caveat.
Where it lives
The Speech & Language space in Caveat Teaching.
Support
Questions about an order, access or a correction: team@caveatacademic.com.
RL
Drawn for this page. Each ear has its own result; a referred ear with no later pass comes before any speech or language testing.

How to use it

  1. Start a record with the student’s initials or a code.
  2. Ask about early health, ear infections, tubes and what the family notices at home.
  3. List every hearing screening or test with the date, where it was done and each ear’s result. The summary always reads the latest result per ear.
  4. Mark health conditions that matter for communication and note medicines by name and purpose; no doses are needed.
  5. Check who else is involved and whether a release to share information is signed, then print the intake.

Start an intake

What the intake is for

Why hearing comes first

A hearing loss, even a mild or one-sided one, can look like a speech sound or language difficulty. Speech-language pathologists screen or confirm hearing before testing, and a student who does not pass a hearing screening is referred to an audiologist. The intake keeps every result in order and reads each ear’s most recent one, so a refer that was never followed up stands out.

Not a medical record

The intake records what the family reports and what school records show. It does not interpret a hearing test, judge a condition or suggest treatment. Ear infections and tubes are noted because they can come with fluctuating hearing; whether they matter for one child is for the audiologist and the child’s doctor.

Health information and privacy

At school, health records kept by school staff are education records under FERPA. Ask for a signed release before contacting outside providers. Records here use a code, never a name, and stay in this browser.

Sources

  1. American Speech-Language-Hearing Association. Practice Portal: Hearing Screening; Permanent Childhood Hearing Loss (asha.org/practice-portal).
  2. Rosenfeld, R. M., et al. (2016). Clinical practice guideline: Otitis media with effusion (update). Otolaryngology–Head and Neck Surgery, 154(1 Suppl), S1–S41.
  3. American Academy of Audiology (2011). Childhood Hearing Screening guidelines, on rescreening and referral after a failed screening.
  4. Individuals with Disabilities Education Act regulations, 34 CFR 300.304(c)(4) (the child is assessed in everything related to the suspected disability, including hearing).
  5. U.S. Departments of Education and Health and Human Services. Joint Guidance on the Application of FERPA and HIPAA to Student Health Records (updated 2019).

The example student is made up. The intake records reported history; it does not screen hearing, interpret results or give medical advice, and it holds no state rules. Support: team@caveatacademic.com.