APSO - APSO - Standard in Progress

Standards Currently in Process

APSO is currently working with subject matter experts across the profession on the following standards. Be sure to check back periodically or join our distribution list for announcements about proposed standards open for comment.

The following standards are currently in INITIAL DRAFT:

S5.1 Tinnitus Management
A standard for audiological management of patients with tinnitus

The following standards are currently in WIDESPREAD PROFESSIONAL REVIEW:

S1.1 General Audiology Intake Standards
This standard addresses processes that should be used and information that should be gathered during the intake process. From a new patient's first contact to performing the initial examination, the intake standard ensures that audiologist are follow
Comment period ends April 13, 2025

Patient communication is conducted in a clear, empathetic manner consistent with the patient's comprehension and their health literacy level.
Information is provided to and collected from the patient, patient’s family member, or legal representative using methods required for effective communication (e.g. hand-written, electronic, oral, or signed language).
The patient is encouraged to include communication partners (e.g., family members, significant others, companions, interpreters) throughout the visit.
During intake, information that is collected may include:
- Demographic and contact information.
- Legal and financial documents. This may include consent to treat, insurance, advance beneficiary notice, good faith estimate, HIPAA notice, release of medical information, prior authorization, or medical referral, as required.
- Chief complaint, history of present illness, and current symptoms including functional impact of hearing or balance deficit.
- Information related to medical and surgical history (including comorbidities), current medications, allergies, medical/specialist team members, and developmental concerns.
- Indications of ear disease which may require medical referral. These may include unilateral or sudden onset hearing loss, physical deformities of the outer ear, drainage, pain, or discomfort of the ear, unilateral or pulsatile tinnitus, dizziness, vertigo, or loss of balance.
- Social history, which may include marital status, sexual orientation and gender identity, employment history, recreational history of alcohol, drug, and tobacco use and environmental factors such as noise exposure history (military, occupational and recreational).
- History of tinnitus, including the nature, onset, and impact on patient's quality of life.
- Indicators of fall risk.
- Audiologic history (e.g. previous hearing examinations, hearing amplification devices) as available.
Specialized questionnaires are completed if relevant to appointment type. These often include measures of hearing handicap, tinnitus distress, mental health, and cognitive screenings.
Following collection of information, the audiologist determines the plan for evaluation.
Additional information continues to be collected throughout the course of the initial appointment and subsequent visits. This is reviewed periodically.

Please provide evidence-based feedback whenever possible. Comments are scored for quality of statements when reviewing them for final edits to the standard.

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S3.2 Diagnostic Hearing Evaluation for Pediatric Patients
A standard for the tasks and processes audiologists use to diagnose hearing changes in children.
Comment period ends April 13, 2025

The full proposed standard is below. Please complete the fields that follow to provide us with your comments. Thank you for helping to develop this standard!

Download a the full standard (with references)

This diagnostic hearing evaluation standard is intended for infants, young children, and those who have not reached an adult stage of development. The audiologist attending to the needs of patients determines whether pediatric or adult standards apply to each patient. Hearing-related services are provided within the patient’s given family/guardian setting, with respect to all aspects of diversity, equity, inclusion, and belonging.

The communication needs of infants and children are complex and change over time. Management of these needs is the responsibility of a multi-disciplinary professional team that includes the audiologist, the child (when applicable), parents, guardians, other family members, and caregivers (herein described as “caregivers”).
Audiologists select developmentally appropriate assessment methods based on the needs of each patient. Assessment decisions are based on the audiologist’s observation of the patient and their caregivers, along with information from the available case history.
Communication with patients and caregivers is conducted in a clear, empathetic manner that is family-centered and consistent with their preferred communication mode, cultural considerations, comprehension, and health literacy level.
A comprehensive patient history is gathered during the evaluation, considering caregiver dynamics, cultural factors, and any potential barriers to healthcare. This history covers the patient's past and current auditory and vestibular status, developmental milestones, and pertinent medical history, including any risk factors for hearing loss.
The goal of the pediatric diagnostic hearing evaluation is to obtain a reliable and valid audiological assessment that includes ear- and frequency-specific information to quantify hearing sensitivity. If the audiologist is unable to quantify hearing sensitivity via behavioral methods, additional measures of auditory function may be necessary in addition to the assessments described below.
The audiologist performs otoscopy (visual inspection of the outer ear, ear canal, and eardrum), documenting any abnormalities.
The audiologist uses appropriate tests to establish frequency-specific air conduction thresholds for as many frequencies as possible, considering the patient’s attentiveness, reliability, and developmental level. Frequencies tested should include at least one low and one high frequency in the range of 250 Hz – 8000 Hz. Ear-specific thresholds are needed to rule out unilateral hearing loss.
When air conduction thresholds are abnormal, frequency-specific bone conduction thresholds are obtained to help determine the type of hearing loss.
Speech awareness or speech reception thresholds are obtained using developmentally appropriate materials to verify agreement with frequency-specific findings.
Acoustic immittance measurements are obtained to evaluate the function of the middle ear and to aid in the differential diagnosis of hearing status.
Otoacoustic emissions are measured to evaluate cochlear function and to aid in the differential diagnosis of hearing status.
Audiologists utilize cross-checks p to validate ear- and frequency-specific data.
Additional testing sessions may be necessary to obtain a complete auditory profile.
The audiologist may determine that evaluation with auditory evoked potentials is necessary when other testing is impractical, inconclusive, or unsuccessful.
For patients with confirmed hearing loss or risk factors for late-onset or progressive hearing loss, periodic monitoring is completed under the direction of the audiologist.
The audiologist may administer screenings or recommend additional evaluations based on the needs of the patient. These may include other audiological, vestibular, physical, behavioral, developmental, or medical evaluations.
The audiologist may refer for additional communication, educational, social, and caregiver support.
Options for intervention are reviewed with the patient and their caregivers when persistent and significant elevation of hearing thresholds or other hearing differences impact communication and learning.
Written documentation of the diagnostic hearing evaluation is maintained as part of the patient record. Written records are thorough and sufficient for patient follow-up as well as sharing with other providers, staff, departments, or facilities.
Results and recommendations are communicated to the patient, family, their caregivers, state agencies, care team, and educational team as appropriate.

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The following standards are currently in FINAL DRAFT:

S4.1 Cerumen Management
This standard describes the processes utilized by audiologists for management and removal of cerumen.

Other Standards Information

Published Standards
APSO publishes all standards without restriction so they are available to all audiologists. Visit our published standards page to view our approved standards. more

Proposed Standards
All standards are opened to the the profession for comment. Watch our proposed standards page for new standards that are planned for development. visit