Among school-age children in the United States, it is estimated that nearly 15% have abnormal hearing in one or both ears (Niskar et al., 1998). With newborn hearing screening now available in nearly every state, many sensorineural hearing losses are identified prior to school entry. Even so, comprehensive hearing screening of school-age children is important, for several reasons. First, it will be years before universal infant hearing screening is fully implemented. Second, late-onset sensorineural loss may occur in the weeks or months following newborn screening, especially in young children with complicated birth histories (Centers for Disease Control and Prevention, 1997). Third, mild sensorineural loss can escape detection even when newborn hearing screening is provided (Joint Committee on Infant Hearing, 2000). In school-age children, acquired sensorineural hearing loss may occur as a result of disease or noise exposure. The effects of sensorineural hearing loss in children are well documented. Even mild, high-frequency, unilateral sensorineural hearing loss can have important developmental consequences (Bess, Dodd-Murphy, and Parker, 1998). More severe losses are likely to affect the development of speech, language, academic performance, and social-emotional development (Gallaudet University, 1998). In addition to sensorineural loss, hearing screening is needed to identify children with conductive hearing loss. In nearly all cases, conductive hearing loss in school-age children is due to otitis media. The incidence of otitis media with effusion (OME) is highest during the infant-toddler period and declines substantially by school age. Even so, otitis media is the most frequent primary diagnosis in children less than 15 years old (American Academy of Pediatrics, 1994). The hearing loss associated with OME, although mild and rarely permanent, can occur throughout childhood and may result in medical complications as well as potentially adverse effects on communication and development.