Health Screenings

The Vision and Hearing Screening Program at the Texas Department of State Health Services (DSHS) works to identify children with vision and hearing disorders who attend public or private preschools and schools.

Vision and Hearing Screening Requirements
As part of Health and Safety Code, Chapter 36, the Hearing and Vision Screening Program requires that all children enrolled for the first time in any public, private, parochial, or denominational school or in a Department of Family and Protective Services (DFPS) licensed child care center and licensed child care home in Texas, or who meet certain grade criteria, must be screened or have a professional examination for possible vision problems.
The requirements for vision screening apply each year for children enrolled in any licensed child care center and licensed child care home or school program at the ages or grades listed below.

 

 

Vision Screening Procedures
For vision screening, a distance acuity for the right and left eyes must be recorded, e.g., 20/20, 20/30, etc. Approved charts for distance acuity testing include: (1) Sloan Letter Chart and (2) HOTV Matching-Symbol Test.

Photoscreening may be used for individuals through five years of age and those with disabilities who do not respond well to other allowable screening methods. If automated screening device is used, pass/fail documentation of results should be recorded. (Muscle balance tests - Hirschberg corneal light reflex and cover-uncover tests - will be included in the certification workshops and are optional tests.)
Approved methods for screening children for vision problems:
The gold standard for testing visual acuity in children 6 and older is an approved eye chart.
• Children 6 and older = approved visual acuity wall chart or approved visual acuity wall chart & photoscreener
• Children through 5 years = photoscreener
• Children with disabilities (at any age) who do not respond well to the visual acuity eye wall chart = photoscreener
Note: Children 6 and older, who have a disability and do not allow visual acuity to be tested with an approved eye chart, can be tested using a photoscreeners. However, children in this group who pass photoscreening may still need to be referred for further evaluation at the schools’ discretion.

Hearing Screening Procedures
For hearing screening, the results of the pure-tone audiometric Sweep-Check Screen must be recorded for both the right and left ears. A Sweep-Check Screen is to be conducted at an intensity less than or equal to 25 dB; at the following frequencies: 1000, 2000, and 4000 Hertz.

Texas Risk Assessment for Type 2 Diabetes in Children (TRAT2DC) will be done on all 1st, 3rd, 5th, and 7th graders per state law. This screening evaluates for a black-brown thickening of the skin in a line that usually appears on the back of the neck. It can be caused by too much insulin in the blood. It may indicate a pre-diabetic condition and a risk factor for Type 2 diabetes. Students identified as having this skin marker will have their height and weight recorded, BMI calculated and blood pressure checked twice. Parents will be notified by the school nurse if risk factors associated with Type 2 diabetes are found in their child.

 

An individual is exempt from risk assessment if risk assessment conflicts with the tenets and practices of a recognized church or religious denomination of which the individual is an adherent or a member. To qualify for the exemption, the individual or, if the individual is a minor, the individual's parent, managing conservator, or guardian must submit to the school nurse on or before the day of the risk assessment process an affidavit stating the objections to the risk assessment.

School-based spinal screening helps identify adolescents with abnormal spinal curvature and refer them for appropriate follow-up by their physician. Screening can detect scoliosis at an early stage, when the curve is mild and may go unnoticed. Early detection is key to controlling spinal deformities.

All students will be screened for abnormal spinal curvature before the end of the school year in accordance with DSHS Spinal Screening schedule.  Also, students entering the district who are past the grades of the screening requirement, but who, according to school records, have never been screened will also be screened.

Spinal screening is non-invasive and conducted following the most recent, nationally accepted and peer-reviewed standards for spinal screening.

Exceptions from spinal screening:
• The school has documentation from a licensed professional that the individual is actively under medical care for one or more spinal problems.
• The school has documentation that the screening was performed by a qualified individual at the appropriate age (10 or 12 year old for girls; 13 years old for boys).
• The school has an acceptable affidavit stating one of the following:

1) The spinal screening will be conducted by a qualified individual outside the school. The parent or guardian must then provide proof the screening has occurred within 60 days of the signed affidavit.
2) The spinal screening conflicts with religious tenets. The parent will need to complete an ‘Affidavit of Religious Exemption’.