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Vision and Hearing Program

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:

Who Must Be Screened  When Screening Must Be Done
  • 4-years-old by September 1 
  • Kindergartners
  • Any other first-time entrants 
    (4 years* through 12th grade) 
Within 120 days of admission 
 1st, 3rd, 5th and 7th graders  Anytime within the school year
(preferably within first semester) 
Although not required by Chapter 36, Department of Family and Protective Services licensed child care center and licensed child care home are encouraged to screen all children younger than 4 years of age who can reliably respond to the screening tests outlined in the Department of State Health Service's vision and hearing screening protocols. 
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.