<<Prev Rule

Texas Administrative Code

Next Rule>>
TITLE 25HEALTH SERVICES
PART 1DEPARTMENT OF STATE HEALTH SERVICES
CHAPTER 37MATERNAL AND INFANT HEALTH SERVICES
SUBCHAPTER CVISION AND HEARING SCREENING
RULE §37.23Vision and Hearing Screening Requirements

(a) Screening for vision and hearing shall be performed by:

  (1) a licensed professional; or

  (2) an individual trained to conduct vision or hearing screening that is certified by the department.

(b) A vision screener shall use the following standards and procedures.

  (1) A vision screener shall test distance acuity for both eyes with one of the following charts or a telebinocular instrument with a distance acuity test capability:

    (A) Sloan Letter chart;

    (B) Snellen Letter chart;

    (C) Snellen "Tumbling E" chart; or

    (D) HOTV Crowded Test Set.

  (2) If a vision screener uses a telebinocular instrument to screen initially for distance acuity, any rescreens shall be conducted with one of the charts listed in paragraph (1) of this subsection.

  (3) A vision screener shall record visual acuity results using the "20/20" format.

  (4) A vision screener may use the following optional muscle-balance tests:

    (A) Hirschberg corneal light reflex test; or

    (B) cover and uncover test.

  (5) A vision screener shall refer for professional examination all children less than five years of age whose test results indicate visual acuity of less than 20/40 in either eye or a difference of two or more lines between passing acuities in either eye.

  (6) A vision screener shall refer for professional examination all children five years of age or older whose test results indicate less than 20/30 acuity in either eye.

(c) A hearing screener shall use the following standards and procedures:

  (1) a pure-tone audiometer with a sweep-check screen;

  (2) record screening results for both ears at less than or equal to 25 dB for 1000 Hz, 2000 Hz, and 4000 Hz;

  (3) recommend or perform a rescreen with another sweep-check if test results indicate failure to respond to any of the three frequencies in either ear, no sooner than three weeks but not more than four weeks after the initial screening was performed;

  (4) recommend or perform an extended recheck or initiate a referral for a professional examination for all children whose test results indicate failure to respond to any of the three frequencies in either ear on the second sweep-check;

  (5) recommend a professional examination if the extended recheck results in a failure to respond to any frequency; and

  (6) conduct an extended recheck according to the following procedures.

    (A) Beginning with the right ear, present the tone at 40 dB hearing level (HL) and at 1000 Hz for two to three seconds. If no response is obtained, record " > 40 dB".

    (B) If the child responds at 40 dB, lower the intensity to 30 dB HL and present the tone again.

    (C) Lower the HL in 10 dB increments until no response is obtained, or until 20 dB is reached. If a response is obtained at 20 dB, record "20 dB".

    (D) When no response is obtained, increase the HL dial in 5 dB increments until a response is obtained. Record the dB results obtained at 1000 Hz for the right ear.

    (E) Repeat steps in subparagraphs (A) - (D) of this paragraph at 40 dB HL for 2000 Hz and 4000 Hz.

    (F) Repeat steps in subparagraphs (A) - (E) of this paragraph for the left ear.

(d) All children enrolled in a facility shall be screened for vision and hearing problems in pre-kindergarten, kindergarten, first, third, fifth, and seventh grades before May 31 of each year.

(e) All children enrolled in a facility must be screened according to the following schedule.

  (1) Children four years of age or older, who are enrolled in any facility for the first time, must be screened for possible vision and hearing problems within 120 calendar days of enrollment. If a child is enrolled within 60 days of the date a facility closes for the summer, the child's vision and hearing must be tested by December 31 of that year.

  (2) Children previously enrolled in a facility who are four years of age on or before September 1, must be screened for possible vision and hearing problems by December 31.

  (3) Except for children enrolled in kindergarten or first grade, a facility shall exempt any child from screening as required by subsection (d) of this section if the child's parent or legal guardian submits proof to the facility that the child's vision and/or hearing has been screened within the prior reporting year.

(f) Upon written request approved by the department, the screening of vision and hearing in a school may occur in pre-kindergarten, kindergarten, and first, second, fourth, and sixth grades instead of pre-kindergarten, kindergarten, and first, third, fifth, and seventh grades.

(g) The parent(s), guardian(s), managing conservator(s), or person(s) having legal responsibility for the child's support may execute an affidavit stating that a person other than the screener used by the facility shall conduct the screening as soon as is feasible. The child may be admitted into the facility on a provisional basis, or the child may be denied admission, until the screening results are provided to the facility.

(h) A facility shall not require a child to be screened if the parent(s), guardian(s), managing conservator(s), or person(s) having a legal responsibility for the child's support submits to the facility, on or before the date vision or hearing screening is scheduled, an affidavit in lieu of the record of screening stating that the vision or hearing screening conflicts with the tenets or practices of a church or religious denomination of which the affiant is an adherent or member.


Source Note: The provisions of this §37.23 adopted to be effective August 1, 2004, 29 TexReg 3791

Next Page Previous Page



Home TxReg TAC OM NewTac Public Footer Bar