Vision and Hearing Screening
Training 2014-2015
Meeting Norms
Begin and end on time
Active participation and attention
Silence cell phones
Objectives
Identify students with vision and hearing
problems
Ensure that student’s vision and hearing
are adequate to access the curriculum
Make timely, appropriate referrals to
specialists for evaluation and follow-up
Who gets screened?
All students in 1
st
, 3
rd
, and 5
th
grades will
participate in State DHR mass screenings
Initial RTI referral
Special Education (IEP) Re-Evaluations
Any student suspected of vision or hearing
problems
When?
Mass vi-he screenings are scheduled
through elementary building
principals and do not require signed
permission from parent
Where?
Screenings take place in a quiet, well
lit, low traffic environment
empty classroom
closet
library
Mass Vision and
Hearing Screenings
Once a year: Grades 1, 3 and 5
Screening dates to be determined by building
administration
•
avoid standardized testing
•
avoid FTE counting periods
•
avoid cold and allergy season
Select screening location that has an electrical outlet
Set up audiometer on a table
Place eye chart on wall
Screen hearing
Screen vision
Vision & Hearing Screening Form
VISION – HEARING SCREENINGVISION: PASSED FAILED UNABLE TO TEST
HVOT WALL CHART/CARDS FUNCTIONAL VISION LEA SYMBOLS CHART
RIGHT EYE 10/ LEFT EYE 10/
Does child have glasses? Yes No If so, are they regularly worn? Yes No Were they worn during current screening? Yes No HEARING: PASSED FAILED UNABLE TO TEST
500 Hz 1000 Hz 2000 Hz 4000 Hz RIGHT EAR
LEFT EAR
Does child have hearing aids? Yes No See attached audiogram and report
Screen at 25 dB Response
No
Response
X
Administered By:
Date notification of failure to parent Date referred to Eye Doctor
Failed Hearing Form Letter
Date: _____________________
To the Parent or Guardian of:________________________
Your child did not pass the hearing screening which was recently completed at his/her school. It is recommended that he/she have a complete hearing
evaluation to see if there is a hearing problem which may need medical attention. You may obtain a hearing test in one of the following ways:
1. A referral has been made to the Bibb County Public Schools Audiology office. This evaluation is free of charge. Please contact Audiology Services at 779-2771 to schedule an appointment.
2. You may take your child, at your own expense, to a private ear specialist who has a licensed audiologist on staff. Take the attached hearing and
vision screening report with you and give it to the audiologist. Please provide the school with a copy of the evaluation results.
The ability to hear is very important to your child’s academic progress. Thank you for your cooperation.
Revised
Failed Vision Form Letter
Date: _____________________
To the Parent or Guardian of:________________________
Your child did not pass the vision screening which was recently completed at his/her school. It is recommended that he/she have a complete eye evaluation to see if there is a
vision problem which may need medical attention. You may obtain an eye evaluation in one of the following ways:
1. You may take your child, at your own expense, to a private eye specialist. Please take the attached hearing and vision screening form with you and give it to the eye specialist. Please provide the school with a copy of the examination results.
2. You may contact your child’s primary care physician for a referral to an optometrist or ophthalmologist. Please take the attached hearing and vision
screening form with you and give it to the eye specialist. Please provide the school with a copy of the examination results.
The ability to see is very important to your child’s academic progress. Thank you for your cooperation.
Failed Vision and Hearing
Screening Forms and Letters
Print forms on school letterhead
Keep copies of completed screening
forms and letters in alpha order by
grade level by school year
Mass Hearing Screening
Process
Initial
Hearing Screening
Pass
Results saved in
alpha order by
by grade level
Fail
Re-Screen
in 10 days
Pass
Results saved in
alpha order
by grade level
Fail
Mass Vision Screening Process
Initial Vision Screening
Pass
Results saved in
alpha order by
grade level
Fail
Re-Screen
in 10 days
Pass
Results saved in
alpha order by
grade level
Fail
Vision
Pass Fail Results to lead PEC teacher Re-screen in 10 days Pass Fail Obtain further professional evaluation Results to lead PEC teacherHearing
Pass Fail Results to lead PEC teacher Re-screen in 10 days Pass Fail Obtain further professional evaluation Results to lead PEC teacher Results to lead PEC teacher Continue re-eval process Results to lead PEC teacher Continue re-eval processWhat you need :
HOTV wall chart or Lea symbols card
Small cards for pre-testing with
single, large letters or Lea symbols
Functional Vision Screening form for
Getting Ready
Be sure that the student is 10 feet (3 meters) from
the wall chart or from where the cards will be
presented
Select the set of cards or the line on the wall chart
that is appropriate for the age of the student to be
screened
Ensure that the there is good room illumination so
that the letters or symbols are well lit when held in
the proper testing position
If the student is wearing distance glasses, or is
Test Procedure
Stand student on “feet” at 10
ft from the wall chart
Use the palm of his/her hand
to completely cover the eye.
No peeking!
Children under 4 years
read the 10/20 line (Lea
symbols or HOTV letters)
Children over 4 years read
the 10/15 line
Results
The student must correctly name half plus one
of the number of symbols on the line to pass.
(Ex: Lea symbols card 10/20 line has 5 symbols,
must name 3 correctly to pass; HOTV wall chart
line 10/15 has 6 symbols, must name 4
correctly to pass)
If the student is unable to correctly name or
match the correct number of symbols for each
eye, the student needs to be referred for a
comprehensive eye examination by an
Tell the child…
Keep encouraging the student to respond to your
questions. Urge the student to keep naming or
matching the letters/symbols even if the student
must guess.
Provide positive comments about the student’s
performance, regardless of whether the student
identifies the letter/symbols correctly or incorrectly.
Remind the student to look straight ahead at the
cards or the wall chart.
What to Record
Check Passed or
Failed
Check which test
was used
Record
distance/acuity (ex:
10/16) for each eye
referrals if needed
VISION – HEARING SCREENING
VISION: PASSED FAILED UNABLE TO TEST HVOT WALL CHART/CARDS PRE-SCHOOL FLASH CARDS TUMBLING E CHART LEA SYMBOLS CHART
RIGHT EYE LEFT EYE
HEARING: PASSED FAILED UNABLE TO TEST 500 Hz 1000 Hz 2000 Hz 4000 Hz RIGHT EAR LEFT EAR Administered By:
Date notification of failure to parent Date referred to Eye Doctor Date professional eval. returned Date referred to Audiologist
