Child Vision Management Standards in the United States

“I believe to my very core that EVERY child deserves the RIGHT to see, to learn and succeed! I will help and FIGHT to demand that EVERY state adopt a COMPREHENSIVE VISION SCREENING for EVERY SINGLE CHILD in our school systems in our nation. Currently the state of Arizona doesn’t have a policy at all and too many children are suffering and going undiagnosed. This causes serious problems with learning, vision loss, self esteem, jobs, economics and so on. NOT ONE MORE… not one more child should have to go undiagnosed for something that takes a few dollars and can truly change their life! check your state and the policy… ”

State-by- State Vision Screening Requirements

(SysOp’s note: There is great debate over the value of ‘screenings’. drboulet.com maintains the best standard is that of a comprehensive vision exam by an pediatric optometrist or ophthalmologist.)

Alabama

Code 16-29-1 (1965) states that the Department of Education and the State Board of Health are to arrange for the examination of each child attending public school in the state or any physical defects of any kind, embracing mental deficiency; diseases of the ear, eye, nose and throat, mouth and teeth; any deformity or dislocation of the hip joints or spinal disease; phymosis; hookworm disease and any and all other communicable or contagious diseases where the county or city board of education or State Department of Education has reason to believe a child has a communicable or contagious disease; and any disease requiring medical or surgical aid in developing the child into a strong and healthy individual.”

Alaska

Statute 14.30.127 (1982) requires a vision and hearing screening examination to be given to each child entering the school system, or soon thereafter, and at regular intervals specified by the district. The Department of Health and Social Services must set standards for the examination, train and certify public health nurses and school employees to administer the examination, assist with referring students who may need professional services, and assist with the maintenance and repair of the screening equipment.

Arkansas

Code 6-18-1501 (2005) requires all children in grades preK-2, 4, 6, and 8 to be given eye and vision tests as well as transfer students.

Arizona

No state policy.

Recommended annually through 6th grade. School district determines.

California

Education Code 49452 (no date available) requires the governing board of a school district to provide for the testing of hearing and vision each enrolled pupil within the district. Education Code 49455 (no date available) required students have their vision screened upon enrollment and at least every third year thereafter until completion of the 8th grade.

Colorado

Statute 22-1-116 (1981) requires all children in grades K-3, 5, 7, and 9 grades be referred for vision and hearing testing.

Connecticut

Statute Chapter 169, Section 10-214 (1996) requires each local or regional board of education to annually provide each pupil in K-6 and 9 a vision screening.

Delaware

Administrative Code 14:815 (2003) states, each public school student in kindergarten and in grades 2, 4, 7 and grades 9 or 10 shall receive a vision and a hearing screening by January 15th”. Additionally, screening shall also be provided to new enterers, students referred by a teacher or an administrator, and students considered for special education”.

DC

Required within 150 days prior to entering pre-kindergarten, kindergarten, 1st, 3rd, 5th, 7th, 9th, and 11th grades

Florida

Florida Statutes, defines “screening” to mean presumptive identification of unknown or unrecognized diseases or defects by the application of tests that can be given with ease and rapidity to apparently healthy persons. This section of statute also requires each county health department to develop, jointly with the district school board and the local school health advisory committee, a school health services plan. The local school health services plan must include provisions for vision and hearing screening. Rule 64F—6.003, Florida Administrative Code, specifies minimum grade level requirements for vision and hearing screening. Students in grades K, 1st, 3rd, 6th, and for students entering Florida schools for the first time in grades K through 5th.

Georgia

Code 20-2-770 authorizes the Department of Human Resources, along with the State Board of Education to promulgate rules to provide for an eye examination for each student entering first grade in the public schools, and at other times as such rules provide.

Hawaii

No state policy.

Idaho

No state policy.

Illinois

The Illinois School Code requires that a child has an eye exam prior to entering kindergarten or entering a public, private or parochial school for the first time.

410 ILCS 205/3 (1998) requires vision and hearing screening services to be administered to all children no later than their first year in public school.

Screenings required for all preschool children 3 years or older in any public or private educational program or licensed child-care facility, all school-aged children who are in K, 2nd, and 8th grades , in all special education classes, referred by teachers, and transfer students. Screenings are recommended for students in grade 4, 6, 10, and 12; shall be provided in all public, independent, private and parochial schools.

Indiana

State Board of Education 511 IAC 4-2-1 (1984) requires all school corporations to conduct annual visual acuity screening tests of all students enrolled in grades 3 and 8.

511 IAC 4-2-1.1 requires schools to conduct a visual acuity test of children when they enroll in either kindergarten or grade 1 unless an eye care professional requests, in writing, that the child not be tested.

Iowa

Code 280.7A (2009) requires schools to provide each parent who registers a child for kindergarten to provide each parent who registers a child for kindergarten a student vision card, with the goal of every child receiving an eye exam by age seven. 281 IAC 41.304(3) requires schools to collect information, and if appropriate assessment or evaluation of vision and hearing, prior to enrollment in special education.

Kansas

Statute 72-5205 (1959) requires each school board to provide basic vision screening without charge to every pupil not less than once every two years.

Statute 72-1205 (1969) requires school districts and accredited nonpublic schools to provide students with basic hearing screening without charge during the first year of admission and not less than once every three years thereafter.

Kentucky

Each local board of education is to require a preventative health care examination one year prior to a child seeking admission to school according to State Board of Education Regulation 704 KAR 4:020 (2000). The examination shall include a physical assessment, including hearing and vision screening and a local spinal screening program for scoliosis. Evidence of a vision examination that meets the criteria prescribed by the Kentucky Board of Education must be submitted to the school no later than Jan 1 of the first year that a 3, 4, 5, or 6-year old child is enrolled in a public school, public preschool, or Head Start program.

Louisiana

17:391.11 (1989) requires every child entering kindergarten for the first time to be given a nationally recognized readiness screening that measures a student’s proficiency in vision and hearing. RS 17:2112 (2003) also requires every local school board to test the sight, including color screening in 1st grade, and hearing during the first semester of the school year or within 30 days of admission into school.

Maine

Statute Title 20-A 6451 (2003) requires school districts to periodically screen for sight and hearing defects. DOE Rule

Chapter 45 provides for the specification of vision and hearing screenings – K,1st, 3rd, 5th, 7th, 9th; all new and transfer students should be screened upon entry

Maryland

SB 600 (2008) requires each county board to provide hearing and vision screening for all students in the first year of school entry into the system and first grade, and eighth or ninth grade. Only those students whose parents object in writing to hearing and vision screening due to religious beliefs may be exempt. State Board of Education Regulation 13A.05.05.10 (no date available) requires a room shall be provided for hearing screening tests and space and lighting requirements for the specific vision test used shall be made available.

Massachusetts

105 CMR 200.400 (1994) requires all public school students to have their vision and hearing tested annually.

Michigan

MCL 380.1177 (2000) requires children enrolling in kindergarten must provide evidence that their vision has been tested once since the age of 3.

Minnesota

Revised Statute 121A.17 Every school board must provide for a mandatory program of early childhood developmental screening for children at least once before school entrance, targeting children who are between three and four years old. This screening program must be established either by one board, by two or more boards acting in cooperation, by service cooperatives, by early childhood family education programs, or by other existing programs. This screening examination is a mandatory requirement for a student to continue attending kindergarten or first grade in a public school.

Missouri

Revised Statute 167.194 (2007) requires every child enrolling in kindergarten or first grade in a public elementary school to receive one comprehensive vision exam performed by a licensed optometrist or physician by January 1 of the first year the child is enrolled in school. Schedules and protocols for screenings for school age children can be found in the Guidelines for Hearing Screening (2004), the Guidelines for Vision Screening (2004), and the Guidelines for Spinal Screening in Schools (2004).

Mississippi

Code 41-79-5 (2000) requires school nurse intervention services to provide hearing and vision screening services.

Montana

No state policy. Recommend vision evaluation on periodic basis in order to identify those health problems which have the potential for interfering with learning.

Nebraska

Statute 79-248 (1996) requires each student to be carefully inspected” to identify whether the child suffers from defective sight or hearing. LB 114 more specifically requires a student to have received a visual evaluation by a physician, physician assistant, an advanced practice nurse, or an optometrist six months prior to school entry beginning with the 2006-07 school year and every year thereafter.

New Hampshire

No state policy.

NH School Health Resource Manual recommends screening at 3-5 yrs, K, 1st, 2nd, or 3rd grades, 4th or 5th grade, 7th or 8th grade, 10th or 11th grade- ideally screening would be performed annually.

North Carolina

Statute 130A-440 (2006) a vision screening in accordance with standards adopted by the Governor’s Commission on Early Childhood Vision care, within 180 days of the start of the school year. For children who receive and fail to pass a vision screening, a comprehensive eye examination is required. If a public school teacher, administrator, or other appropriate school personnel has reason to believe that a child enrolled in K-3 is having problems with vision, the school personnel may recommend to the parent that the child have a comprehensive eye examination. Funds may be available from the Governor’s Commission on Early Childhood Vision Care to pay providers for the examination, including corrective lenses. Once the comprehensive exam is completed, the parent shall submit a provider-signed transmittal form to the school.

North Dakota

No state policy.

Nevada

NRS 392.420 (2001) requires schools to provide tests for visual and auditory problems in at least two grades of the elementary schools, one grade of the middle or junior high schools, and one grade of the high schools”.

New Mexico

NMSA 24-1-30 through 24-1-32 (2007) created the Save Our Children’s Sight Fund and requires vision screening tests to be administered to students enrolled in the school in pre-kindergarten, kindergarten, first grade and third grade and for transfer and new students in those grades, unless a parent affirmatively prohibits the visual screening. The statute also requires the Department of Health to promulgate rules for the award of money for certain eligible students from the fund along with rules to establish vision screening test standards based upon a DOH Secretary-appointed advisory committee’s recommendation.

New Jersey

N.J.S.A. 18A:40-4 requires a screening of hearing examination to be conducted on each pupil during the school year. State Board of Education Administrative Code N.J.A.C. 6A:16-2.2(k) requires biennial screening for visual acuity in kindergarten through grade 10.

New York

Education Law 905 (no date available) requires schools to perform vision and hearing tests of all students “at such times defined by the regulations of the commissioner.

Ohio

ORC 3313.673 (1990) requires students, prior to November 1st of the school year in which they are enrolled in kindergarten or the first grade, to be screened for vision, hearing, and health or medical problems and for any developmental disorders. ORC 3313.69 (1953) requires a test to determine the existence of hearing and vision defects in school children. The methods of making such tests and the devices to be used shall be approved by the department of health.

Oklahoma

§70-1210.284 (2006) requires the parent or guardian of each student enrolled in kindergarten in public school to prevent a certification to school personnel that the student passed a vision screening during the previous 12 months. Parents of students enrolled in first and third grade must present a certification to school personnel within 30 days of the beginning of the school year confirming that the student passed a vision screening during the previous 12 months. Students who do not pass a vision exam will receive a recommendation for a comprehensive eye examination. The ophthalmologist or optometrist shall forward a written report of the comprehensive eye exam to the school, parent or guardian and health care provider.

Oregon

OAR 581-022-0705 (1996) requires school districts to provide vision and hearing screening

Pennsylvania

028 PA Code 23.1 (1959), per 24 P.S. 14-1402 (1966), states that each child shall be given a vision test and hearing test as outlined in 028 PA Code 23.4 which states that vision screening tests shall be conducted annually by a nurse, teacher or medical technician. The Snellen Chart or other screening device approved by the Department of Health shall be utilized for vision screening.

Puerto Rico

Rhode Island

Statute 16-21-14 (1961) requires hearing and vision screening tests be provided for schools statewide. Statute 16-21-14.1 (2006) requires a vision screening upon entering kindergarten or within 30 days of the start of the school year. Section 9.0 of the Rules and Regulations for School Health (2009) requires each student receive a vision screening at a minimum upon school entry and in the 1st, 2nd, 3rd, 4th, 5th, 7th, and 9th grades.

South Carolina

No state policy. Memo from Dept of Health recommends screening at K, 1st, 3rd, 5th, 7th, 9th and 11th

South Dakota

No state policy.

Tennessee

At a minimum, all students in grades PreK, K, 2, 4, 6, and 8 shall receive a vision screening once a year. Screening one year of high school is optional, however whatever year of high school that is selected must be then screened year after year. For example, if the wellness classes were chosen then wellness classes should be screened every year thereafter. If a PreK student has already been screened prior to school entry, then the data from their permanent record can be used instead of re-screening these students. At any point, a student can be referred for screening per local school district

protocol.

Texas

Health and Safety Code 36.001 requires the screening of individuals who attend public or private preschools or schools to detect hearing and vision disorders as specified by the Board of Education. The Vision and Hearing Screening Requirements require vision screening for all 4 year olds, kindergarten entrants and all other first-time entrants. In addition, a vision screening is required for 1st, 3rd, 5th and 7th graders.

Utah

Code 53A-11-201 (1996) also requires each local school board to implement rules as prescribed by the Department of Health for vision, dental, abnormal spinal curvature, and hearing examinations of students attending the district’s schools. Code 53A-11-203 (2010) requires children entering school under the age of eight to have a vision screening. Each school district may conduct free vision screening clinics for children aged 3 1/2 to 8. The statute also authorizes districts to provide free vision screening for children ages 8 and older, establishes guidelines for administering a free vision screening programs, and establish penalties for a violation of certain provisions related to free vision screenings.

Vermont

16 VSA 1422 (2009) requires periodic hearing and vision screening of school-aged children screening by primary care providers and school districts based on research-based guidelines developed by the commissioner of health in consultation with the commissioner of education. Each year in grades 1, 2, 3, 5, 7,and 9 and any pupil who appears to have defective vision or appears to be need for test.

Virginia

Code 22.1-273 (1995) calls for the principal of each school identified by the school board to ensure the testing of sight and hearing of relevant pupils unless it was included as part of the examination required in Code 22.1-270 (2004).

Washington

RCW 28A.210.020 (1971) requires all school boards to provide vision and hearing screening for their students.

WAC 246-760 Schools shall conduct auditory and visual screening of children:

(1) In kindergarten and grades one, two, three, five, and seven; and

(2) For any child showing symptoms of possible loss in auditory or visual acuity referred to the district by parents, guardians, or school staff.

(3) If resources permit, schools shall annually screen children at other grade levels.

Personnel conducting the screening must use a Snellen test chart for screening for distance central vision acuity. Either the Snellen E chart or the standard Snellen distance acuity chart may be used as appropriate to the child’s age and abilities. The test chart must be properly illuminated and glare free. Other screening procedures equivalent to the Snellen test may be used only if approved by the state board of health.

West Virginia

Code 18-5-17 requires new school enterers to be screened for vision, hearing and speech and language prior to enrollment. Development screenings are performed upon request from parent or community member. State Board of Education Policy 2525 requires all PreK students to have an EPSDT(HealthCheck) on file prior to enrollment or 45 days after enrollment which in inclusive of hearing, vision, speech & language, developmental and dental.

Wisconsin

Statute 118.135 (2001) requires each school board and each charter school to request each pupil entering kindergarten to provide evidence that the pupil has had his or her eyes examined by a [licensed] optometrist or evaluated by a [licensed] physician”. This statute also encourages, but does not require, physicians and optometrists to provide free examinations for those in financial need.

Wyoming

Rule 4362, Chapter VI (2001) requires the district to provide an organized program that identifies potential and existing health problems through routine hearing and vision screenings performed by qualified personnel.