Vision, Hearing and Spinal Screening

The Texas Department of State Health Services Vision, Hearing and Spinal Screening requirements mandate that all children must be screened or have a professional examination for possible vision, hearing  and spinal curvature problems.

The Vision and Hearing requirements 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:

  • Children who turn 4-years-old by September 1, kindergartners or any other first-time entrants (4 years* through 12th grade) - screening must be done within 120 days of admission

  • 1st-, 3rd-, 5th- and 7th graders - screening must be done anytime within the school year (preferably within 120 days)

The requirements for Spinal Screening apply each year for all children who attend public and private schools, to detect abnormal spinal curvature in accordance with the following schedule:

  • Girls (two times) - screening must be done at age 10 (or fall semester of grade 5) and age 12 (or fall semester of grade 7)

  • Boys (one time) - age 13 or 14 (of fall semester of grade 8)

A student may be exempted from the mandated Spinal Screening if the parent/guardian submits a record to the school nurse prior to the spinal screening at the campus. The  professional examination must be properly conducted during the grade year in which the screening is required. The TX UIL Preparticipation Physical Evaluation-Medical History Form meets this requirement. The documentation must be signed and dated by a licensed professional.  ​​

Click here to learn more about these requirements.


Photoscreening is a form of pediatric vision screening that uses a special-purpose camera to determine how well a child can see. It is an alternative to visual acuity-based screening with an eye chart for certain children, as specified in state rules. Other related terms are: autorefractor, objective screening and instrument-based screening. Photoscreening cannot determine exactly how well a child’s visual acuity is developing. Important factors that affect visual acuity such as accommodative ability (focusing ability), binocular vision development and other eye health issues are not assessed via photoscreening.

Photoscreening is a method of screening recommended by the American Academy of Pediatric Ophthalmology & Strabismus that may be used for screening children through age 5. In addition, photoscreening may be used for children with disabilities who do not respond well to other allowable screening methods. A referral for a professional examination is required if the child fails the photoscreening.

Texas Risk Assessment for Type 2 Diabetes

The Texas Risk Assessment for Type 2 Diabetes in Children is a legislatively mandated program developed, coordinated, and administrated by The University of Texas Pan-American Border Health Office (BHO). The program assesses children who may be at high risk of developing Type 2 Diabetes in Texas Education Agency Regional Education Service Centers 1, 2, 3, 4, 10, 11, 13, 15, 18, 19, and 20. During vision/hearing and scoliosis screenings of 1st, 3rd, 5th, and 7th graders in public and private schools, certified individuals assess children for the acanthosis nigricans marker, a skin condition that signals high insulin levels. Children who are positively identified with the marker undergo additional assessments of body mass index (BMI), BMI percentile, and blood pressure. Referrals are issued to the parents of these children, alerting each parent of their child's risk factors and encouraging further evaluation from a health professional. Becoming aware of and understanding what the risk factors suggest can help stimulate the changes necessary to prevent or delay future health problems for children at risk of developing Type 2 Diabetes and other conditions.

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