Welcome to the training on Hearing and Vision Screening provided by the Texas Health and Human Services Commission (HHSC) and the Texas Department of State Health Services (DSHS).
Goal
The goal of this module is to equip Texas Health Steps providers and others to implement legal requirements and best practices for early and periodic screening of hearing and vision in children and adolescents.
Target Audience
Texas Health Steps providers and other interested health-care professionals.
Specific Learning Objectives
After completing the activities of this module, you will be able to:
- Evaluate causes of hearing and vision loss and the role of screening in early detection and treatment.
- Apply protocols for hearing screening of newborns, children, and adolescents; coordinate with school-based screenings; and provide appropriate follow up and referral as required.
- Apply protocols for ocular health and vision screening of newborns, children, and adolescents, coordinate with school-based screenings, and provide appropriate follow-up and referral as required.
Please note this module expires on 3/6/2023.
This module was released on 3/6/2020.
Accreditation Statement
Continuing Medical Education
The Texas Department of State Health Services, Continuing Education Service is accredited by the Texas Medical Association to provide continuing medical education for physicians.
The Texas Department of State Health Services, Continuing Education Service designates this enduring material for a maximum of 1.50 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Continuing Nursing Education
The Texas Department of State Health Services, Continuing Education Service is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation. The Texas Department of State Health Services, Continuing Education Service has awarded 1.50 contact hour(s) of Continuing Nursing Education.
Social Workers
The Texas Department of State Health Services, Continuing Education Service under sponsor number CS3065 has been approved by the Texas State Board of Social Worker Examiners to offer continuing education contact hours to social workers. The approved status of The Texas Department of State Health Services, Continuing Education Service expires annually on December 31. The Texas Department of State Health Services, Continuing Education Service has awarded 1.50 contact hour(s) of Continuing Social Work Education.
Certificate of Attendance
The Texas Department of State Health Services, Continuing Education Service has designated 1.50 hour(s) for attendance.
Certified Community Health Worker
The Texas Department of State Health Services, Promotor(a)/Community Health Worker Training and Certification Program has certified this course for 1.50 contact hour(s) of continuing education for Certified Community Health Workers and Community Health Worker Instructors.
Disclosures
One of the requirements of continuing education is disclosure of the following information to the learner:
- Notice of requirements for successful completion of continuing education activity. To receive continuing education credit the learner must successfully complete the following activities:
- Create a Texas Health Steps account.
- Complete on-line registration process.
- Thoroughly read the content of the module.
- Complete the on-line examination.
- Complete the evaluation.
- Commercial Support.
The THSTEPS Web-based Continuing Education Series has received no commercial support. - Disclosure of Relevant Financial Relationships.
The THSTEPS Continuing Education Planning Committee and the authors of these modules have no relevant financial relationships to disclose. - Non-Endorsement Statement.
Accredited status does not imply endorsement of any commercial products or services by the Department of State Health Services, Continuing Education Service; Texas Medical Association; or American Nurse Credentialing Center. - Off-Label Use.
Using a disclosure review process, the THSTEPS Continuing Education Planning Committee has examined documents and has concluded that the authors of these modules have not included content that discusses off-label use (use of products for a purpose other than that for which they were approved by the Food and Drug Administration).
The following are policies and definitions of terms related to continuing education disclosure:
The intent of disclosure is to allow Department of State Health Services (DSHS) Continuing Education Service the opportunity to resolve any potential conflicts of interest to assure balance, independence, objectivity and scientific rigor in all of its Continuing Education activities.
All faculty, planners, speakers and authors of Department of State Health Services (DSHS) Continuing Education Service sponsored activities are expected to disclose to the Department of State Health Services (DSHS) Continuing Education Service any relevant financial, relationships with any commercial or personal interest that produces health care goods or services concerned with the content of an educational presentation. Faculty, planners, speakers and authors must also disclose where there are any other potentially biasing relationships of a professional or personal nature.
Glossary of Terms
Conflict of Interest: Circumstances create a conflict of interest when an individual has an opportunity to affect Continuing Education content about products or services of a commercial interest with which she/he has a financial relationship or where there are any other potentially biasing relationships of a professional or personal nature.
Commercial Interest: Any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients.
Financial Relationships: Those relationships in which the individual benefits by receiving a salary, royalty, intellectual property rights, consulting fee, honoraria, ownership interest (e.g., stocks, stock options or other ownership interest, excluding diversified mutual funds), or other financial benefit. Financial benefits are usually associated with roles such as employment, management position, independent contractor (including contracted research), consulting, teaching, membership on advisory committees or review panels, board membership, and other activities for which remuneration is received or expected. Relevant financial relationships would include those within the past 12 months of the person involved in the activity and a spouse or partner. Relevant financial relationships of your spouse or partner are those of which you are aware at the time of this disclosure.
Off Label: Using products for a purpose other that that for which it was approved by the Food and Drug Administration (FDA).
Browser Requirements
Texas Health Steps courses are best viewed using a current browser. If you are using an out-of-date browser or a version of Internet Explorer less than 11, lesson progress and interactive features may not function properly.
American Academy of Pediatrics. (2018). Screening Examination of Premature Infants for Retinopathy of Prematurity. Pediatrics, 142(6):e20183061.
American Academy of Pediatrics & Joint Committee on Infant Hearing. (2007). Year 2007 Position Statement: Principles and Guidelines for Early Hearing Detection and Intervention Programs. Pediatrics, 120(4): 898-921.
American Association for Pediatric Ophthalmology and Strabismus. (2013). Vision Screening Kit.
Biotinidase deficiency:
- GeneReviews. Click this GeneReviews link for additional information about biotinidase deficiency.
- Texas Health and Human Services Commission, Children with Special Health Care Needs (CSHCN) Services Program can be contacted for more information on biotidinase deficiency at 800-252-8023.
- Texas Department of State Health Services. (2015). ACT Sheet on Biotinidase Deficiency.
Centers for Disease Control and Prevention. (2019). Babies Born with CMV (Congenital CMV Infection).
Centers for Disease Control and Prevention. (2019). Cytomegalovirus (CMV) and Congenital CMV Infection.
Joint Committee on Infant Hearing. (2019). Year 2019 Position Statement: Principles and Guidelines for Early Hearing Detection and Intervention Programs. The Journal of Early Hearing Detection and Intervention, 4(2):1-44.
National Institute on Deafness and Other Communication Disorders, resources web page about auditory neuropathy.
Schrank, L. W. (2003). Is Baby OK? Assessing Development. Chicago, IL: The Learning Seed.
Texas Department of State Health Services. (2019). Hearing Screening Manual-Student.
Texas Department of State Health Services. (2019). Vision Screening Manual-Student.
Texas Department of State Health Services. (2016). Hearing and Vision Screening Program. Provides information for registering and calibrating audiometers.
Texas Department of State Health Services. Audiometric Laboratory, for registration.
Texas Department of State Health Services. Hearing Checklist for Parents.
Texas Early Hearing Detection and Intervention (TEHDI) web page from DSHS offers information on becoming certified to perform audiometric screenings.
Texas Early Learning Council. (2013). Texas Infant, Toddler, and Three-Year-Old Early Learning Guides.
Texas Health and Human Services Commission. (2019). Children with Special Health Care Needs (CSHCN) Services Program.
Texas Health and Human Services Early Childhood Intervention (ECI) referral form.
Texas Health and Human Services Early Childhood Intervention Program Search.
Texas Health and Safety Code, Chapter 36 related to audiometers. Audiometers must be properly registered, electronically calibrated, and maintained on a monthly as well as on a long-term basis, so review to learn how to adhere to the laws.
Texas Medicaid & Healthcare Partnership. (2019). Texas Medicaid Provider Procedures Manual.
Texas Medicaid & Healthcare Partnership, Online Provider Lookup. Providers also can call the Texas Health Steps toll-free help line for assistance at 877-847-8377 (877-THSTEPS) Monday through Friday from 8 a.m. to 6 p.m. Central Time.
Texas Medicaid & Healthcare Partnership, Vision Care Eyeglass Patient Certification Form.
U.S. Department of Health and Human Services, National Institutes of Health, National Institute on Deafness and Other Communication Disorders. (2018). Auditory Neuropathy.
World Health Organization report, Make Listening Safe.
Word Health Organization, toolkit on voluntary standards for personal listening devices.
American Academy of Pediatrics. (2018). Screening Examination of Premature Infants for Retinopathy of Prematurity. Pediatrics, 142(6):e20183061.
American Academy of Pediatrics. (2018). Newborn Hearing Screening FAQs. Healthychildren.org.
American Academy of Pediatrics. (2016). Visual System Assessment in Infants, Children, and Young Adults by Pediatricians. Pediatrics, 137(1), e20153596.
American Academy of Pediatrics. (2012). Instrument-Based Pediatric Vision Screening Policy Statement. Pediatrics, 130(5):983-986.
American Academy of Pediatrics. (2008). Red Reflex Examination in Neonates, Infants, and Children. Pediatrics, 122(6):1401-1404.
American Academy of Pediatrics. (2002, reaffirmed 2008). Policy Statement: The Medical Home. Pediatrics, 110:184–186.
American Academy of Pediatrics, Joint Committee on Infant Hearing. (2007). Year 2007 Position Statement: Principles and Guidelines for Early Hearing Detection and Intervention Programs. Pediatrics, 120(4):898-921.
American Association for Pediatric Ophthalmology and Strabismus. (n.d.). Vision Screening.
Centers for Disease Control and Prevention. (2019). Screening and Diagnosis of Hearing Loss.
Centers for Disease Control and Prevention. (2019). Cytomegalovirus and Congenital CMV Infection: About Cytomegalovirus.
Centers for Disease Control and Prevention. (2019). Cytomegalovirus and Congenital CMV Infection: Laboratory Testing.
Centers for Disease Control and Prevention. (2016). Keep an Eye on Your Vision Health.
Centers for Disease Control and Prevention. National Center on Birth Defects and Developmental Disabilities. (2012). Genetics of Hearing Loss.
Child and Adolescent Health Measurement Initiative, Data Resource Center for Child and Adolescent Health. (2012). 2011/12 National Survey of Children's Health. Johns Hopkins Bloomberg School of Public Health.
Contemporary Pediatrics. (2016). Hearing loss and the pediatrician.
Donahue, S., Baker C., American Academy of Pediatrics, American Association for Pediatric Ophthalmology and Strabismus, American Academy of Ophthalmology, & American Association of Certified Orthoptists. (2016). Procedures for the Evaluation of the Visual System by Pediatricians. Pediatrics, 137(1).
Foust, T., Eiserman, W., Shisler, L., & Geroso, A. (2013). Using Otoacoustic Emissions to Screen Young Children for Hearing Loss in Primary Care Settings. Pediatrics, 132(1):118-123. [Abstract].
Grossman, D. C., & the U.S. Preventive Services Task Force. (2017). Vision Screening in Children Aged 6 Months to Five Years: U.S. Preventive Task Force Recommendation Statement. JAMA, 318(9):836-844.
Jeffries, A. L. (2010). Retinopathy of prematurity: Recommendations for screening. Paediatrics & Child Health, 15(10):667-670.
Jiang, W., Zhao, F., Guderley, N., & Manchaiah, V. (2016). Daily music exposure dose and hearing problems using personal listening devices in adolescents and young adults: A systematic review. International Journal of Audiology, 55(4):197-205.
Joint Committee on Infant Hearing. (2019). Year 2019 Position Statement: Principles and Guidelines for Early Hearing Detection and Intervention Programs. The Journal of Early Hearing Detection and Intervention, 4(2):1-44.
Kral, A. & O'Donoghue, G. M. (2010). Profound deafness in childhood. The New England Journal of Medicine, 363(15):1438–1450.
Loh, A. R., & Chiang, M. F. (2018). Pediatric Vision Screening. Pediatrics in Review, 39(5):225-234.
National Center for Children’s Vision & Eye Health. (2016). Children’s Vision and Eye Health: A Snapshot of Current National Issues.
Ruderman, M. (2016). Children’s Vision and Eye Health: A Snapshot of Current National Issues (1st ed.). Chicago, IL: National Center for Children’s Vision and Eye Health at Prevent Blindness.
Su, B. M., & Chan, D. K. (2017). Prevalence of Hearing Loss in US Children and Adolescents: Findings From NHANES 1988-2010. JAMA Otolaryngology—Head & Neck Surgery, 143(9):920-927.
Texas Department of State Health Services. (2019). Hearing Screening Manual-Student.
Texas Department of State Health Services. (2019). Vision Screening Manual-Student.
Texas Department of State Health Services. (2018). 2018 Healthy Texas Mothers & Babies Data Book.
Texas Department of State Health Services. (2018). Vision, Hearing, and Spinal Screening Programs: Implementing Changes in the Vision, Hearing and Spinal Screening Programs for School Year 2018-2019. Webinar PowerPoint.
Texas Department of State Health Services. (2019). Vision and Hearing Screening Program.
Texas Department of State Health Services. (2018). Texas Health Steps Medical Checkup Periodicity Schedule for Infants, Children, and Adolescents.
Texas Department of State Health Services. (n.d.). Hearing Checklist for Parents.
Texas Health and Human Services Commission. (2019). Children with Special Health Care Needs (CSHCN) Services Program.
Texas Health and Human Services Commission. (n.d.). Early Childhood Intervention Services.
Texas Medicaid & Healthcare Partnership. (2019). Texas Medicaid Provider Procedures Manual.
U.S. Preventive Services Task Force. (2017). Vision in Children Ages 6 months to 5 Years: Screening.
Vasconcellos, A. P., Kyle, M. E., Gilani, S., & Shin, J. J. (2014). Personally Modifiable Risk Factors Associated with Pediatric Hearing Loss: A Systematic Review. JAMA Otolaryngology—Head & Neck Surgery, 151(1):14–28.
World Health Organization. (2015). Make Listening Safe.
Wrightson, A. S. (2007). Universal newborn hearing screening. American Family Physician, 75(9): 1,349–1,352.
Ying, G., Maguire, M. G., Cyert, L. A., Ciner, E., Quinn, G. E., Kulp, M. T., . . . Vision in Preschoolers (VIP) Study Group. (2014). Prevalence of Vision Disorders by Racial and Ethnic Group among Children Participating in Head Start. Ophthalmology, 121(3):630-636.
Yoshinaga-Itano, C., Sedey, A. L., Wiggin, M., & Chung, W. (2017). Early Hearing Detection and Vocabulary of Children With Hearing Loss. Pediatrics, 140(2):2016-2964.
The medical definitions provided in this module were obtained or adapted from the American Association for Pediatric Ophthalmology and Strabismus, Centers for Disease Control and Prevention, Dorland’s Medical Dictionary for Health Consumers, the FreeDictionary, KidsHealth from Nemours, Mayo Clinic, MedlinePlus, Medscape, National Institute on Deafness and Other Communication Disorders, National Institute of Neurological Disorders and Stroke, National Library of Medicine, and NewYorkPresbyterian.org.
