Screening Manuals

Manuals are provided to participants at the time of training. There is no charge for training. Please contact your regional coordinator for more information.

Vision Screening Manual

Hearing Screening Manual


The vision screening manual is intended for use in conjunction with a vision screener training session conducted by a Department of State Health Services certified vision instructor. It provides information on standards for the administration of preschool and school vision screening tests, appropriate referral criteria, and the necessary referral procedures.

To become certified as a vision screener or an instructor of vision screeners, a person must meet specified training criteria. Certification is valid for five (5) years.

Within the state, many vision screening programs for children have progressed to levels beyond the minimum standards described in these guidelines. Vision screeners exceeding the minimum requirements are encouraged to continue to do so provided that:

  1. The screening method is professionally recognized as being valid for vision screening, and
  2. All persons performing such screening are trained by a professional knowledgeable in and experienced with the screening tool(s).

Vision Screening Program's Goals & Objectives for Screeners:

It is the goal of this program to equip each vision screener with the knowledge and skills necessary to make appropriate referrals for evaluation by a medical professional. To achieve this, vision screeners will be expected to meet the following objectives: 

  1. Recognize signs and symptoms associated with visual problems.
  2. Select and use materials to create an appropriate screening environment.
  3. Determine by the age of the child which of the three screening charts should be selected.
  4. Train the child to respond accurately to indicated target objects (symbols) on the selected chart.
  5. Pretest to determine whether training for distance acuity screening was effective and chart selection was appropriate to the child's developmental level.
  6. Demonstrate proper screening and record-keeping procedures for distance acuity, Hirschberg corneal light reflex, and cover and uncover tests.
  7. Determine the pass/fail, rescreen, and referral status of a child based on established criteria for two age groups.
  8. Demonstrate knowledge of appropriate follow-up procedures for children who fail the screen.
  9. Demonstrate knowledge of appropriate procedures for making statistical reports to the Department of State Health Services.



 In 1975, State regulations were passed that required the registration of all audiometers, users of audiometers, and firms calibrating audiometers for use in Texas. These same regulations (Chapter 401 of the Health and Safety Code) also required that users be trained by, or have training approved by, the Department of State Health Services. The Vision and Hearing Screening Program, Texas Health and Safety Code, Chapter 36, which was passed in the 1983 Legislative Session, mandates hearing screening for preschool- and school-age children, as well as the standards for such screening.

The hearing training manual deals primarily with the technical aspects of conducting hearing screening programs for preschool- and school-age children to differentiate between those who might have hearing problems and those who might not. This manual is an adjunct to the Audiometric Screening Techniques Workshops provided by Vision and Hearing Screening of the Department of State Health Services. It is not designed to stand alone as a complete textbook of all methods of hearing screening, nor should it be used by one screener to train another person in hearing screening techniques.

A hearing conservation program is part of a total school health program. It includes student education in devices and behaviors to prevent hearing loss; state-mandated screening procedures; treatment of professionally diagnosed cases; proper educational placement; and rehabilitation when necessary. Methods of carrying out individual programs will depend upon the availability of personnel and facilities in schools and local communities.

Screening is a means to identify those children who may have hearing loss. After the identification process is completed, an analysis of existing resources will identify which of those necessary follow-up services will be available locally. 

Objectives for a Hearing Screening Program:

There are four objectives of a hearing screening program:

  1. Identify children who may need diagnostic examination,
  2. Refer these children for professional examination and needed health services,
  3. Follow-up on referrals to encourage that professional and medical recommendations are carried out, and
  4. Convey information to the educational staff concerning the child's hearing difficulty diagnosed by professional personnel, so that recommended adjustments can be made in the educational program.