Spinal Screening Program

The Texas Department of State Health Services (DSHS) Spinal Screening Program was established by the Texas Legislature to detect abnormal spinal curvature in students. The program is required to adopt rules as mandated by the statute

School-based spinal screening helps to identify adolescents with abnormal spinal curves and refer them for appropriate follow-up with their doctor. Screening can detect scoliosis at an early stage when the curve is mild and may go unnoticed. Early detection is key to controlling spinal deformities. 


Provisional Certificate Holders   

This is a reminder that your vision, hearing and spinal screening certification has expired. Please contact your vision, hearing, and spinal screening regional coordinators to schedule an in-person recertification class before the expiration date. Thank you for your cooperation. If you have questions please contact your regional coordinator or contact our customer service line at 512-776-7420, 1-800-252-8023 extension 7420, or vhssprogram@dshs.texas.gov.  

Regarding Screening Rules During Each School Year   

Health and Safety Code, Chapter 36 and 25 Texas Administrative Code Chapter 37 require Public, Private, Parochial, and Denominational Schools (Schools) and Department of Family and Protective Services (DFPS) Licensed Child Care Centers and Licensed Child Care Homes (Child Cares) to screen children for vision, hearing, and spinal problems. 

The Health Screening Group understands the challenges that schools and school districts are facing due to the COVID-19 pandemic.  Although screening is still required for this school year, DSHS understands the need for flexibility and advises schools and school districts to assess their capacity to safely conduct screenings.  Schools and childcares with the capacity to screen should notify parents and follow best practices previously developed by the department.  Parents who choose not to participate at this time may decline screenings. 

DSHS recommends schools notify the parents of children who have missed or will miss a screening. This notification should inform parents of the missed screening and encourage them to ask for screenings at their child’s next well-child appointment with their medical provider. If a parent suspects their child has a vision, hearing, or spinal problem they should notify the school nurse or school administration for help in obtaining a screening. The Health Screening Group has developed sample letters for parents for vision and hearing screening  and spinal screening that schools may use. The letters are also available in Spanish: vision and hearing screening - Spanish, spinal screening - Spanish

In Person/Online Instructions 

Schools should follow these guidelines for students to get vision, hearing, and spinal screenings that are receiving in-person or online instructions.   

  • Send a letter to parents notifying them in advance that screenings will be conducted on designated dates 

  • Request parents to please bring students receiving online instructions to the school so screenings may be performed in accordance with the statutes 

  • Instead of the screening(s) provided by the school: 
    a.      parents or guardians may provide screening records signed by a licensed professional 
    b.      parents or guardians may provide a signed statement that the vision, hearing or spinal screening conflicts with the views and practices of their religion 

Vision, Hearing and Spinal Screening Updates   

Schools who are screening students, please refer to this best practices document for guidance on safely screening children this school year.     

Vision, Hearing and Spinal Screening Reporting Period Begins January 15 

The reporting period for vision, hearing, and spinal screening (VHSS) begins on January 15th of each year. Results are required to be submitted to the Department of State Health Services online at the Child Health Reporting System (CHRS) by June 30th of each year.  View the vision, hearing and spinal screening annual reports flyer. 

The last day to submit your report for this school year is June 30th of each year.  After June 30, the reporting system shuts down and late reporting cannot be submitted. 

Spinal Screening Policy (Updated August 2018)

Due to feedback from stakeholders, the Spinal Screening Policy has been reviewed and updated regarding ages and grades to be screened for the 2018-2019 school year. In September 2015, the Scoliosis Research Society (SRS) published a joint position statement paper with the American Academy of Orthopedic Surgeons (AAOS), the Pediatric Orthopedic Society of North America (POSNA), and the American Academy of Pediatrics (AAP) and have the following recommendation: “AAOS, SRS, POSNA, and AAP believe that screening examinations for spine deformity should be part of the medical home preventative services visit for females at age 10 and 12 years, and males once at age 13 or 14 years.” 

Grade-based screening is considered an acceptable alternative to age-based screening in a school setting. The grades, however, must align with the professionally recommended ages so that most children are screened at the appropriate age, or as close to it as reasonably possible. 

In compliance with the Health and Safety Code, Chapter 37, all children must undergo screening for abnormal spinal curvature per the following schedule: 

  • Girls will be screened two times, once at age 10 (or fall semester of grade 5) and again at age 12 (or fall semester of grade 7). 

  • Boys will be screened one time at age 13 or 14 (or the fall semester of grade 8). 

Schools must identify exceptions (i.e., children promoted to higher grades or held back) and ensure their screenings align with appropriate ages rather than grades.  

Updated Program Guidelines and Spinal Screening Report (M-51)

The Spinal Screening Program Guidelines is the teaching manual for DSHS-approved spinal screening certification workshops. It has been updated to reflect the changes effective in the 2018-2019 school year. 

School districts, private school systems, and charter schools use Form M-51 to report cumulative totals of the spinal screenings conducted at each campus.