Spinal Screening Program

Sign up for e-mail updates.

    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 by their primary care physician. 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. 

    Announcements

    Draft Letter for Students Who Have Missed or Will Miss a Vision or Hearing Screening:  

    Dear Parent/Guardian:  

    Due to challenges presented by the COVID-19 pandemic, your child has not received a vision or hearing screening. Vision and hearing problems can affect a child’s wellbeing and their ability to learn.   

    The Department of State Health Services encourages parents to take their children to a medical provider for well child exams. During these appointments you can ask for screenings. If your child is screened, we encourage you to send us the results of those screens for our records.  
    Signs of a possible vision problem include:   

    • Squinting
    • Tilting the head
    • Sitting too close to the television
    • Constant eye rubbing
    • Abnormal alignment or movement of the eyes

    Signs of a possible hearing problem include:   

    • Your child wants volumes louder than other members of the family
    • Your child often says “What?”
    • It seems like your child isn’t listening
    • Your child seems to hear fine sometimes and not others

    If you think your child has a vision or hearing problem, please contact the school nurse. Discuss your concerns with them right away.  

    Sincerely,

    Draft Letter for Students Who Have Missed or Will Miss a Spinal Screening:  

    Dear Parent/Guardian:  

    Due to challenges presented by the COVID-19 pandemic, your child has not received a spinal screening. Spinal screening can detect abnormal spinal curvatures at an early stage. Early detection is important for controlling spinal deformities.

    The Department of State Health Services encourages parents to take their children to a medical provider for well child exams. During these appointments you can ask for your child to receive a spinal screening. If your child is screened, we encourage you to send us the results of the screen for our records.     

    Signs your child may have an abnormal spinal curvature:

    • Uneven shoulders or hips
    • Ribs that are prominent or stick out in one area
    • Muscles that are prominent in the lower back or bulge on one side

    If you think your child has an abnormal spinal curvature, please contact the school nurse. Discuss your concerns with them.

    Sincerely,

    Vision, Hearing and Spinal Screening Updates  

    The program is currently determining if screening rules will be in effect this year due to the extra challenges to schools posed by the COVID-19 pandemic.  We will notify stakeholders as soon as a decision is reached.  In the meantime, for schools who are screening students, please refer to this best practices document for guidance on safely screening children this school year.  

    The Vision, Hearing and Spinal Screening Program (VHSS) will offer virtual Vision and Hearing Basic workshops beginning Sept 1, 2020 for individuals who do not have a current vision and hearing certification.  Please contact the Regional Coordinator for your area for more information and to sign up for training. Regional Coordinator contact information can be found on our website: https://dshs.texas.gov/vhs/regions.shtm  

    Please email vhssprogram@dshs.texas.gov if you have any questions.

    Vision, Hearing, Spinal Screening

    Regarding Screening Rules During 2020-2021 School Year  

    ANNOUNCEMENT:

    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 child cares with the capacity to screen should notify parents and follow best practices previous 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 assistance 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 Child Health Reporting System (CHRS) opens for 2020-2021 reporting on January 15 and closes June 30.  School districts and child cares who conducted screenings should enter their screening results as usual.  The schools and child cares who were unable to screen children this year due to COVID-19 should still report in CHRS by entering zeroes in the number fields.  Doing this indicates the school districts and child cares have reported their data and will not appear on the “Did Not Report” list.

    Instructions for adding zeroes are located under “Announcements” on our website located at: www.dshs.texas.gov/vhs .  

    Please contact the Vision, Hearing and Spinal Screening Program at vhssprogram@dshs.texas.gov if you have questions or concerns.
     

    Draft Letter for Students Who Have Missed or Will Miss a Vision or Hearing Screening (5th grade reading level):

     

    Dear Parent/Guardian:  

    Due to challenges presented by the COVID-19 pandemic, your child has not received a vision or hearing screening. Vision and hearing problems can affect a child’s wellbeing and their ability to learn.   

    The Department of State Health Services encourages parents to take their children to a medical provider for well child exams. During these appointments you can ask for screenings. If your child is screened, we encourage you to send us the results of those screens for our records.  
    Signs of a possible vision problem include:   

    • Squinting
    • Tilting the head
    • Sitting too close to the television
    • Constant eye rubbing
    • Abnormal alignment or movement of the eyes

    Signs of a possible hearing problem include:   

    • Your child wants volumes louder than other members of the family
    • Your child often says “What?”
    • It seems like your child isn’t listening
    • Your child seems to hear fine sometimes and not others

    If you think your child has a vision or hearing problem, please contact the school nurse. Discuss your concerns with them right away.

     

    Sincerely,

       

    Draft Letter for Students Who Have Missed or Will Miss a Spinal Screening (7th grade reading level):

     

    Dear Parent/Guardian:  

    Due to challenges presented by the COVID-19 pandemic, your child has not received a spinal screening. Spinal screening can detect abnormal spinal curvatures at an early stage. Early detection is important for controlling spinal deformities.

    The Department of State Health Services encourages parents to take their children to a medical provider for well child exams. During these appointments you can ask for your child to receive a spinal screening. If your child is screened, we encourage you to send us the results of the screen for our records.     

    Signs your child may have an abnormal spinal curvature:

    • Uneven shoulders or hips
    • Ribs that are prominent or stick out in one area
    • Muscles that are prominent in the lower back or bulge on one side  

    If you think your child has an abnormal spinal curvature, please contact the school nurse. Discuss your concerns with them.

     

    Sincerely,


    Schools should follow these guidelines for students to obtain 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 parent to please bring student receiving online instructions to the school so screenings may be performed in accordance with the statutes
    • In lieu of the screening(s) provided by the school:
      1. parents or guardians may provide screening record signed by a licensed professional
      2. parents or guardians may provide signed statement that the vision, hearing or spinal screening conflicts with the tenets and practices of a church or religious denomination of which the affiant is an adherent or member


    SUBJECT: INSTRUCTIONS FOR SUBMITTING VISION, HEARING AND SPINAL SCREENING ANNUAL REPORTS FOR FACILITIES THAT WERE UNABLE TO SCREEN FOR THE 2020-2021 SCHOOL YEAR (ADDING ZEROES).


    Vision, Hearing and Spinal Screening and Reporting Rules are Waived for 2019-2020 School Year. Optional reporting window for screenings already conducted extended to July 31.  

    • Due to COVID-19 and school closures, in accordance with section 418.016 of the Texas Government Code, the Office of the Governor grants the Department of State Health Services’ request to suspend HSC section 37.001(b), 25 TAC 37.144(c)(1), and 25 TAC 37.145(b)(5) for spinal screening and reporting, and HSC sections 36.004(a), 36.006(d), and 25 TAC 37.23(a), 25 TAC 37.24(a), and 25 TAC 37.26(b)(6) for hearing and vision screening and reporting. This suspension is in effect for the 2019-2020 school year.
    • Schools may report screening results of previously performed screenings by July 31st for the 2019-2020 school year if they elect to do so. Results can be submitted to DSHS online at the Child Health Reporting System (CHRS).  If you have any questions, please email VHSSprogram@dshs.texas.gov.

    Vision, Hearing and Spinal Screening Reporting Period Begins January 15

    The reporting period for vision, hearing and spinal screening (VHSS) begins on January 15, 2020. Results are required to be submitted to the Department of State Health Services online at the Child Health Reporting System (CHRS) by June 30 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 30, 2020. After June 30, the reporting system shuts down and late reporting cannot be submitted.

    Updated Spinal Screening Policy Effective 2018-2019 School Year

    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 Health and Safety Code, Chapter 37, all children shall undergo screening for abnormal spinal curvature in accordance with 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 fall semester of grade 8).

    It is incumbent on schools to identify outliers (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 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.

    Contact Us

    Texas Department of State Health Services 
    Spinal Screening Program - Mail Code 1818
    PO Box 149347 | Austin, Texas 78714-9347
    1100 West 49th Street | Austin, Texas 78756-3199
    Phone: 512-776-7420 | Toll Free 1-800-252-8023, extension 7420 
    Fax: 512-776-7256 
    Email: vhssprogram@dshs.texas.gov

    Last updated January 14, 2021