Babble Chart

							                                                    Approved by Health Advisory on 1/30/08
                                                   Approved by the Policy Council __3/8/08
                                                             Approved by Board __4/17/08

SPCAA Head Start Program
Policy & procedure
Child Health and Developmental Services

Subject:     Vision and Hearing Screening

Source:      Performance Standards and Minimum Standards

Reference: 1304.20 (b) (1),                   746.603 & 746.629



Policy:
Vision and Hearing are important for development, physical activity, and social
interactions. Early identification and treatment of Vision and Hearing problems
can help promote a child’s development.

Procedure:
   1. Within the first 45 calendar days of the child’s entry into the program Head
      Start employee will screen child for any possible vision and hearing loss if
      not documented on the Child Health Record (physical exam form).

   2. For those centers that are licensed by TDFPS, vision and hearing results
      may be obtained from the Child Health Record (physical exam form). If it
      is not on the Child Health Record, Head Start employees will then
      complete a vision and or hearing screening. Copies will be placed in the
      child’s brown folder. For those centers licensed by TDFPS a copy of the
      screenings are placed in the child’s TDFPS folder.

   3. Family Support Workers (FSW) have primary responsibility for ensuring
      that the vision and hearing screening is completed within the 45 calendar
      days from entry into Head Start/Early Head Start. Center staff that is
      certified to perform screenings may assist the FSW.

   4. If the Family Support Workers/Center Director need assistance with the
      vision and hearing screenings, they should send an email or phone call
      requesting assistance to their Team Leader (TL), Health Manager and or
      Health Assistant.

   5. If vision, strabismus and or hearing is not completed on the physical then
      the FSW is responsible for entering the screenings and or referral into the
      Child Plus system. When the vision, strabismus and or hearing is

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   completed on the child’s physical form, then Data Entry will enter the
   information into the Child Plus system.

6. The vision screening instrument used by SPCAA Head Start is a standard
   eye chart. Many of the partners use the Snellen E eye chart.

7. Strabismus known as Muscle balance test- Hirschberg corneal light reflex
   and cover/uncover test are part of the screening.

8. What to observe for in vision problems
      Eyes that cross or point outward
      Frequent blinking, squinting, or rubbing eyes
      Difficulty picking up small objects, catching balls, or seeing objects
      Holding books and objects unusually close
      Short attention for visual activities
      Frequent complaints of eye discomfort, headaches, or dizziness

9. The passing line (the line which must be read to pass the test) is, 20/40.
   The chart must be eye level of the child to be screened.

10. In order for a child to pass he/she must read more than half the symbols
    on the 20/40 line or more than two-line difference in vision between one
    eye and the other on the standard eye chart.

11. What to observe for in hearing problems

      An infant does not startle at noises, turns to voices, or babble at seven
      to 12 months of age
     A child has difficulty with listing activities
     A child with speech is:
              Limited compared to children at that age
              Not easily understood
              Very loud or soft or sounds unusual
     A child has frequent earaches

12. If a child fails the vision screening of either or both eyes, re-screening will
    be done within 2 weeks of the date of the 1st failed eye screening.

13. The pure-tone audiometer Sweep-Check screening will be completed on
    all Head Start children. The screening consists of three frequencies, which
    must be done on both ears.

14. Children failing to respond to one (of the three) frequencies in either ear
    should be re-screened with another Sweep-Cheek with in 2 weeks from 1st
    failed screening.


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15. With in one week of the second failed screening for vision and or hearing
    a referral will be completed by the screener and submitted to the Health
    Manager and disability staff. The Disability staff will work with the
    classroom staff and other center staff on modifications of the educational
    environment.

16. Health Manager, along with Family Support Workers will ensure proper
    referral is submitted to a health care provider.

17. SPCAA Head Start utilizes the Vision Service Plan, Sight for Students
    Program for those children who have no Medicaid, or insurance.


18. The Vision and Hearing screening report is compiled and sent to the State
    Health Department by June 30 of each program year.




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