Source: http://apps.leg.wa.gov/WAC/default.aspx?cite=246-760&full=true
Timestamp: 2018-12-10 17:22:50
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Chapter 246-760 WAC:
WACs > Title 246 > Chapter 246-760
Chapter 246-760 WAC
AUDITORY AND VISUAL STANDARDS—SCHOOL DISTRICTS
246-760-001 Purpose and application of auditory and visual screening standards for school districts.
246-760-010 Definitions, abbreviations, and acronyms.
AUDITORY ACUITY STANDARDS
246-760-020 Frequency for schools to screen children.
246-760-030 What are the auditory acuity screening standards for screening equipment and procedures?
246-760-040 What are the procedures for auditory acuity screening?
246-760-050 What are the auditory acuity screening referral procedures?
246-760-060 What are the auditory acuity screening qualifications for personnel?
246-760-070 Vision screening.
246-760-071 Required and alternative vision screening tools and referral criteria.
246-760-080 Vision screening procedures.
246-760-100 Qualifications for the visual acuity screening personnel.
246-760-090 What are the visual acuity screening referral procedures? [Statutory Authority: RCW 28A.210.200. WSR 02-20-079, § 246-760-090, filed 9/30/02, effective 10/31/02. Statutory Authority: RCW 43.20.050. WSR 91-02-051 (Order 124B), recodified as § 246-760-090, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 28A.31.030. WSR 87-22-010 (Order 306), § 248-148-131, filed 10/26/87.] Repealed by WSR 17-03-009, filed 1/4/17, effective 7/1/17. Statutory Authority: RCW 28A.210.020.
246-760-001
Purpose and application of auditory and visual screening standards for school districts.
Each board of school directors in the state shall provide for and require screening of the auditory and visual acuity of children attending schools in their districts to determine if any child demonstrates auditory or visual problems that may negatively impact their learning. Each board of school directors shall establish procedures to implement these rules.
[Statutory Authority: RCW 28A.210.020. WSR 17-03-009, § 246-760-001, filed 1/4/17, effective 7/1/17. Statutory Authority: RCW 28A.210.200. WSR 02-20-079, § 246-760-001, filed 9/30/02, effective 10/31/02. Statutory Authority: RCW 43.20.050 and 28A.210.020. WSR 92-02-019 (Order 225B), § 246-760-001, filed 12/23/91, effective 1/23/92. Statutory Authority: RCW 43.20.050. WSR 91-02-051 (Order 124B), recodified as § 246-760-001, filed 12/27/90, effective 1/31/91; Order 63, § 248-144-010 (codified as WAC 248-148-010), filed 11/1/71.]
246-760-010
The definitions, abbreviations, and acronyms in this section apply throughout this chapter unless the context clearly requires otherwise.
(1) "AAPOS" or "American Association for Pediatric Ophthalmology and Strabismus" means the national organization that advances the quality of children's eye care, supports the training of pediatric ophthalmologists, supports research activities in pediatric ophthalmology, and advances the care of adults with strabismus.
(2) "Crowding bars" means four individual lines surrounding a single optotype.
(3) "Crowding box" or "surround box" means crowding bars on all four sides extended to form a crowding rectangle surrounding a single line of optotypes.
(4) "Distance vision" means the ability of the eye to see images clearly at a calibrated distance.
(5) "HOTV letters" means a test using the letters H, O, T, and V calibrated of a certain size used to assess visual acuity.
(6) "Instrument-based vision screening device" means a U.S. Food and Drug Administration approved instrument for vision screening that uses automated technology to provide information about amblyopia and reduced-vision risk factors such as estimates of refractive error and eye misalignment.
(7) "Lay person" means any individual who is conducting school-based vision screening other than a school nurse, a school principal or his or her designee, a licensed vision care professional, or an individual trained by and conducting vision screening on behalf of a nationally recognized service organization that utilizes a test-retest protocol for vision screening. This includes, but is not limited to, retired nurses, nursing students, parents, and school staff.
(8) "LEA vision test(s)" means a test used to measure visual acuity using specific symbols or numbers, designed for those who do not know how to read the letters of the alphabet.
(9) "Licensed vision care professional" means a licensed ophthalmologist or licensed optometrist.
(10) "Near vision acuity" means the ability of the human eye to see objects with clarity at close range, also termed near point acuity or near acuity.
(11) "Optotype" means figures, numbers or letters of different sizes used in testing visual acuity.
(12) "Principal's designee" means a public health nurse, special educator, teacher or administrator designated by the school principal and responsible for supervision, training, reporting and referral of vision screening in instances where the school nurse or school principal is not filling this role.
(13) "School nurse" means a registered nurse acting as the health professional in a school whose specialized practice and attendant tasks and activities advance student health, well-being and achievement; and conforms to Washington state educational and nursing laws according to chapters 18.79 RCW and 246-840 WAC, and WAC 181-79A-223.
(14) "Sloan letters" means a test using ten specially formed letters which include C, D, H, K, N, O, R, S, V and Z to assess visual acuity.
(15) "Test-retest protocol" means a method of screening where a screener conducts two or more screenings for any student who meets the referral criteria in order to ensure the reliability of the initial screening.
(16) "Visual acuity" refers to the ability of the visual system to discern fine distinctions in the environment as measured with printed or projected visual stimuli.
[Statutory Authority: RCW 28A.210.020. WSR 17-03-009, § 246-760-010, filed 1/4/17, effective 7/1/17.]
246-760-020
246-760-030
What are the auditory acuity screening standards for screening equipment and procedures?
(1) Schools shall use auditory screening equipment providing tonal stimuli at frequencies at one thousand, two thousand, and four thousand herz (Hz) at hearing levels of twenty decibels (dB), as measured at the earphones, in reference to American National Standards Institute (ANSI) 1996 standards.
(2) Qualified persons will check the calibration of frequencies and intensity at least every twelve months, at the earphones, using equipment designed for audiometer calibration.
[Statutory Authority: RCW 28A.210.200. WSR 02-20-079, § 246-760-030, filed 9/30/02, effective 10/31/02. Statutory Authority: RCW 43.20.050. WSR 91-02-051 (Order 124B), recodified as § 246-760-030, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 28A.31.030. WSR 87-22-010 (Order 306), § 248-148-031, filed 10/26/87.]
246-760-040
What are the procedures for auditory acuity screening?
(1) Schools shall screen all children referenced in WAC 246-760-020 on an individual basis at one thousand, two thousand, and four thousand Hz.
(2) The screener shall:
(a) Present each of the tonal stimuli at a hearing level of twenty dB based on the ANSI 1996 standards;
(b) Conduct screenings in an environment free of extraneous noise;
(c) If at all possible, complete screening within the first semester of each school year;
(d) Place the results of screenings, any referrals, and referral results in each student's health and/or school record; and
(e) Forward the results to the student's new school if the student transfers.
[Statutory Authority: RCW 28A.210.200. WSR 02-20-079, § 246-760-040, filed 9/30/02, effective 10/31/02. Statutory Authority: RCW 43.20.050 and 28A.210.020. WSR 92-02-019 (Order 225B), § 246-760-040, filed 12/23/91, effective 1/23/92. Statutory Authority: RCW 43.20.050. WSR 91-02-051 (Order 124B), recodified as § 246-760-040, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 28A.31.030. WSR 87-22-010 (Order 306), § 248-148-035, filed 10/26/87.]
246-760-050
What are the auditory acuity screening referral procedures?
(1) If a child does not respond to one or more frequencies in either ear:
(a) The school must rescreen the child within six weeks; and
(b) Notify their teachers of the need for preferential positioning in class because of the possibility of decreased hearing; and
(c) Notify the parents or legal guardian of the need for audiological evaluation if the student fails the second screening.
(2) Schools shall notify parents or legal guardian of the need for medical evaluation if:
(a) Indicated by audiological evaluation; or
(b) Audiological evaluation is not available.
[Statutory Authority: RCW 28A.210.200. WSR 02-20-079, § 246-760-050, filed 9/30/02, effective 10/31/02. Statutory Authority: RCW 43.20.050. WSR 91-02-051 (Order 124B), recodified as § 246-760-050, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 28A.31.030. WSR 87-22-010 (Order 306), § 248-148-091, filed 10/26/87.]
What are the auditory acuity screening qualifications for personnel?
Each school district shall designate a district audiologist or district staff member having:
(1) Responsibility for administering the auditory screening program; and
(2) Training and experience to:
(a) Develop an administrative plan for conducting auditory screening in cooperation with the appropriate school personnel to ensure the program is carried out efficiently and effectively;
(b) Obtain the necessary instrumentation for carrying out the screening program, and ensuring the equipment is in proper working order and calibration; and
(c) Secure appropriate personnel for carrying out the screening program, if assistance is necessary, and for assuring these personnel are sufficiently trained to:
(i) Understand the purposes and regulations involved in the auditory screening programs; and
(ii) Utilize the screening equipment to ensure maximum accuracy;
(d) Ensure records are made and distributed as appropriate; and
(e) Disseminate information to other school personnel familiarizing them with aspects of a child's behavior indicating the need for referral for auditory screening.
[Statutory Authority: RCW 28A.210.200. WSR 02-20-079, § 246-760-060, filed 9/30/02, effective 10/31/02. Statutory Authority: RCW 43.20.050. WSR 91-02-051 (Order 124B), recodified as § 246-760-060, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 28A.31.030. WSR 87-22-010 (Order 306), § 248-148-101, filed 10/26/87.]
246-760-070
246-760-071
Required and alternative vision screening tools and referral criteria.
(1) A school must use the standardized optotype-based distance vision and near vision acuity screening tools approved for each grade as well as the rescreening and referral criteria by grade outlined in Table 1 of this section. When using a screening tool with a single isolated optotype or a single line of optotypes, the tool must include the use of crowding bars or crowding boxes.
(2) A school may use an instrument-based vision screening device in lieu of the optotype-based tools outlined in this section. Referral using instrument-based vision screening devices is determined through the manufacturer's criteria. If the instrument-based screening device does not generate a result for a student, a school must screen that student using the optotype-based tools outlined in this section.
Rescreening and Referral Criteria
LEA vision test: Single LEA symbol (at 5 feet), or
HOTV letter
Visual acuity worse than 20/40 in either eye
Visual acuity worse than 20/32 in either eye
Grades two and above
LEA vision tests: LEA symbols or numbers, or HOTV letters, or Sloan letters
LEA vision tests: LEA symbols near vision, HOTV, or Sloan letters
Grade one and above
[Statutory Authority: RCW 28A.210.020. WSR 17-03-009, § 246-760-071, filed 1/4/17, effective 7/1/17.]
Vision screening procedures.
(1) A school shall:
(a) Screen children with their corrective lenses on;
(b) Place the results of screening, any referrals, and referral results in each student's health record; and
(c) Forward the results to the student's new school if the student transfers.
(2) If a student meets the referral criteria set forth in WAC 246-760-071 during the first vision screening and the screening was conducted by a lay person, then the school nurse, or the school principal or his or her designee as qualified under WAC 246-760-100(4) shall rescreen the student within two weeks or as soon as possible after the original screening before referring the child to a licensed vision care professional for an assessment.
(3) If the student meets the referral criteria set forth in WAC 246-760-071 during the first vision screening, and the screening was conducted by the school nurse; the school principal or his or her designee; a volunteer who is a licensed vision care professional; or an individual trained by and conducting vision screening on behalf of a nationally recognized service organization that utilizes a test-retest protocol for vision screening, a school may either refer the student after the first screening or rescreen the student at the discretion of the school nurse, or the school principal or his or her designee.
(4) A school shall notify a child's parent or guardian with a written referral if a child meets the referral criteria set forth in WAC 246-760-071 during:
(a) The first screening if a rescreening is not required; or
(b) The second screening if a rescreening is required or is conducted at the discretion of the school nurse, or the school principal or his or designee.
(5) This written referral shall indicate that school-based vision screening is not a substitute for a comprehensive eye examination, include the screening results, and include language recommending that:
(a) The parent or guardian take the child to a licensed vision care professional to receive a comprehensive eye examination; and
(b) An appropriate remedy, such as corrective lenses, be obtained if indicated.
(6) Only the school nurse, or the school principal or his or her designee may notify a child's parent or guardian in order to refer the student for professional care. A school nurse, or school principal or his or her designee shall notify parents or guardians in writing that their child should be evaluated by a licensed vision care professional when:
(a) The student meets the referral criteria for vision screening tests conducted under WAC 246-760-071; or
(b) The school nurse, or school principal or his or her designee observes other signs or symptoms related to eye problems that negatively impact the student's learning; or
(c) The student is unable to complete vision screening for any reason.
[Statutory Authority: RCW 28A.210.020. WSR 17-03-009, § 246-760-080, filed 1/4/17, effective 7/1/17. Statutory Authority: RCW 28A.210.200. WSR 02-20-079, § 246-760-080, filed 9/30/02, effective 10/31/02. Statutory Authority: RCW 43.20.050. WSR 91-02-051 (Order 124B), recodified as § 246-760-080, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 28A.31.030. WSR 87-22-010 (Order 306), § 248-148-123, filed 10/26/87.]
246-760-100