School Vision and Hearing Screening

Health Screeners carry out a vision and hearing test for children in school in their reception year.

If you have any concerns about your child’s vision or hearing, or if your child has any specific health or development needs, telephone: 01904 555475 (Monday to Friday, 9.00am to 4.30pm) or email: [email protected].

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Hearing Screening

Routine hearing tests are offered to newborn babies and children to identify any hearing problems early on in their development.

Find further information about hearing tests:

Early testing in children is important to detect and treat hearing problems early as this may affect their speech development or progress in school.

When should you complete a hearing screening

Within a few weeks of birth, the newborn hearing screening will be carried out and is routine for all children, even those having a home birth will be invited to come to hospital for this. See the NHS Newborn hearing test for more information.

As part of the Healthy Child Service and during babies and children’s reviews, you'll be asked about any concerns about your babies or child’s hearing and hearing tests can be arranged if necessary.

The school hearing test is carried out in school by trained hearing screeners from the Healthy Child Service. Screening will usually happen in the term of a child’s fifth birthday. Hearing screening in this local authority uses opt-out consent. This means that parents and carers only need to respond if you do not want your child to receive the screening. When your child has the screening test, you'll only be notified that it has happened if the child does not pass the test. If any follow-up tests are required, the Audiology team at York Teaching Hospital will contact you.

Your child’s hearing can also be checked at any other time if you have any concerns.

If you have any concerns about your child’s hearing at any time, speak to a GP or contact the Healthy Child service on telephone: 01904 555475 (Monday to Friday, 9.00am to 4.30pm) or email: [email protected].

How the hearing screening is completed

During the Pure tone audiometry (school age hearing test) your child carries out a simple listening game. The game involves your child wearing headphones and clapping their hands if they hear a noise.

Headphones are worn by your child and a machine generates sounds at different volumes and frequencies. Your child is asked to respond when they hear the sounds by clapping.

By changing the level of the sound, the tester can work out the quietest sounds your child can hear. The NHS has some more information on hearing tests and how the test is done.

The Hearing Screeners have had extensive training and have many years of experience in testing hearing in 4- to 5-year-olds.

Missed tests

If a child is absent on the day of screening or unable to perform the screening test then a further test will be scheduled, usually within 3 months. If they are still unable to perform the test, they will be referred to Audiology at the hospital. If your child has additional needs and the screener believes the test, they are using isn’t suitable for your child then they will refer you to the Audiology department at the hospital who are able to use different methods of testing hearing that are more suitable.

The hearing screening is not compulsory

The hearing screening is not compulsory, you can choose if you want your child to be screened or not. Consent is opt-out which means that if you do not want your child to have the hearing test you need to state that you want to opt-out on the forms that you're sent when your child starts in Reception class. If you change your mind at any time as to whether your child is tested or not you can contact the Healthy Child Service and they will update your child’s record in line with your request.

Outcome of the screening

You'll not be informed of the outcome of the test if your child passes the test. You'll only be contacted if they do not pass the screening test. If you wish to know more about the outcome of the test you can contact the Healthy Child Service to request further information.

If any follow-up tests are required, you will be informed via letter and the Audiology team at York Teaching Hospital will contact you with an appointment.

If you have any concerns about your child’s hearing screening or their hearing, please contact the Healthy Child service on telephone: 01904 555475 (Monday to Friday, 9.00am to 4.30pm) or email: [email protected].

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Vision Screening

Vision screening is when a child’s vision is tested in school to detect Amblyopia. Amblyopia is more commonly known as a “lazy eye” and means that the vision in one or both eyes hasn’t developed properly. It is estimated that 1 in 50 children will develop this condition.

The aim of screening is to detect reduced vision in one or both eyes.

You can find out more about eye tests in children online.

In addition, read:

Young children rarely complain about having reduced vision. They are usually unaware that their vision is weaker than normal in one or both eyes. There are often no visible signs so problems can easily go unnoticed. Children with reduced vision in one or both eyes don’t usually complain of headaches or ‘eyestrain.’

Reduced vision due to a ‘Lazy eye’ (Amblyopia) can be treated successfully in younger children, therefore early detection is important so that treatment with glasses, eye patches or both can be started. Treatment for amblyopia has been shown to be less successful beyond approximately eight years of age. If amblyopia goes undetected it can result in lifelong reduced vision.

It is recommended by the UK national screening committee (UKNSC) that standardised vision screening should be offered to all children aged 4- to 5-years-old.

Location of the test

The test is carried out in school by trained vision screeners from the Healthy Child Service. Screening will usually happen in the term of a child’s fifth birthday. Vision screening in this local authority uses opt-out consent. This means that parents/carers only need to respond if you do not want your child to receive the screening.

Testing at 4 to 5 years allows a simple vision test to be carried out that is accurate enough to detect genuinely reduced vision, whilst minimising the number of children referred for further testing unnecessarily.

Additionally, testing in a familiar environment such as school improves confidence and ability to cooperate. This also enables screening to be consistently delivered to almost all children in the area.

When your child has the screening test, you will only be notified that it has happened if the child does not pass the test.

The test

Children are tested in a quiet room within the school.

Each eye will be tested separately, by covering the other eye with a patch or glasses with one lens blanked out.

We'll then ask the child to either name or match letters on a card to the letters held 3 metres away. Children do not need to know their letters to complete the screening.

Testing a child typically takes no longer than 10 minutes.

It's not necessary for your child to know their letters; the screener will give them a card with the relevant letters on so that they can match the letter on the card to the one being shown if needed.

Accuracy of the test

The Vision Screeners have had extensive training and have many years of experience in testing vision in 4–5-year-olds. On average in the York area, over the last 5 years 86% of children referred to the Orthoptist from the Vision Screeners did have a vision problem.

Missing the test

If a child is absent on day of screening or unable to perform the screening test then a further test will be scheduled, usually within 3 months. If they are still unable to perform the test, they will be referred to the Orthoptist at the hospital eye service who can test vision using a different test. If your child has additional needs and the screener believes the test they are using isn’t suitable for your child then they will refer you to the Orthoptist at the hospital who are able to use different methods of testing vision that are more suitable.

The vision screening is not compulsory

You can choose if you want your child to be screened or not. Consent is opt-out which means that if you do not want your child to have the vision test you need to state that you want to opt-out on the forms that you are sent when your child starts in Reception class. If you change your mind at any time as to whether your child is tested or not you can contact the Healthy Child team and they will update your child’s record in line with your request.

Results of the screening

You'll not be informed of the outcome of the test if your child passes the test. You'll only be contacted if they do not pass the screening test. If you wish to know more about the outcome of the test you can contact the Healthy Child team to request further information.

If your child fails the screening test with one or both eyes, the Healthy Child team you will send you a letter advising you of this. They will also send a referral letter to the Hospital Eye Service requesting an assessment with the Orthoptist and an appointment will be sent out for your child to be seen.

At the hospital, your child will see an Orthoptist for further assessment which will consist of repeating the vision test done at school but will also assess whether your child has a squint(strabismus) or any other potential problem that may affect how their vision develops.

Orthoptists are allied health professionals who specialise in testing vision and detecting visual problems in children. They are experts in the assessment of visual defects in young children. They are also uniquely qualified to offer services for children with learning disabilities or with specific needs who require an alternative method of testing.

Opting-out

If your child has already seen an Orthoptist or a High Street Optometrist or if they already wear glasses, they do not need to have the screening test done. You can opt-out by letting the screening service know on the consent form that your child already attends a High Street Optometrist or that they already wear glasses.

However, if you have not opted out and your child isn’t wearing glasses on the day or that the screeners aren’t aware that your child already has glasses, they may still be screened.

If you have been advised that your child failed their screening and you prefer to take your child to see a High Street Optometrist rather than the Hospital, this is OK - it is your choice as to where you want your child to be seen. If the High Street Optometrist feels your child has an eye problem that requires treatment or management by an Orthoptist or Ophthalmologist, they will then refer you into the Hospital Eye Service.

If after screening you have chosen to go to a High Street Optometrist, please let the Screening Service or the Hospital know so that you’re not sent an appointment when you no longer need one and this appointment can then be offered to someone else.

Glasses

If the Orthoptic assessment confirms reduced vision, then an appointment with the Hospital Optician will be arranged, who also specialise in testing children’s eyes. Unfortunately, children are not able to do the same sort of test for glasses as an adult. With adults and older children, we can undertake a more subjective test, which means they can tell us what looks better. Younger children cannot do this reliably, so by using dilating drops this allows us to do a very accurate glasses check. The drops dilate the pupil and relax the focusing muscles of the eye which blurs the vision temporarily and make the pupil (the black bit of the eye) bigger. The optometrist is then able to determine if your child needs glasses and what strength they need. The test can be quick, easy, and reliably accurate.

After vision screening

Like all screening tests, vision screening is not 100% perfect but should find most problems. Children’s’ vision will change over time and vision screening may not pick up less common eye problems.

If your child complains of any problems with their eyes after their screening assessment, we recommend you take your child to any high street optometrist or your GP.

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