Caring 4 Kids
Nurse Consulting
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Hearing and Vision Screenings

Why is it important to check your child's hearing and vision?

Your child's health and ability to learn is our priority! Early identification and treatment of vision and hearing concerns can boost confidence, and support growth in learning, reading, social skills and behavior. 

Who can be screened? 

Hearing:  All children can be screened for hearing as we use an Otoacoustic emissions (OAEs) test. OAE are sounds given off by the inner ear when the cochlea is stimulated by a sound. When sound stimulates the cochlea, the outer hair cells vibrate. The vibration produces a nearly inaudible sound that echoes back into the middle ear. The sound can be measured with a small probe inserted into the ear canal. The OAE test is often part of a newborn hearing screening program. This test can detect blockage in the outer ear canal, as well as the presence of middle ear fluid and damage to the outer hair cells in the cochlea.

Vision: Children who are 2 1/2 year and older can have their vision screened by our cover test. However, the child must be able to identify four basic shapes (Circle, Square, House, and Heart/Apple). We are very patient and will work with your child to give them every opportunity to be successful at the cover test. We also test stereopsis for depth perception.

* Be sure your child brings their prescription glasses or contacts on the day of the screening.

* Please note that earwax build-up or ear infections can interfere with the hearing test and may result in a rescreen or referral for your child.

Recommendations for Specialist Referral

There are several factors and situations in which the Colorado Department of Education ( along with Caring 4 Kids recommends an automatic doctor referral or either hearing or vision specialist visit for your child if any of the following apply:

A. Health History: Medical concerns with higher incidence of vision and eye health problems

• Preterm or low birth weight (<3.5 lbs)

• Autism

• Hearing Impairments

• Speech/Language delays

• Down Syndrome

• Cerebral Palsy

• Fetal Alcohol Syndrome

• Fragile X

• Intellectual and Developmental Disabilities

• First-degree relatives with strabismus or amblyopia 

• Medications (e.g. ADHD medications)

B. Appearance of Eyes

• One eye turns in or out at any time; eyes are crossed

• Pupils/eyes appear different sizes

• Reddened eyes or lids

• Eyes tear excessively 

• Drainage encrusted eyelids

• Frequent styes or swollen lids

• Drooping lids

• Discharge from eyes

C. Behavioral signs of visual problems

1. Eye movement abilities (Ocular Motility) 

• Needs finger or marker to keep place

• Displays short attention span when reading or copying

• Frequently omits words

• Writes up or down hill on paper

• Rereads or skips lines unknowingly

• Unusual placement of drawings on paper

2. Binocular vision problems 

• Repeats letters within words

• Omits letters, numbers or phrases

• Misaligns digits in number columns

• Squints, closes or covers one eye

• Tilts head extremely while working at desk

• Consistently shows gross postural deviations with close work

• Only able to read for short periods of time

• Clumsy, runs into things

3. Near vision and fine motor skill abnormalities 

• Must feel things to assist in any interpretation required

• Writing is crooked, poorly spaced and child cannot stay on the ruled lines

• Misaligns both horizontal and vertical series of numbers

• Uses hand or fingers to keep place on the page

• Avoids near work, loses interest

4. Visual form perception (visual comparison, visual imagery, visualization) Distance

Vision, Near Vision

• Fails to recognize same word in next sentence

• Confuses same word in same sentence

• Repeatedly confuses similar beginnings and endings or words

• Whispers to self for reinforcement while reading silently

5. Refractive Status (Nearsightedness, Farsightedness, and Focus Problems)

Distance Vision, Near Vision 

• Comprehension decreases as reading continues; loses interest quickly

• Mispronounces similar words while reading

• Blinks excessively with close work and reading

• Holds book closely to face or face close to the desk top

• Avoids all near/close tasks

• Closes or covers one eye when reading or doing close work

• Makes errors in copying from reference book to paper

• Makes errors in copying from the board to paper

• Squints to see the board or overhead screen or asks to move nearer

• Rubs eyes during or after short periods of visual activity

• Fatigues easily

• Blinks excessively to “clear up” when changing focus from near to far

D. Complaints (student statements)

• Headaches in forehead or temples

• Burning or itching eyes after reading or desk work

• Nausea or dizziness

• Unable to see board

• Words move or jump

• Eye discomfort in tasks that demand visual attention

• Complains of seeing double (diplopia)

• Print blurs after reading a short time

• History of head injury 


If a child has any of the listed symptoms, even if he or she passes all other vision screening, please make an appointment with a specialist. 

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