WHO MAY SCREEN
Health aides, licensed vocational nurses, physical education teachers, classroom teachers, and volunteers may screen if they participate in a workshop conducted by a Department of State Health Services approved trainer and have become certified according to the Spinal Screening Program Guidelines. School districts will be responsible for maintaining documentation of state certification for the spinal screeners in the district. Each district will need to be able to confirm each spinal screener certification, if an inquiry arises.
Licensed professional health practitioners such as registered nurses, physicians, chiropractors, and physical therapists may screen if their course of study included screening for abnormal spinal curvature or if they received formal advanced instruction as part of their continuing education.
SCREENING FOR SCOLIOSIS
For scoliosis, each student is observed from the front, side and back: (a) while standing straight, and (b) while gradually bending forward, with the arms hanging down and palms touching, as if diving into a pool. The screener looks for head misalignment to one side of the cleft in the buttocks; one shoulder or hip higher than the other; a prominence of the rib cage or the small of the back; unequal distance between arms and body; and a curve in the spine. An experienced person should be able to screen 25-30 students per hour. Screening should be performed with the subject's shoes taken off.
SPINAL SCREENING PROCEDURE - FORWARD BEND TECHNIQUE
Position I
Student stands facing the screener. He/she should stand straight, feet slightly apart with weight evenly distributed, knees straight, arms at side, and eyes straight ahead.
Observe the following:
- Shoulder
- Waist
- Hip
Is one shoulder higher than the other one?
Is the waistline the same on both sides or is there a larger space between the arm and flank on one side?
Are the hips level and equal; is one side higher, or does it stand out more than the other?
Position II
While still facing the screener, the student bends slowly forward until his back is parallel to the floor. The feet are slightly apart, knees straight, the palms of the hands are together and hanging down as if diving into a pool. The head is down and relaxed.
Observe the following:
- Chest Cage Hump
- Lumbar Inequality
Are both sides of the back of the rib cage equal or does the rib cage have a hump on one side?
Are both muscle masses in the small of the back equal or does one stand out more than the other?
Position III
Student stands as in Position I, with his/her side toward the screener.
Observe the following:
- Round Back
- Sway Back Is there an exaggerated roundness in the upper back?
Is there an exaggerated arch in the lower back?
Position IV
With his/her side toward the screener, the student bends forward as in Position II.
Observe the following:
- Rib Hump
Is there an accentuated roundness over the rib cage or the area between the lower rib cage and the small of the back?
Position V
Student has back toward the screener, stands straight as in Position I.
Long hair should be pinned up or be evenly separated and brought forward in front of each shoulder. Examiner views the entire back:
Observe the following:
- Head
Does the head line up over the crease in the buttocks or is it displaced to one side?
- Shoulders
Is one shoulder higher than the other?
- Shoulder Blade (Scapula)
Is the wing on one shoulder blade higher or does it stand out more than the other one?
- Spine
Is the spine straight or does it curve sideways?
- Waist
Is the waistline the same on both sides or is there a larger space between the arm and flank on one side?
Position VI
With the back still toward the screener, the student bends forward as in Position II.
- Is there a bulge on one side of the rib cage?
- Is there a bulge on one side of the lower back?
For information regarding spinal screener training in your area, call the school health specialist at the nearest Regional Education Service Center or contact the Spinal Screening Program .
To order training workshop materials you must be a certified trainer and use the DSHS Spinal Screening Program materials request form (Microsoft Word document, 27 KB). Please allow at least two weeks for materials to be delivered.